Plunge in HFMD cases with better hygiene amid Covid-19

SINGAPORE - The number of people diagnosed with hand, foot and mouth disease (HFMD) has fallen sharply during the Covid-19 pandemic.

According to the Ministry of Health's weekly infectious disease bulletin, there were 1,133 HFMD cases last year, down from 5,013 in 2019.

In the first 22 weeks this year, up to June 5, there have been 252 HFMD cases compared with 906 in the same period last year.

Doctors interviewed by The Straits Times attribute the drop mainly to better hygiene practices.

Dr Arti Jaiswal, a paediatric-trained doctor at International Medical Clinic in Orchard Boulevard, has seen "a significant drop" in HFMD cases since February last year.

As the disease is spread via direct contact with nasal secretions, saliva, stools or fluid from the blisters of an infected person, she says increased disinfection, hand washing and hand sanitising during the pandemic has reduced its spread.

HFMD, an infectious disease that causes painful mouth sores or an itchy rash on the body, particularly on the hands, feet, legs or buttocks, is most common in infants or children below the age of five, but older children and adults can get it as well.

Dr Leo Deng Jin, a paediatrician at Thomson Paediatric Centre at Hillion Mall, has seen a more than 90 per cent decrease in HFMD cases since the circuit breaker last year.

Besides good hygiene, he said the closure of playgrounds, childcare centres and schools also played a part in the "abrupt drop" in the number of cases.

Associate Professor Chong Chia Yin, a senior consultant at KK Women's and Children's Hospital's infectious disease service, said the hospital manages moderate to severe cases of HFMD throughout the year and saw at least one severe case a year.

But there has not been any serious case of HFMD since July 2019.

While the number of cases is still low, it seemed to have gradually increased from mid-April to mid-May - with more than 20 cases reported weekly - compared with an average of fewer than 10 cases weekly in the first two months of this year.

This is in line with the higher incidence of HFMD cases worldwide from April to July when it is warmer.

Said Dr Leo: "It is possible that warm weather increases the ability of the virus to survive in the environment. And partially due to the fact that in temperate countries, children are also more likely to be outdoors and mingling around more in the summer."

Doctors stressed the importance of recognising the symptoms of the disease such as a blister- or pimple-like rash on the hands, feet and buttocks, mouth ulcers and fever, and taking children to the clinic to confirm the diagnosis.

Prof Chong said an infected child should avoid school and crowded places for at least 10 days after the symptoms have appeared.

The disease is most contagious in the first week, but is usually mild and most children will recover in about a week, she added.

While there is no specific treatment for HFMD, children may be given fever medication to relieve the fever or pain.

If the child has difficulty eating due to the mouth sores, try applying a mouth gel or take lozenges to relieve the pain in the mouth, said Prof Chong.

To prevent dehydration, she advised patients to frequently consume small amounts of liquids such as milk, diluted juice, rice water or barley water at room temperature.

Parents may also give their children soft foods such as ice cream, pureed fruit or porridge.

Doctors emphasised that good personal hygiene is the best way to protect one from getting HFMD.

Parents should encourage their children to adopt practices such as washing their hands with soap and water before and after eating and after going to the toilet; not sharing food, drinks or cutlery; and not sharing towels, toothbrushes or other personal items.

They should also cover their mouth and nose with tissue paper when coughing or sneezing, and throw used tissues into the rubbish bin and immediately wash their hands with soap and water.

Said Prof Chong: "A child who gets HFMD is not protected from getting the disease again so parents need to remain vigilant."