HFMD is caused by a group of viruses known as enteroviruses. This group includes several types, including polioviruses, coxsackieviruses, echoviruses, and others. HFMD in particular is more commonly caused by coxsackievirus A16, which results in a mild and self-limiting disease. Nearly all patients recover on their own without medical treatment in 7-10 days. Only in rare cases do patients develop viral meningitis, characterised by fever, headache, stiff neck, and back pain.
The bad news is HFMD can also be caused by enterovirus 71, which comes with serious complications and, in particularly bad cases, death. HFMD caused by this virus strain has been associated with meningitis and encephalitis, and can cause neurological, cardiovascular, and respiratory complications. Patients diagnosed by EV71-caused HFMD need to be hospitalised.
When someone is infected with HFMD, usually the first signs are fever, malaise, sore throat, and poor appetite. The fever is normally followed by mouth sores, which start as red spots that blister and eventually become ulcers. Other signs are skin rashes with red spots, usually on the palms and soles. HFMD virus is contagious and spreads from person to person through direct contact with nose and throat discharges, saliva, blisters fluid, or stool. Do note that a person may still harbour HFMD virus even when he/she does not display the signs anymore as the virus can persist in the stool.
In Singapore, HFMD is by far the number one cause of infectious disease cases among those reported by the Ministry of Health in its weekly bulletin. MOH recorded a total of 34,177 HFMD cases in 2016, with 26,376 recorded cases in 2017 up until 29 September. For comparison, the number two cause was dengue fever with 11,849 cases in 2016 and only 2,064 cases recorded so far in 2017. These numbers show how prevalent HFMD is compared to other infectious diseases in Singapore.
In terms of prevention, there is no specific antiviral drug or vaccine available against HFMD viruses. However, infection risk can be greatly lowered by employing good hygiene practices such as frequent handwashing with soap and water, cleaning and disinfecting contaminated surfaces and soiled items, avoiding close contact with HFMD patients, keeping sick infants or children away from childcares and schools, covering mouth/nose when sneezing and coughing, properly disposing used tissues or nappies, and maintaining general cleanliness of home, childcare centres, kindergartens, and schools.
Considering the high number of HFMD cases in Singapore, it is very important to own an insurance policy which covers HFMD to assist with the treatment costs, if needed. Although serious cases of HFMD are rare, all the EV71-associated complications named above can be debilitating to the patient if they are infected by this particular strain. To protect one’s child from this disease, a health insurance package is needed. It will cover your child’s hospital costs, giving yourself and your family some peace of mind from not having to think about the financial burdens and enabling you to focus on providing the best care for your ill child.
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