Colombo, Oct. 19 (Daily Mirror) - With hand, foot and mouth disease increasingly reported in Sri Lanka, parents are urged to recognise the warning signs, keep children hydrated and seek medical attention if symptoms worsen.
Consultant Paediatrician at Base Hospital Marawila, Dr. Maheshaka Wijayawardena, told Daily Mirror that the viral infection is usually mild, with most children recovering within seven to 10 days.
However, early recognition, proper home care and good hygiene are essential to prevent complications and reduce the spread of the disease.
HFMD is caused by viruses belonging to the enterovirus group, including Coxsackie viruses, and commonly affects children under five years of age, although older children and adults can also contract the infection.
The illness typically begins with fever, reduced appetite, a sore throat or a general feeling of being unwell. Red spots or small blisters may subsequently appear on the palms, soles of the feet and inside the mouth. The rash can also affect the buttocks, knees, elbows, arms and legs.
Painful mouth ulcers may make eating and drinking difficult, increasing the risk of dehydration. Dr. Wijayawardena said there is no specific antiviral treatment for HFMD, and antibiotics are ineffective against the viral infection. Treatment focuses on relieving symptoms and ensuring adequate fluid intake.
Parents are advised to offer children frequent, small amounts of fluids, while cool water, milk and soft foods such as yoghurt, porridge and jelly may be easier to tolerate. Acidic drinks, including orange and lime juice, as well as spicy or salty foods, should be avoided if they aggravate mouth ulcers. Paracetamol may be given for fever or pain at the appropriate dose for the child’s age and weight, but aspirin should not be given to children. Numbing gels and other medicines should not be applied inside the mouth unless advised by a healthcare professional.
As such, parents should seek medical advice if a child refuses fluids, urinates less frequently, develops a dry mouth, produces fewer tears or becomes unusually tired, as these may be signs of dehydration. Urgent medical assessment is necessary if the child develops a persistent or recurrent high fever, severe headache, neck stiffness, repeated vomiting, unusual drowsiness, confusion, breathing difficulties or seizures. Infants under three months with a temperature of 38°C or higher also require prompt medical attention.
HFMD is highly contagious and spreads through saliva, respiratory secretions, fluid from blisters, contaminated hands and surfaces, and the stools of infected individuals. Transmission is particularly common in preschools and day-care centres, where children play closely together and share toys and other objects.
To reduce transmission, Dr. Wijayawardena advised parents and schools to ensure regular handwashing with soap and water, particularly after changing nappies, after using the toilet and before preparing or eating food. Frequently touched surfaces, toys, tables, door handles and shared equipment should also be cleaned and disinfected regularly. Children should avoid sharing cups, spoons, towels and other personal items, while blisters should be kept clean and not deliberately burst.
Children who have a fever, feel unwell, cannot participate comfortably in activities or have uncontrolled drooling due to painful mouth ulcers should remain at home. They can generally return to school or preschool when they are fever-free, feel well enough to participate, can manage their oral secretions and their blisters have dried, subject to local health guidance.
The paediatrician also advised parents not to confuse HFMD with chickenpox. Although both illnesses can cause fever and skin blisters, HFMD commonly affects the palms, soles and mouth, while chickenpox more often begins on the chest, back or face before spreading, with itchy blisters appearing in successive crops. However, symptoms may vary, and parents should consult a doctor rather than relying solely on the appearance of the rash.
Although complications are uncommon, dehydration remains a major concern when painful mouth ulcers prevent children from drinking enough fluids. Rarely, certain enteroviruses can cause serious complications affecting the nervous system or other organs. Some children may also experience peeling or shedding of their fingernails or toenails several weeks after the illness, although these changes are generally temporary.
Dr. Wijayawardena further cautioned that the virus may continue to be shed in stools for weeks after recovery, making continued hand hygiene important even after the rash disappears.
He urged parents not to panic but to ensure adequate fluid intake, maintain good hygiene and seek medical attention promptly if warning signs develop, stressing that early recognition and appropriate care can help children recover safely while limiting the spread of infection in homes, preschools and schools.
