The Health Ministry has confirmed that to date, a total of 40,198 HMFD cases have been detected with an average of 73 cases weekly.

It was reported that HFMD is so rampant now, viruses causing the disease were found on the handlebars of the trolleys and on child ride equipment in supermarkets.

Many schools have also been ordered to temporarily close due to this outbreak and the Health Ministry has constantly been issuing statements to the public on the do’s and dont’s during this crucial period of time.

These happenings, heightened by the fact the country saw its first fatality from HFMD in June when a 17-month-old boy in Penang succumbed to the disease and a second death of a two-year-old in Sarawak last month, have instilled worry and fear in concerned parents.

There are a lot of information out there for anxious parents to read up on for better comprehension about the disease but more often than not, they have to grapple with unverified news.

Rojak Daily recently spoke to Consultant Paediatrician and Exco Member of the Malaysian Paediatric Association (MPA) Datuk Dr Zulkifli Ismail to share his knowledge on HFMD and shed some light onto the myths surrounding the disease.

What Exactly Is HFMD?

Dr Zulkifli Ismail said HFMD is a typically benign but infectious disease caused by a virus.

“A number of viruses in the Coxsackie A & B and Enterovirus groups cause HFMD.

“Enterovirus 71 has been associated with outbreaks of the disease that can cause neurological or brain involvement. However, Coxsackie viruses usually causes fever, malaise, rash, and small blisters that ulcerate and can also rarely cause inflammation of the heart,” he said.

Dr Zulkifli said the disease spreads by direct contact with secretions from patients.

“Secretions could be saliva, secretions from skin vesicles, nasal discharge or even faeces and urine. Close exposures to patients who cough or sneeze will help spread the disease.

“It can also be transmitted through things that have been touched or handled by patients,” he said adding that anybody who had been in contact with a patient or with belongings contaminated by patients can be infected with it.

Symptoms of HMFD

Dr Zulkifli said symptoms in children include initial fever or sore throat and refusal to eat.

The child would also see typical raised red rashes with fluid (vesicles) popping up on his hands, feet and/or buttocks.

“The rashes can also spread to other areas and can cover a greater part of the skin. Ulcers in the mouth will be noticed when the patient refuses to eat or drink.

The bad news is, according to Dr Zulkifli, there is currently no available vaccine to treat the disease.

“The only way to prevent the disease is to avoid contact with infected patients. Those who are infected can take medicine for fever or pain and must keep themselves rested and hydrated,” he said.

Debunking the myths

Dr Zulkifli said there are a lot of myths surrounding HFMD and it needs to be debunked. Here are some of the most common ones:

1. Adults cannot get HMFD It’s not just the little ones who are at risk of the virus, warned Dr Zukifly. Adults can be infected by HFMD too, and in fact, they can even carry the virus and transmit it to children who are susceptible.

2. Lactating mothers with HFMD should not breastfeed their children This is not true, according to Dr Zulkifli. You can’t transmit the virus through breastmilk, thus new mothers are safe to continue breastfeed their newborn.

3. You can only get HMFD once in your lifetime This is also not true. HFMD is caused by a number of viruses, so getting infected by one does not confer immunity against the other viruses. Dr Zulkifli told us that the likelihood of being infected again is there, so you have to be really, really careful.

4. A person infected with HFMD can only get rashes or blisters on hands, mouth and feet Again, this is not true, said Dr Zukifli. While hands, mouth and feet are the most common places to get blisters, they can also appear around the buttocks and gluteal area. Sometimes a major part of the child’s trunk can have the blisters or rashes, which is a typical symptom of HFMD.

5. HFMD can only spread if an infected person touches or comes into contact with another person Dr Zulkifli said this statement is false. Infection can be transmitted through contact with objects that have been touched by a patient. These can be eating utensils, door handles, supermarket trolley handles, toys and table tops, to name a few. Almost any surfaces or objects that had been touched by or sneezed on can harbour and spread the virus.

6. There is a treatment available for the disease There is no specific treatment available for the disease. Most of the treatment involves supportive care and intelligent ways to ensure that the child continues to eat and drink despite having painful mouth ulcers, said Dr Zulkifli. If the patient can't eat or drink, intravenous fluids may be required to prevent dehydration. Also, he revealed that there is currently no specific antibiotic or antiviral agent available.

7. Once all of the blisters have disappeared, the patient is no longer infectious This is one of the biggest myths surrounding HFMD, Dr Zulkifli told us. Despite not having anymore blisters or rashes, the infected person continues to shed the virus for another six weeks in their stools, so proper hand washing is absolutely essential for at least another month and a half.

How can we protect ourselves?

Dr Zulkifli said there has always been a low baseline number of cases occurring throughout the year in the country.

However, he said there are certain peaks at certain times and the circulating viruses will also differ with the time of the outbreak.

“Having said so, there is no particular reason why there is a sudden surge of cases of HFMD in some parts of the country.

“It is best to avoid close physical contact with those infected with HFMD. Do not share food or cutlery with others if you suspect one of you is infected. Avoid going to places where we know there are HFMD patients.

Besides that, Dr Zulkifli advised Malaysians to practice a healthy lifestyle by eating nutritious foods such as fruits, vegetables, nuts and grains to improve your immunity.