Families and early childhood education and care (ECEC) providers in Far North Queensland have been warned to remain on the alert for symptoms of Hand, Foot and Mouth disease (HFMD) in young children after dozens of cases were identified by the public health officials in recent months. By late February, there had been more than 60 presentations of HFMD to Cairns Hospital’s Emergency Department, including nine patient admissions. Tropical Public Health Services Cairns Public Health Medical Officer Dr Annie Preston-Thomas said the team was aware of at least 15 ECEC centres affected by the disease across the Cairns and Tablelands regions since early January. “We are currently investigating why and how this virus is circulating in our region, but it is commonly linked to warm weather, and there is a rising global incidence of HFMD, particularly in the Asia-Pacific region.” While it is common for health providers to see a small number of cases during the hotter parts of the year, this year has been especially severe. HFMD is usually a mild illness that occurs mainly in young children but can also affect older children and adults, and is caused by several different enteroviruses. People can be infected with these viruses but not develop symptoms of the disease, and outbreaks of HFMD can occur among groups of children, including in childcare centres. Dr Preston-Thomas said the disease usually began with a mild fever and a runny nose, followed by a sore throat and mouth, with the appearance of blisters in the mouth, and on hands and feet. Sometimes blisters, which usually last for three to five days, may also be seen on knees, elbows or in the nappy area. In rare cases, those infected with HFMD go on to develop neurological diseases such as meningitis (inflammation of the lining of the brain), encephalitis (inflammation of the brain itself), or paralysis. “Any person with consistent symptoms should not attend daycare or school until they are symptom-free, and all blisters have completely dried,” she said. “To prevent the disease spreading, ensure you practise good hand hygiene; clean and disinfect frequently touched surfaces and soiled items, including toys; avoid sharing cups, eating utensils, towels, and clothing; and teach children about cough and sneeze etiquette.” To assist in the prevention of spread, parents should report the illness to the director of the childcare centre or school principal. For more information on the symptoms of HFMD, please see the list below. Symptoms:
HFMD starts with blisters that begin as small red dots which later become ulcers.
Blisters appear inside the cheeks, gums, and on the sides of the tongue, as well as on the palms of the hands and soles of the feet.
In infants, blisters can sometimes be seen in the nappy area. Blisters usually last for 3-5 days
Children can sometimes have a low fever, irritability, sore throat, tiredness, feel off colour and may be off their food for a day or two.
Very rarely, enteroviruses can cause other illnesses that affect the heart, brain, lining of the brain (meningitis), lungs, or eyes.
Signs that an infant or older child might have a more serious form of hand, foot and mouth disease include any of the following:
Persistent fever (38°C or above for 72 hours or more)
Abnormal movements/jerking movements
Excessive tiredness, drowsiness
If any of these signs are present, then the child should be seen by a doctor urgently even if they have been checked earlier in the illness.