Hand, foot and mouth disease (HFMD) typically doesn’t make headlines in Hong Kong, but it doesn’t mean it has disappeared. According to local health data, 184 HFMD infections were recorded in September and October 2024 . As Hong Kong enters the May-to-July HFMD peak season, and with a potential second wave from October to December, it is essential to understand how the disease manifests, spreads, and can be managed.
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What Is Hand, Foot and Mouth Disease?
Hand, foot and mouth disease is a contagious viral infection caused by viruses such as coxsackievirus and enterovirus 71 (EV71), which belong to a group of viruses called enteroviruses. The virus commonly affects children under five, but adults can also contract the disease. While generally considered mild, its high transmissibility makes it a public health concern, especially in settings where personal hygiene may not be strictly enforced. The disease is easily spread through schools and care homes, and can cause symptoms such as fever and others.
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The Symptoms of Hand, Foot and Mouth Disease
The mild symptoms of hand, foot, and mouth disease typically last 7-10 days in children, with most individuals experiencing improvement on their own within the same period. These symptoms can vary, ranging from visible, blister-like rashes to cold-like symptoms and high-temperature fevers.
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Blister-like Rashes
One of the earliest and most recognizable signs of hand, foot and mouth disease is the sudden appearance of small red spots that often develop into fluid-filled blisters. These typically emerge on the tongue, gums, and inner cheeks, where they can cause significant discomfort, making it painful for children to eat or drink. Similar lesions may also form on the hands and feet, especially on the palms and soles. In some cases, the rash can appear on the buttocks or even in the genital area. It is important to note that not every patient will develop blisters in all of these areas; some children may only exhibit symptoms within the mouth without any visible rashes on the skin. While these blisters are generally not itchy, they can feel tender or sore to the touch, particularly on pressure points such as the soles of the feet, which can make walking uncomfortable.
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High-temperature Fever
In the case of hand, foot, and mouth disease, patients, especially young children, typically develop a moderate to high fever, ranging from 38°c to 39°c. This fever may appear before any visible rashes or sores, making it easy to mistake the illness for a common cold or flu. While fever is a natural immune response, it can make children feel irritable, lethargic, or less interested in eating and drinking. In extremely rare cases, serious complications such as encephalitis (brain inflammation) or viral meningitis have been reported, particularly when the fever is unusually high and persistent, but these outcomes are very uncommon and should not cause alarm for most families.
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Cold-like Symptoms
Before the rash appears, many children may exhibit cold-like symptoms, which can include a sore throat, runny nose, mild cough, or a noticeable decrease in appetite. These symptoms can easily be confused with those of a seasonal cold, making early detection of HFMD difficult, especially in crowded environments such as schools. Children may seem more tired than usual or refuse food due to mouth discomfort, even if no visible sores have developed yet.
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Why is Hand-foot-mouth Disease So Prevalent in Schools and Care Homes?
Hand, foot, and mouth disease spreads easily in schools and care homes, where close contact and crowded shared spaces are vulnerable to transmission. In these settings, children and elderly residents often spend extended periods together in communal areas, such as classrooms and dining halls, where the virus can easily pass from person to person. Many of these facilities also share items, such as toys, books, cutlery, and furniture, which can become reservoirs for infectious particles if not properly disinfected.
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How to Treat Hand-foot-mouth Disease
There is no specific cure for hand, foot, and mouth disease, and antibiotics have no effect since the disease is caused by a virus. During the recovery period, which typically lasts around 7-10 days, treatment focuses on managing symptoms and keeping the patient comfortable. Staying well-hydrated is essential, especially for children who may avoid eating or drinking due to painful mouth sores. It's best to avoid acidic, spicy, or salty foods, as these can irritate mouth ulcers, while softer foods are advised to minimise pain when eating. For fever or general discomfort, over-the-counter medications such as acetaminophen can be used to relieve symptoms. While most cases are mild, parents and caregivers should monitor symptoms closely and seek medical advice if signs of dehydration, prolonged high fever, or unusual drowsiness develop.
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Preventing Hand-foot-mouth Disease
Despite it being highly contagious, hand-foot-mouth disease is largely preventable through good hygiene and proper infection control. Handwashing with soap and water for at least 20 seconds remains the most effective defense, particularly after changing diapers, using the toilet, or wiping a child’s nose. Parents and caregivers should also teach children how to wash their hands thoroughly, especially before meals or after outdoor play.
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Avoid touching the face with unwashed hands, especially the eyes, nose, and mouth, as this is one of the most common ways the virus enters the body. In shared environments like homes, schools, and child care centers, frequently touched surfaces such as toys, doorknobs, and tabletops should be cleaned and disinfected regularly to reduce the chance of surface transmission.
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Breaking the Chain of Hand-foot-mouth Disease
While hand-foot-mouth disease may seem like a routine childhood illness, its ability to spread rapidly in community settings makes it a recurring concern. As we approach the first peak season of the year, awareness and timely action are essential for parents, caregivers, schools, and healthcare providers. Understanding the early signs, recognizing how the virus spreads, and responding with practical hygiene habits can go a long way in protecting not only children but also other vulnerable groups like the elderly.
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Blue Care Consultation Services
Blue Care Medical Centres staffed with highly qualified family doctors provide family doctor consultation.
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For appointment, please contact Blue Care Medical Centre.
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Central clinic
Tel : 2523 1808
Address : 10/F, 33 Des Voeux Road Central, Central, Hong Kong
(MTR Central Station Exit “B” or Hong Kong Station Exit “C”)
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Kwun Tong clinic
Tel : 2523 9383
Address: Unit 2802, 28/F, BEA Tower, Millennium City 5, 418 Kwun Tong Road, Kowloon (MTR Kwun Tong Station Exit “A2”)
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Remarks:
1. The Government of Hong Kong Special Administrative Region Press Releases. (2024). Heightened vigilance is urged amid an increase in the activity of hand, foot, and mouth disease. https://www.info.gov.hk/gia/general/202410/09/P2024100900445.htm
2. CDC. (2024). About Hand, Foot, and Mouth Disease. https://www.cdc.gov/hand-foot-mouth/about/index.html
3. Centre for Health Protection. (2024). Hand, Foot and Mouth Disease. https://www.chp.gov.hk/en/healthtopics/content/24/23.html
4. NHS. (2024). Hand, foot and mouth disease. Retrieved from https://www.nhs.uk/conditions/hand-foot-mouth-disease/
