
The health ministry recently reported a 20-fold surge in hand, foot and mouth disease (HFMD) in Malaysia. In light of this, TELEME spoke with Dr Andrew Kok, a general practitioner, to find out more about this contagious condition.
Here are 10 things every parent should know about HFMD.
1. What is it?
Despite its scary name, HFMD is a common, contagious illness caused by different viruses. It typically affects infants and children under the age of five, but older kids and adults can catch it as well.
2. What are the signs and symptoms?
It takes three to six days for the first symptoms to show, which usually starts with a fever, sore throat and runny nose. This is followed by a rash with tiny blisters that may start to show on the following parts of the body:
- in the mouth
- on the inner cheeks
- on the gums
- on the sides of the tongue
- on the roof of the mouth
- on the fingers
- on the palms
- on the soles of the feet
- on the buttocks
Symptoms are the worst in the first few days but usually disappear within a week. There might be peeling of the skin on the fingers and toes after one to two weeks, but this is harmless.
3. How is HFMD diagnosed?
HFMD is suspected if a patient presents with mouth or tongue ulcers, alongside rashes or blisters on the palms and soles. The diagnosis can be confirmed by sending throat-swab samples, or taken from the patient’s blisters or stool, to a lab.

4. What is the treatment?
The treatment for mild cases is similar to treatment for fever and ulcers. It is important to ensure children are adequately hydrated and well rested.
In children aged over one year, parents should consult their doctor as a variety of mouth-soothing liquid remedies may alleviate ulcer pain. Do not use regular mouthwash as it would sting.
5. How long is it contagious?
A person is generally the most contagious during the first week of illness. But children may shed the virus from the respiratory tract (nose, mouth and lungs) for one to three weeks, and in the stool for weeks to months after the infection starts.
6. How does it spread?
HFMD is transmitted from contact with respiratory droplets containing the virus, the touching of an infected person, or contact with contaminated surfaces.
7. How can parents help prevent and control the spread of HFMD?
- Instruct children to cover their mouths and noses with tissue paper when sneezing or coughing.
- Teach them to wash their hands frequently.
- Clean, rinse and sanitise toys that may have come in contact with the child’s saliva.
- Prevent sharing of food, drinks and eating utensils, toothbrushes and towels.
- Protect other children in the house by making sure they do not come in close contact with the infected child. If children share a room, separate them while the sick child is contagious.
- Disinfect all surfaces regularly.
Parents must wash hands thoroughly after changing diapers, as they could also spread the virus by coming in contact with faeces, blister fluid or saliva.

8. Can my child go to school or childcare with HFMD?
The child will need to remain away from school for at least 10 days after the onset of symptoms, and can only return once a doctor has certified them to be free of infection.
Exclusion from childcare or school will not necessarily reduce the spread of HFMD because children can spread the virus even if they have no symptoms. Remember, the virus may be present in the stool for weeks after symptoms have disappeared.
9. When can the child go back to school or childcare?
The child can return to school or childcare after the criteria in the previous point are fulfilled and the child feels well enough to participate.
Parents should consult the child’s paediatrician if they are unsure whether or not he or she should return to school or childcare.
10. If a child has already had HFMD, can he or she get it again?
Yes, a child can have repeat infections with the same type of virus or different viruses that cause HFMD.
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