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Straight from the Doctor: HFMD and Juvenile Arthritis explained

Smart Parenting caught up with Dr Cham Wen Tarng, Consultant Paediatrician and Rheumatology Paediatrician of Sunway Medical Centre for a Q & A session on the subjects of Hand, Foot and Mouth disease (HFMD), as well as Juvenile Arthritis for the benefit of our readers.

Hand, foot and mouth disease (HFMD)

Q: What is hand, foot and mouth disease (HFMD)?

A: It is a viral disease caused by an enterovirus and spreads via coughing, sneezing and through infected stools.

Q: Who is susceptible to HFMD?

A: It usually affects children younger than the age of five but even adults can get it.

Q: How is it diagnosed?

A: Children affected by this disease usually have sores or ulcers in their mouth and rashes on the palms and soles, hence the name hand, foot and mouth disease. It can present in a fluid-filled rash on the body in some children. Some of them may have fever too.

Q: How is HFMD treated?

A: The treatment is mainly supportive as there are no antiviral medications to treat this condition. It is therefore most important that parents and caregivers ensure the affected child drinks lots of cooled down drinks and is on a soft diet to ensure adequate nutrition and hydration.

Q: What do parents have to know about controlling the spread of this disease?

A: This disease is highly contagious and parents must isolate their child from other children. They should be out of daycare or kindergarten for the time being to prevent it from spreading. To help curb the spread of the disease, younger children within the family who are not affected should not share cups or utensils with the affected child.

Q: How can parents prevent their child from getting HFMD?

A: Personal hygiene is very important and parents should inculcate certain habits into their children from as young as possible such as washing their hands before they eat, covering their mouths with tissue or their hands when coughing and brushing their teeth twice a day.

Juvenile Arthritis

Q: What are the symptoms and signs of juvenile rheumatism?

A: Joint pain is the predominant symptom and this can lead to significant debility as the child may not be able to walk or write using the affected limb. Sometimes they can have prolonged fever with rashes. In more severe cases, the liver, heart and spleen can also enlarge and lead to significant morbidity.

Q: What causes it?

A: There is no known cause. It’s known however, that it is not due to changes in weather or certain foods that the child has taken. Instead, we know that it is due to a deranged immune system that attacks the child himself and this is called an autoimmune disease.

Q: Is there a cure for this condition?

A: There is unfortunately no cure for this condition, however, we have many medications that can help to control this disease effectively. If this condition is treated early, almost 80 to 90% of these children can lead completely normal lives with or without medications.

Q: What types of treatment are available for this condition and how long will it take for a child to get well again?

A: There are many medications that help to regulate the immune system to prevent it from causing further damage to the joints. These include targeted steroid injections, disease-modifying anti-rheumatic medications and immunotherapy.

Q: Is there anything that can be done by parents to prevent their kids from getting rheumatism at such a young age?

A: Unfortunately there is no prevention for this condition as our immune system is very complex and we need the immune system to help protect us against infections. As such, early identification is the key to prevent delay in diagnosis and treatment since the success rate in treating this condition with current medications is quite high.

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