Hand, Foot & Mouth Disease in Children

Hand, Foot & Mouth Disease in Children

Hand foot and mouth disease (HFMD) is typically a common illness among infants and children (up to the age of 10 years) caused by a group of viruses called Enterovirus especially Coxsackie A16 or enterovirus 71. It has become an important public health concern because it is very contagious and can cause large outbreaks among children especially in nursery and schools.

What are the symptoms?


The disease is characterised by rapidly ulcerating vesicles (blisters) in the mouth, tongue, palate and on the palms of hand and soles of the feet.  It starts with non-specific symptoms such as fever, sore throat and generally feeling unwell before the blisters develop 1-2 days later.  It can range from being mild or severe with loss of appetite.

How is the virus transmitted?

The most infectious period is the first week of illness and the virus is transmitted by contact with the nasal discharge or saliva, fluids from the blisters and stools of an infected child. As such, it is important that any infected child is kept away from school and other children.  Avoid close contact like sharing toys, pillows, towels or eating utensils and touching objects or surfaces that could have been contaminated by the virus.  Any nursery or school which has an infected child is often advised to close for a short period to allow sterilisation of the school premises and prevent virus spread.

Image Source: Wikipedia

How serious is HFMD?

Majority of the children get a mild illness with no complications. Younger children are at risk of getting weak or dehydrated because they  may refuse to eat or drink due to the painful mouth ulcers. Rare complications occur when the virus (in particular, enterovirus 17 strain) has spread to the brain causing meningitis or encephalitis or to the lung and heart causing pulmonary oedema.

What is the treatment for HFMD?

Bed rest, paracetamol and sponging for fever and keeping the child hydrated is sufficient. Most children recover within 7-10 days without requiring any medication. However, if the child is getting dehydrated or weak, it is better to admit the child to the hospital for intravenous fluids and observation by the doctor. The child should remain away from school for at least 10 days since the onset of the disease or until certified free from disease by the treating doctor.

Statistics of Reported Hand, Foot and Mouth Disease Cases in Malaysia (Source: Kementerian Kesihatan Malaysia)

What are the danger signs of HFMD?

Take your child to see a doctor when the child has the following symptoms:

  • Not taking enough oral feeds or fluids
  • Not passing much urine
  • Persistent high fever (>38oC) more than 48 hours
  • Weak or drowsy or refusing to play
  • Having shallow rapid breathing
  • Irritable or having some jerky movements (fits)

How should a parent look after the infected child?

Let the child stay at home (away from school) and isolate the child away from the other siblings. Do not let them to share beds, pillow, towels, eating utensils and toys.  It is best to have one person looking after the child to ease the discomfort like giving:

  • Paracetamol for fever. Applying a cool towel over the forehead may be comforting
  • Cold treats like Popsicles or milk shakes/smoothies for the sore throat
  • Oral Aids for mouth ulcers
  • Soft diet as it is easier to swallow

Image Source: Pexels

How to prevent the virus from spreading?

Ensure good hygiene by washing your hands after caring for the infected child as well as disinfecting objects or surfaces touched by the child to prevent spreading the virus to other inhabitants in the house.

CHOMEL Antibacterial Range

Dettol Disinfectant Spray Crisp Breeze

Against 24 Disinfection

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Common Contraception Myths

Common Contraception Myths

We have all heard about different ways to prevent pregnancy from friends, family and the social media. Every culture across the world has their own traditional methods of pregnancy prevention. We take a look at some of the common myths.

1. The contraceptive pills makes you fat

Multiple studies have shown that there is no difference in weight gain compared to women on the pill and those who are not taking it.

2. The contraceptive pill causes cancer

Women on the pill have a 50% reduction in the risk of uterine and ovarian cancer. There is a very small increase in the risk of breast cancer but this risk goes down to normal levels when the pill is stopped.

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3. You don’t need to be on any contraception if you are breastfeeding

Breastfeeding is only a reliable mode of contraception in the first 6 months after delivery if it is exclusive breastfeeding and no return of periods. Breastfeeding does reduce a woman’s fertility but unless these requirements are met, there is a significant risk of getting pregnant. If you do not fit in this criteria, then another method of contraception is advised.

4. Taking the contraceptive pill or any hormonal contraception will make it harder to get pregnant in the future

All hormonal contraceptives have temporary effects on fertility. Fertility will return with cessation of the contraception, the timing depending on the type of hormonal contraception used. There are no long term effects on fertility.

Image Source: Pregnant SG

5. Accidentally get pregnant while on hormonal contraception (including the pill) will cause birth defects to the baby

There is good evidence that shows hormonal contraceptives (including the pill) does not cause birth defects.

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Types of Contraception

Types of Contraception

Emergency Contraception

Emergency contraception is for all those ‘oops!’ times when something unforeseen has happened, for example like when a condom has broken, when you have unprotected sex or a missed pill. It should NEVER be used as a regular method of contraception as pregnancy risks increase if used repeatedly.

There are 2 types of Emergency contraception:

A) Intrauterine Contraceptive Device has a success rate of 99% and can be used up to 5 days after intercourse. It can also be left in place and used as long term contraception.

B) Hormonal Emergency Contraception Pills can be used up to 3 or 5 days after intercourse, depending on the type of pill used.

Types of contraception

There are up to many types of contraception available, which means there is definitely one right for you! So discuss with your doctor to help you get the most suitable one.

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The Pill

  • The Pill consist of synthetic hormones with an effective rate of around 91%.  It also helps to regulate periods, especially those with heavy or painful periods
  • Side effects: headache, nausea (feel like vomiting) and breast tenderness.
  • Not suitable for women with history or family history of blood clots in the veins

The Injection (Progesterone only Injectable Contraceptive Methods)

  • Effective rate is around 94%
  • Side effects: Return to fertility may be delayed between 6 months to 1 year

The Intrauterine Device

  • Small T shaped device placed into the uterus by a doctor at the clinic.
  • Effective rate is around 97-98% and safe to use for 3 or 5 years, depending on type and dose
  • Side effects: Periods may be heavier or more painful in the first few months

The Implant

  • Implant is one of the most effective contraceptive methods available.  It consists of synthetic hormone in a small plastic capsule that is placed under the skin of the upper arm. The procedure is done by a doctor at the clinic.
  • Effective rate is almost 100% for up to 3 years
  • Side effects: Periods may be irregular, less than usual or no periods.


  • Rubber (latex) cover that is placed over the penis during sex and must be removed immediately after ejaculation
  • Ideal for protection against any sexually transmitted diseases
  • Effective rate is around 75%

DUREX Together Easy-On

Durex Extra Safe

Durex Close Fit

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Why Do You Need Contraception or Family Planning

Why Do You Need Contraception or Family Planning

In 2008, 41% of pregnancies in the world were unintended while in Asia, the rate was 38%.  Some of the reasons for unintended pregnancies were:

  • Substantial unmet need for family planning services.
  • Poverty and lack of education
  • Not using or incorrect use of contraception
  • Socio economic, regulatory and religious conditions

Many still oppose to the use contraception because of perceived side effects of contraception and thinking infrequent sex did not require contraception.

Global research has shown that unintended pregnancy results in one of 3 outcomes:

  • Abortion (48%)
  • Miscarriages (38%)
  • Unplanned live birth (14%)

How many of us use contraception?

Image Source: Pexels

The Contraceptive Prevalence rate (number of women using contraception) in Malaysia is between 50 to 55 %.  In comparison, more people in our neighbouring countries of Thailand, Vietnam, Singapore and Indonesia at 72%, 78%, 62% and 61% respectively use contraception methods.

Provision of Contraceptive Provision and Services in Malaysia

Contraceptive services are provided by Ministry of Health, Family Planning and Development Board as well as The Federation of Reproductive Health Association Malaysia. In addition, contraception methods are available in private hospitals, pharmacies as well as private clinics.

Why do you need contraception?

Many women don’t realise how easy it is to get pregnant. There are 16.7 million unplanned pregnancies around the world every year which could have been prevented with the correct use of contraception.  It doesn’t matter whether it’s your first time, you only occasionally have sex or you only have sex on the so called ‘safe days’.

Image Source: Pexels

The message is, if you are having unprotected sex, you can get pregnant.

Coitus interruptus (withdrawing before ejaculation) is not as safe as you think. In fact, it is the least effective contraceptive method with 22 in 100 women who practice this method getting pregnant every year (that’s 22% failure rate!).

And remember, if your period is 2 weeks late, regardless of whatever contraception you are using, talk to your doctor. You may consider doing a pregnancy test. Pregnancy is ALWAYS a possibility.

Clearblue Pregnancy Test

Dip n Tell Midstream Pregnancy Test

Things to remember while on contraception

Certain methods of contraception may affect your periods and this will be explained by your doctor. Consult your doctor should you have any unexpected changes.

Certain medications (including some herbal supplements) may reduce the effectiveness of your contraception. Please inform your doctor if you are taking any medications or supplements.

Image Source: Cleo

Many women are worried about excessive weight gain, headaches or mood changes while on contraception. These side effects are not common and often occur because of many reasons other than your contraception. Consult your doctor to see if there are other underlying problems or if you require a change in your contraception method.

Consult your doctor before stopping or changing your contraception.  Wrongly timed contraception cessation or change may result in an unintended pregnancy

The health risks and side effects of an unintended pregnancy are far greater than any method of contraception. Always use contraception if you do not intend to get pregnant.

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Hepatitis C Screening Campaign – How’s Your Blood

Hepatitis C Screening Campaign – How’s Your Blood

Hepatitis Free Malaysia (HFM) has launched the How’s Your Blood? Campaign, a nationwide Hepatitis C awareness campaign to educate the public, especially high-risk groups, about Hepatitis C and the importance of blood test for early detection and timely treatment.

Hepatitis C is a type of liver inflammation that is caused by the Hepatitis C Virus (HCV) and can lead to cirrhosis or liver cancer, if left untreated. In Malaysia, there are at least 380,000 people living with HCV and the vast majority are unaware that they are infected. Globally, there’s an estimation of 70 million people who have chronic Hepatitis C and over 80% of liver cancer deaths are caused by Hepatitis B or C. The number of deaths caused by viral hepatitis have surpassed chronic infectious diseases such as human immunodeficiency virus (HIV) and tuberculosis (TB).

The success of Hepatitis B vaccination showed significant reductions in Hepatitis B virus infection and death rates. Unfortunately, there is no vaccination for HCV which makes early detection the key to preventing the spread of HCV and for those who are infected to receive timely treatment.

The How’s Your Blood? Campaign’s key goal is to encourage the public, especially high-risk groups, to get tested for Hepatitis C and help Hepatitis C patients to receive timely treatment. Along with the campaign partners, HFM has teamed up with doctors, including general practitioners (GPs), clinics and blood test centres around the country to encourage high-risk groups to get tested.

How can Hepatitis C be detected?

80% of people who are infected with HCV do NOT develop any symptoms. Even if symptoms develop, these symptoms are non-specific such as:

  • Fever
  • Fatigue
  • Dark urine
  • Vomiting
  • Loss of appetite
  • Nausea

The only way to know for sure whether you have Hepatitis C is to get your blood tested.

What are the blood tests to diagnose Hepatitis C?

  1. Hepatitis C Virus (HCV) antibodies. If your blood shows the presence of HCV antibodies, it means you might have been exposed to HCV and will need a 2nd blood test to confirm if the virus is still present in your bloodstream.
  2. A second blood test is required to confirm the presence of HCV in your bloodstream by testing:
    a) HCV RNA Nucleic Acid Test (NAT): This test detects HCV RNA in serum or plasma and determines if the infection is active.
    b)  HCV Core Antigen (HCVcAg) Test: This test detects the protein produced by HCV. It can detect HCV infections about 40-50 days earlier, compared to other test

What should you do next?

Find the nearest blood test centre, medical centre or clinic to have your blood tested.

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