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Singaw and Rashes: A Quick Guide to Hand, Foot, and Mouth Disease
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    If you’re the parent of a young child, you may already be familiar with hand, foot, and mouth disease (HFMD). Your child may have had it, or you might know a friend whose child has.

    According to data from the Department of Health released this year, the number of cases of HFMD in the Philippines is increasing. From January to April 2017, there have been 556 suspected and confirmed cases of the disease, an increase of almost 60% from the same period last year which saw only 354 cases. 

    Children were most affected. Majority of the cases (87%) belonged to the 0 to 5 age group, said the report, and the regions with the most cases include the NCR, Region IV-A, and Region VI. 

    HFMD is a contagious disease. Though usually a minor illness, according to Mayo Clinic, it can also turn serious in rare cases.

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    What it is
    HFMD usually affects infants and children below age 5, according to the Centers for Disease Control and Prevention (CDC). “Kids under age 5 are most at risk for HFMD, as infections are common in childcare centers, preschools, and other places where kids are in close quarters,” said KidsHealth, a parenting health resource site from the Nemours Foundation.

    The disease causes fever, painful blisters in the mouth (singaw in Filipino), and rashes on the hands, feet and diaper area. “It’s usually a mild viral illness, but it’s highly contagious,” Dr. Carmina Delos Reyes, a pediatrician and infectious disease specialist who holds clinic at the Philippine General Hospital, told Smart Parenting.

    Parents should remain observant of their child, nonetheless. Though uncommon, it can also be a serious illness, Dr. Ma. Eleanor Sevilla-Sia, a pediatrician and neonatologist at St. Luke’s Medical Center in Taguig and at the Asian Hospital and Medical Center in Muntinlupa, told Smart Parenting. Complications can include dehydration, meningitis, and encephalitis.

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    Typically, HFMD is distinguished by blisters in the mouth. “Ang kaibahan kasi ng hand, foot, mouth, ang pinaka distinct sa kanya is 'yung mga singaw sa bibig,” said Dr. Pia Torres, a pediatric infectious disease specialist, in an interview on dzMM.

    It also causes all or a few of these symptoms: 

    • Fever
    • Mouth sores
    • Red rash on the palms, feets and buttocks
    • Sore throat
    • Irritability
    • Loss of appetite 

    “Nagsisimula siya as lagnat, and then after ng lagnat nagkakaroon sila ng singaw sa lalamunan. And then magkakaroon sila ng mga butlig. It's either pulang mga butlig sa palad, or para siyang mga ulcer,” said Dr. Torres. She also explained that though dengue fever can also cause rashes, the mosquito-borne illness does not present with mouth sores. 

    The rashes caused by HFMD can look like flat or raised spots, sometimes with blisters, explained Dr. Maria Nenita L. Salcedo, head physician at Ateneo De Manila University High School, in an article on the university website. 

    Peeling of the skin on the hands and feet can also occur, said HealthyChildren, the parenting resource site of the American Academy of Pediatrics. “Symptoms are the worst in the first few days but are usually completely gone within a week.”

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    Symptoms of HFMD typically last a week. Most children with the disease can be treated at home, said Dr. Torres. 

    Young children may not be able to tell a parent that there's something wrong, but mouth sores will make it difficult for a child to eat or drink, and may refuse to feed. Cold foods and drink, like ice cream or iced water, can lessen the pain. Avoid anything hot which can worsen the pain. 

    Make sure your child gets enough fluids. “Some people, especially young children, may get dehydrated if they are not able to swallow enough liquids because of painful mouth sores,” said the CDC. Seek medical attention if your child shows signs of dehydration including dry mouth, sunken eyes, and a drier diaper than usual. 

    For fever and pain treatment, ask a pediatrician who may prescribe over-the-counter medication. Paracetamol is typically given, said Dr. Delos Reyes.

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    In infected persons, the virus can be found in their saliva, nasal mucus (sipon), fluid from blisters, and stool. “The disease is spread from person to person by direct contact with the infectious viruses,” said Dr. Salcedo. 

    Teach children the habit of regular handwashing, especially after using the toilet and before eating. If you suspect your child has HFMD, keep her home until the fever is gone and her mouth sores have healed, advised Mayo Clinic. 

    When to worry
    In rare cases, HFMD can become serious and involve complications that affect the brain, like viral meningitis. According to Mayo Clinic and the CDC, meningitis is an infection and inflammation of the tissue that covers the brain and spinal cord. It can also lead to encephalitis, an inflammation of the brain itself, but this is even rarer, added the CDC. 

    If your child exhibits symptoms including a stiff neck, confusion, and seizures, seek immediate medical attention. For any concerns regarding your child’s health, always consult a health professional. 

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