Melaka childcare centres to close if over 4 cases found
Nurseries, kindergartens and childcare centres in Melaka recording more than four cases of hand, foot and mouth disease (HFMD) will be closed for 10 days.
State Health Department (JKNM) director Dr Rusdi Abd Rahman said this was in accordance with the Prevention and Control of Infectious Diseases Act 1988 (Act 342).
He also urged operators of the premises to immediately report cases to JKNM and warned that those who failed to do so could be charged in court.
“HFMD often goes away on its own, but sometimes, it may lead to complications like myocarditis or inflammation of the heart, and that is what we fear most.
“If there are more than four cases reported, the premises will be closed, and if there are only two cases but we find many children in the premises having fever with no blisters, we will also close the premises,” he said after participating in the Control of Tobacco Product Regulations 2004 (PPKHT) enforcement operation here on Thursday night.
Dr Rusdi said HFMD cases in Melaka showed an increasing trend and, as of Wednesday, 1,633 cases were recorded and 20 premises were ordered to close.
Of the total, he said 772 cases were reported in the district of Melaka Tengah, Alor Gajah (516 cases) and Jasin (345 cases) while six nurseries, kindergartens (seven), preschool (one), private houses (four) and childcare centres (two) were ordered to close.
On Wednesday, the cases registered in the three districts alone in Melaka were above the epidemic level, namely 148 cases in Melaka Tengah, Alor Gajah (83 cases) and Jasin (24 cases).
Meanwhile, KPJ Ampang Puteri Specialist Hospital paediatric cardiologist and paediatrician Datin Seri Dr Nomee Ashikin Mohammed Radzi said HFMD was caused by the coxsackie group of enteroviruses, particularly coxsackie virus A16.
She said the virus could spread through direct contact with fluid from blisters, nose and throat discharges, droplets and faeces. The blisters caused by the virus were also infectious until they become crusty and dry, she added.
“The virus may also be shed in the faeces for several weeks after the blisters have resolved. Usually HFMD infects children below 10 years old, or sometimes older children and adults.
“Normally, HFMD patients develop common symptoms such as fever, sore throat or visible small, blister-like lesions that may occur on the inside of the mouth, sides of the tongue, palms of the hands, fingers, soles of the feet and ‘nappy area’ within three to seven days after being infected,” she said yesterday.
Dr Nomee advised parents not to panic at the first sight of HFMD symptoms.
“It is a self-limiting disease, which means it can rid itself over time.
“Parents can help their children eat better with over-thecounter pain relievers like paracetamol or ibuprofen, or mouth sprays to numb the ulcers.
“They can also feed their children with cold and soft meals such as yoghurt, jelly or smoothies to soothe any sore throat. But they need to avoid juice and soda, which have acids that may irritate the sore throat.”
She said HFMD was a mild illness that would resolve itself within a week, hence there was no specific treatment and usually none would be required.
“Usually, it can be treated with paracetamol and not aspirin, as it is directed for fever and any discomfort. The patients should also allow blisters to dry naturally and not pierce them as the fluid within them is infectious.
“However, if children with HFMD complain of severe headache, persistent fever and eating difficulties, they should be brought for doctor’s consultation immediately,” she said.
Dr Nomee said separating children with symptoms of HFMD from school or childcare centres could help curb the spread of the virus.
“We should also practise hand hygiene. Parents should thoroughly wash and clean any soiled clothing and surfaces or toys that may have been contaminated.
“With HFMD cases on the rise, we should avoid sharing items of personal hygiene (such as towels and toothbrushes) and clothing (particularly shoes and socks),” she said.