MY MOM'S BEST

[lay_see_ong]

Hi all,

My nephew was down with Coxsackie and now staying at home with his mom. According to the doctor, coxsackie virus is back.

My niece nursery also because of coxsackie, it has to be closed for 1 week.

Please take good care of your love one and stay at home.
_________________
Lay See 王丽丝

[Maria Ho]

Hi Lay See,
what are the symptom of this C virus?
_________________
Maria Ho汤宁霄,
SAHM, Isabelle & Annabelle, born 25-11-2002. BF for 13 months

[lay_see_ong]

What is hand, foot, and mouth disease?

Hand, foot, and mouth disease (HFMD) is a common illness of infants and children. It is characterized by fever, sores in the mouth, and a rash with blisters. HFMD begins with a mild fever, poor appetite, malaise ("feeling sick"), and frequently a sore throat. One or 2 days after the fever begins, painful sores develop in the mouth. They begin as small red spots that blister and then often become ulcers. They are usually located on the tongue, gums, and inside of the cheeks. The skin rash develops over 1 to 2 days with flat or raised red spots, some with blisters. The rash does not itch, and it is usually located on the palms of the hands and soles of the feet. It may also appear on the buttocks. A person with HFMD may have only the rash or the mouth ulcers.
Is HFMD the same as foot-and-mouth disease?

No. HFMD is often confused with foot-and-mouth disease of cattle, sheep, and swine. Although the names are similar, the two diseases are not related at all and are caused by different viruses. For information on foot-and-mouth disease, please visit the web site of the US Department of Agriculture at http://www.aphis.usda.gov/lpa/issues/fmd/fmd.html

What causes HFMD?

Viruses from the group called enteroviruses cause HFMD. The most common cause is coxsackievirus A16; sometimes, HFMD is caused by enterovirus 71 or other enteroviruses. The enterovirus group includes polioviruses, coxsackieviruses, echoviruses and other enteroviruses.

Is HFMD serious?

Usually not. HFMD caused by coxsackievirus A16 infection is a mild disease and nearly all patients recover without medical treatment in 7 to 10 days. Complications are uncommon. Rarely, the patient with coxsackievirus A16 infection may also develop "aseptic" or viral meningitis, in which the person has fever, headache, stiff neck, or back pain, and may need to be hospitalized for a few days. Another cause of HFMD, EV71 may also cause viral meningitis and, rarely, more serious diseases, such as encephalitis, or a poliomyelitis-like paralysis. EV71 encephalitis may be fatal. Cases of fatal encephalitis occurred during outbreaks of HFMD in Malaysia in 1997 and in Taiwan in 1998.

Is HFMD contagious?

Yes, HFMD is moderately contagious. Infection is spread from person to person by direct contact with nose and throat discharges, saliva, fluid from blisters, or the stool of infected persons. A person is most contagious during the first week of the illness. HFMD is not transmitted to or from pets or other animals

How soon will someone become ill after getting infected?

The usual period from infection to onset of symptoms (“incubation period”) is 3 to 7 days. Fever is often the first symptom of HFMD.

Who is at risk for HFMD?

HFMD occurs mainly in children under 10 years old, but adults may also be at risk. Everyone is susceptible to infection, but not everyone who is infected becomes ill. Infection results in immunity to the specific virus, but a second episode may occur following infection with a different member of the enterovirus group.

When and where does HFMD occur?

Individual cases and outbreaks of HFMD occur worldwide, more frequently in summer and early autumn. In the recent past, major outbreaks of HFMD attributable to enterovirus 71 have been reported in some South East Asian countries (Malaysia, 1997; Taiwan, 1998).

How is HFMD diagnosed?

HFMD is one of many infections that result in mouth sores. Another common cause is oral herpesvirus infection, which produces an inflammation of the mouth and gums (sometimes called stomatitis). Usually, the physician can distinguish between HFMD and other causes of mouth sores based on the age of the patient, the pattern of symptoms reported by the patient or parent, and the appearance of the rash and sores on examination. A throat swab or stool specimen may be sent to a laboratory to determine which enterovirus caused the illness. Since the testing often takes 2 to 4 weeks to obtain a final answer, the physician usually does not order these tests.

How is HFMD treated?

No specific treatment is available for this or other enterovirus infections. Symptomatic treatment is given to provide relief from fever, aches, or pain from the mouth ulcers.

Can HFMD be prevented?

Specific prevention for HFMD or other enterovirus infections is not available, but the risk of infection can be lowered by good hygienic practices. Preventive measures include frequent handwashing, especially after diaper changes (see “Handwashing” in: “An Ounce of Prevention: Keeps the Germs Away” at http://www.cdc.gov/ncidod/op/handwashing.htm), cleaning of contaminated surfaces and items by diluted solution of chlorine-containing bleach (made by mixing approximately ¼ cup of bleach with 1 gallon of water), and washing soiled articles of clothing. (See more about cleaning and disinfecting in general at http://www.cdc.gov/ncidod/op/cleaning.htm). Children are often excluded from group settings during the first few days of the illness, which may reduce the spread of infection, but will not completely interrupt it.

Hand, Foot, and Mouth Disease in the Child Care Setting
HFMD outbreaks in child care facilities usually coincide with an increased number of cases in the community. If an outbreak occurs in the child care setting:

Make sure that all children and adults use good handwashing technique (see above), especially after diaper changes.
Thoroughly clean contaminated surfaces and items using dilute solution of chlorine-containing bleach (see above). Wash soiled articles of clothing.
CDC has no specific recommendations regarding the exclusion of children with HFMD from child care programs, schools, or other group settings. Children are often excluded during the first few days of the illness, which may reduce the spread of infection, but will not completely interrupt it. Exclusion of ill persons may not prevent additional cases since the virus may be excreted for weeks after the symptoms have disappeared. Also, some persons excreting the virus, including most adults, may have no symptoms. Some benefit may be gained, however, by excluding children who have blisters in their mouths and drool or who have weeping lesions on their hands.
_________________
Lay See 王丽丝

[lilian]

And no children play-area in McD, KFC also.
_________________
5xmom

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[simonX]

my sis-in-law's 4yo son just got struck with HFMD in JB. Ulcers in the mouth. Extremely painful, hard to eat.

will keep you guys updated if anything new develops.
_________________
Herz Aus Stahl!

my personal humor blog:
http://simontalks.com

for property news and info:
http://propertymalaysia.blogsome.com

[PlanetBaby]

My elder son (4 years old) got Coxsackie. Just admitted to hospital last night. I am so worry about him and at the same time worry about my 7 months old baby. Afraid that he pass the virus to my baby. They were playing together !

Adult might infected but show no symptoms. I am afraid I am infected and no symptoms and I pass the virus to my baby because I am still breast feeding my baby ! Will the virus pass to my baby thru breast milk ? should I stop breast feed my baby ?
_________________
-- Siew Lee --
Mum of Ee Shen (4 yrs) & Ee Wei (7 mths)

[lilian]

Siew Lee

Can you ask your doctor to be sure? If your doctor is not very sure, can you phone up Dr. Pong of Penang Adventist Hospital. Tell him Lilian of MyMomsBest suggested you call him. Ask him and see? Dr. Pong is a paed and a breastfeeding counsellor. No worries about the different hospital.

I see you list as in Penang. If you are from KL, then call Dr. Koe.

After that, WHEN you have time, do share with us what is the outcome etc. so that we can learn more about this.

Take care!
_________________
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[PlanetBaby]

Thanks Lilian. I called Dr.Pong and he told me the following :

1) Adult is very rare to get Coxsackie. It mostly occurs among children below 6 years old.
2) Infant, baby below 1 year old are not common to get it but avoid direct contact with the brother. Need to monitor the baby if he gets any symptoms like rashes and fever. If there is any symtom then should bring him to doctor.
3) It is safe to breast feed my baby.

For my son, he did not get any fever. He was coughing few days ago, very minor. I gave him cough medicine. Yesterday evening, when my husband bath him, found some rashes on his hand and buttock. We were worry as heard a few cases of Coxsackie recently. Fetch him to the clinic and doctor confirmed it is Coxackie. He is still active and playful like usual.
Doctor performed a blood test and the result will come out later today.

I called my son's nursery and the teacher said there was no case reported in the nursery so far. My son is the first one and the unlucky one !

I will write more next time.
_________________
-- Siew Lee --
Mum of Ee Shen (4 yrs) & Ee Wei (7 mths)

[Vivian Foo]

Hi Siew Lee,

Eugene had Coxsackie too a few months back. It's extremely painful for him to eat, or even swallowing and nursing. My paed suggested us to give him some ice cream or plain yoghurt. My paed also told us that Coxsackie is painful, but usually not harmful, so not too worry yeah. But remember to prevent dehydration on your son, as he might not be able to eat or drink well. You may try offering him some diluted fruit juice. I wet Eugene's lips frequent too, hoping that it will help preventing dehydration.

I actually had some painful rashes on my palms too, but no one believes it that I got Coxsackie too, and as I already know that Coxsackie can't be cured with medication, so I didn't see any doctor, and the rashes just disappear a few days later.

Take care,
_________________
Ryan and Vivi
Proud parents to little Eugene (27 March 2003) and baby Eu Anne (29 March 2006)

[lilian]

Hi Siew Lee

So glad to hear that Dr. Pong offered his advice. He is very nice indeed. Not that I am promoting him 'cos my kids never see him before. But if anyone of you need to choose, he is the one in that hospital. He got two kids, I think one newborn 'cos I saw him and his wife (very pregnant) at Sunshine Farlim a month ago, buying baby products.

Vivian - Thanks for that assurance. Previously I think the outbreak of cosackie was a different strain. The one that happened in Sarawak? That one ganas one ler.

Never mind, when I am free, I will surf and blog it.
_________________
5xmom

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[Vivian Foo]

Hi Lilian,

Yes, the one happened in Sarawak was 'ganas'! My gynae said it's Coxsackie B. And that's why he always asked mothers who see him to breastfeed for at least 6 months - to get the antibodies which will help babies through if unfortunately hit by the Coxsackie B viruses. As the viruses are very highly contagious and almost unpreventable!

According to my paed, the most common Coxsackie viruses which hit children are Coxsackie A16. Coxsackie is a very big family. I believe Eugene had got this A16 viruses too.
_________________
Ryan and Vivi
Proud parents to little Eugene (27 March 2003) and baby Eu Anne (29 March 2006)

[chingux]

Hi Siew Lee,

Both my kids ages 3 and 5 were down with Coxsackie just a couple of months back.

The older one especially had it real bad as she could not eat or drink becos of the position (and size!) of the ulcers in the mouth. The paed gave her some sort of pain killer medicine to apply so that she can at least take some drinks. We bought lots of juices, soya bean drinks etc for her - anything to get fluid down. We also used straws for drinking and syringes too. The younger one had rashes on the hand and bottoms and just a bit in the mouth.

It was very stressful at that time as my third child was only a 2month old baby then but I continued with breastfeeding and separated the kids from her. The baby was ok and did not come down with any symptoms.

Do take care and continue with the breastfeeding.

[lilian]

Remember to wash hands with antiseptic handwash when handling both children. It is spread by contact. I.e. do not let the sick child clothing, beddings get to the other not sick child. That's what I read from the CDC site la. Lay See has copied the whole content to this thread, read the first posting.

So, now at least we learnt few things :

1) Coxsackie A and Coxsackie B are two different thing.
We are talking about Coxsackie A here which is less harmful.

2) Children below 6 yrs (some said 10 yrs) are most prone to get them because their bodies haven't got the immunity.
3) It is highly infectious.
4) Moms can safely breastfeed the child, in fact breastmilk will provide the immunity.
5) Maintain proper hygiene.


I had blogged about this on Mom's Daily. Thanks to all the inputs from you moomies.
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[sofhib]

Thank you to all of you for highlighting this. Hibban got coxsackie few months back. Bring him to see doctor and he said Hibban got coxsackie. Wow I'm shock once I heard the word "coxsackie". After he explained to me then only I understand that Hibban was on harmless coxsackie.
_________________
Ipah ~ mum of Kakak (10/11/02) & Ben (25/08/04)

[PlanetBaby]

Hi, all

Thanks for all the info and concerns. I finally have some time to post a reply. When Ee Shen was down with Coxsackie, I was really stressful, worried about him and the baby, at the same time my project's due date was just a week away. Luckily my husband help up by staying with him in the hospital and I can continue working. Only slept for 4 hours for 10 days continuously.

Ee Shen is consider lucky as his mouth only has 1 small ulcer which did not cause him to have the difficulty in eating. He had fever on the 2nd day after admitted to hospital. The rashes on his palms and legs can be seen clearly. Doctor injected the antibiotic 3 times per day. The 3rd day, no more fever, the number of rashes has stop increasing and the red colour also faded.

He is still very talkative. The only thing that bordered him was, he was not allowed to go out from the room. My husband made a football game set with manila card for him. He enjoy it but still wanted to go out. His temper was so bad due to staying in the room for so many days. We had a discussion with the doctor and he was allowed to go back on the 4th day. However, he cannot mix around with others as he still can pass the virus to others. According to the doctor, we need to wait until all the rashes on his palm and legs disappear.

The hospital also have to file a report to the GH for any case of Coxsackie. GH called me a few days later to confirm on the info and they are trying to find out how my son got it.
I called the nursery and nobody got it except my son. So, it must be from some other places. One of my neighbor's daughter also got it, but she only got the symptoms on the next day after Ee Shen was admitted. Not sure whether Ee Shen passed it to her or she pass it to Ee Shen. The only place we went was Pizza Hut at Tesco. We went to celebrate Ee Shen's birthday, mana tau, got admitted the next day !

Well, he is fully recovered now. One thing that good is he gained 350g during his stay in the hospital ! maybe due to lack of outdoor activities !

Again, thanks for all your useful info. I really appreciated it.
_________________
-- Siew Lee --
Mum of Ee Shen (4 yrs) & Ee Wei (7 mths)

[yanna]

Hi! Just putting my thots down...

My little girls were down with Coxsackie A just 2 weeks ago. Initially I thot my 1yr old was down with chicken pox (& I haven't brought her to the dr. for her MMR!! ) Guilt was all over me until her pediatritian said that it's Coxsackie & not chicken pox...pheww... but Coxsackie??

I frantically read about it wanting to know what has caused the outbreak... like what has been discussed.. hygiene!!

Now I feel like a BADDDD mom... I thot I'd done all I could & be as hygienic as possible. But as a working mom, I do have to rely on the maid at times. But even then, I send my girls to my mom's hse so that there's supervision (& my mom has another maid to help her out!!)

I was a little embarrassed with the fact that my kids got Coxsackie. I started to question myself...Where did I go wrong?? Could it have been prevented... poor kids...

Whatever it is I'm thankful that it's harmless and it has gone away...
_________________
Yanna
Mom to Shiryn (14.11.01) and Syaira (9.9.04)

[lmokhtar]

[yanna]

Hi Linda,

Thanks for your kind words You're rite about leaving things to God when we have done our best for our children...

Can't help it but we do worry too much don't we Wish I could be a SAHM or a WAHM... but we all wish to be what we're not too at times
_________________
Yanna
Mom to Shiryn (14.11.01) and Syaira (9.9.04)