HFMD is back. Here's what every parent needs to know right now.

Hi Mama & Papa, 💜

Can I tell you something I've been noticing lately?

The past few weeks, the clinic has been busy in a specific way.

Not just the usual sniffles-and-coughs busy.

I'm talking about the kind where a parent walks in, lifts their child's shirt, and before they even finish explaining, I already know what I'm looking at.

Blisters on the palms. Ulcers in the mouth. Sometimes a rash on the soles of the feet.

And the parent sitting across from me with that same look.

Part worried. Part guilty. Part… "I should have known."

HFMD is back. And this season, it is spreading fast.

HFMD remains highly active during mid-year school holidays, with Selangor historically among the hardest-hit states. And with the holidays in full swing, children are mixing more than usual. Playgrounds, open houses, cousins, swimming pools.

I want to make sure you're not caught off guard.

First: what even is HFMD?

Hand, Foot and Mouth Disease is a viral infection caused by enteroviruses (most commonly Coxsackievirus A16 and Enterovirus 71). It spreads through direct contact: saliva, mucus, the fluid in blisters, and contaminated surfaces.

It mostly affects children under 5. But older children and adults can get it too.

Most cases are mild and resolve on their own within 7 to 10 days.

But "mild" doesn't mean comfortable. And there are signs that should prompt you to see a doctor sooner.

5 things I want you to know right now 👇

1. The early signs are easy to miss.

Before the blisters appear, your child might just seem irritable. Off their food. Low-grade fever. Mouth hurting but they can't tell you why.

If your child suddenly refuses to eat or drink, and seems unusually cranky for a day or two, pay attention.

🚨 Check the mouth. Check the palms. Check the soles.

2. Not drinking is the real danger.

HFMD ulcers in the mouth are painful. So painful that some children refuse to swallow anything, even water.

Dehydration is the main reason children with HFMD end up needing hospital care.

Keep offering cool fluids. Cold milk. Ice water. Even ice chips or cold yoghurt can help.

If your child hasn't urinated in 8 hours, or their lips are dry, or they seem unusually sleepy, please go to a doctor.

3. Keep them home. Seriously.

HFMD is most contagious in the first week.

I know the school holidays feel like the wrong time to be stuck at home. Cousins are visiting. The family trip is planned. There are open houses to go to.

But one child mixing while unwell can seed an entire classroom, or an entire extended family, when school restarts.

Keep them home until all blisters have fully dried AND they have been fever-free for at least 24 hours. That's usually 7 to 10 days.

4. Wash hands like you mean it.

The virus survives on surfaces for hours. Door handles. Shared toys. Swimming pool railings. Stroller handles.

Regular handwashing, with soap, for 20 seconds, is genuinely the most effective prevention we have.

This is not the "remember to brush your teeth" kind of advice. During an active outbreak, this one habit makes a real difference.

5. Know when to go to A&E.

Most HFMD children can be managed comfortably at home. But come in immediately if you see:

🚨 Fever above 39°C that doesn't come down with paracetamol, or lasts more than 2 days
🚨 Child is unusually drowsy or hard to wake
🚨 Breathing seems laboured or fast
🚨 Limbs are trembling or jerking
🚨 Child seems confused or is not responding normally

These can be signs of rare but serious complications: viral meningitis or encephalitis, most commonly linked to the EV71 strain. They are uncommon, but they are real.

I made a carousel on this. Watch it if you want a quick visual explainer 👇

I know this is a lot of information. And I know how overwhelming it feels when your child is unwell and you're not sure if you should panic or wait.

So let me leave you with this.

Most children who get HFMD will be okay. They'll be miserable for a few days. You'll be exhausted and worried. And then, almost without warning, they'll ask for their favourite food again, and you'll know the worst is over.

That moment is coming.

In the meantime, keep them hydrated, keep them home, keep the surfaces clean.

And trust your instincts. If something feels wrong, come in. That's what we're here for.

Rooting for your family always. 💜