Hand-foot-mouth sufferers need more rest and nutrition

By Ida Indawati Khouw

JAKARTA (JP): Some kindergartens and elementary schools in Jakarta closed down temporarily last week after some of their students became infected by a disease that causes ulcers around the hands, feet and mouth.

The closure has definitely caused panic among Jakartans, especially those who have children.

The hand-foot-mouth disease (HFMD) has returned to the capital with the number of cases reaching 58 since the first reports were received by the city health agency between August and September.

Although HFMD is a contagious disease, it is still categorized as influenza.

Parents are concerned because the virus can easily be spread through saliva and contaminate food or drink. A person can also be infected by the disease after touching an object contaminated with the virus.

Firman Lubis, a senior lecturer at the Department of Community Medicine from the University of Indonesia's School of Medicine, considered the schools' decision to close down an overreaction.

"Just isolate students with HFMD symptoms by asking them to stay at home. It's not an alarming disease but a common, contagious disease," he said.

Firman said the sufferers would initially experience symptoms similar to influenza, including a running nose, fever and sneezing. Those symptoms are followed by the appearance of ulcers around the mouth and a rash on the hands and feet.

"It's a matter of virus mutation that results in a more serious form of influenza and infects other parts of the body, in this case the hands, feet and mouth," he said.

"And the virus could mutate even further, becoming more virulent due to factors like radiation, the influence of drugs or the environment. Humans can't stop the process and so far there is no medication," he added.

The HFMD disease, which is also called vesicular stomatitis with exanthem, was first discovered in Singapore last year, which is the reason why some people call it the Singapore flu, and is caused by the coxsackie virus.

The first outbreak of the disease in Indonesia was in November 2000, when a preschool in Pondok Indah, South Jakarta, identified two cases among its students.

Last year in Malaysia and Singapore, 1,150 children were diagnosed with the disease and four of the patients died.

Another example of the influenza virus's mutation is the appearance of Hong Kong flu. Sufferers of this disease are contagious for a longer period of time than usual.

Firman said the virus mutation also interacts with other disease like dengue fever.

"In the past, people suffering dengue fever didn't bleed, but now they are always bleeding. The condition is similar with the influenza. So, we don't know what kind of influenza we will have in the future."

Children are most prone to the disease because their immunity has yet to fully develop, unlike adults, said Firman.

"But the spread of the virus always relies on the condition of the host (the human body), the agent (the virus) and the environment. If someone's immunity is good the virus won't be prolific, and if the environment isn't conducive for the virus to spread, people won't become contagious," he said.

Firman further said that if the symptoms were identified -- a fever that lasts for three to four days, reddish spots around the hands, feet and mouth, followed by vesicles -- sufferers must maintain their condition and avoid physical tiredness. They should also go to a doctor, ensure they eat and get enough rest.

"As medication for the disease has not been created, the virus-caused illness can only be cured by our own antibodies," he said.

In extreme cases and when not treated properly, the virus can deteriorate the immune system to an extent that organs can be affected, including damage to the liver and inflammation of the brain, which can result in death.