by Sally Plomley
sallyp@isb.ac.th

Dear Parents,

Many of you may be aware there has been an outbreak of Hand, Foot and Mouth Disease in Bangkok over the last few weeks. At ISB we have had five confirmed cases over the last week.

Hand, Foot and Mouth disease is a viral illness which is usually mild but is contagious. Most children have this infection in early childhood.

We have had four cases in our PreK class and as a result we have had to close that class for a week (following the Thai Ministry of Public Health Regulations).

In an effort to limit the spread of this infection we are screening all students who could have been exposed to the virus by checking them for signs of the disease (checking temperature as well as looking for blisters in their mouths and on their hands and feet). We also have Buildings and Grounds doing a deep clean of all classrooms and areas where students diagnosed with the infection have been.

We also need your help in limiting spread of this infection. If you child is unwell please keep them at home until they are well. If they get a fever please take them to a doctor to see if they have Hand, Foot and Mouth Disease (or any other infectious illness) and keep them home until they are no longer contagious. With your help we can hopefully prevent this outbreak being a major problem at ISB.

Please see information below about the infection:

Hand, Foot and Mouth disease

Hand, foot and mouth disease is a viral infection.

The virus can spread from an infected person via contact with the fluid in the blisters, by coughing and sneezing, by contact with faeces and by contact with contaminated objects or surfaces. A person will take 3-5 days to get symptoms and will be contagious whilst there is fluid in the blisters (the faeces can remain infectious for several weeks).

Symptoms

• fever
• tiredness
• loss of appetite
• blisters in the mouth and on the hands and feet
• a sore mouth for a few days before the ulcers or blisters appear.

Children may refuse to eat or drink due to the pain.

Diagnosis is usually made by clinical presentation.

Treatment

Usually none is required. Use of paracetamol/acetaminophen or ibuprofen for the fever and any discomfort may be indicated. Aspirin should not be given to children under 12 years of age.

The blisters should not be deliberately pierced or broken because the fluid within the blisters is infectious. The blisters will dry naturally.

If your child is diagnosed with Hand, Foot and Mouth Disease please notify the Health Clinic and they need to present a medical certificate to the Health Clinic stating they are fit to return to school and no longer contagious prior to going to class.

Prevention

• Exclude people with hand, foot and mouth disease from school until all blisters have dried.
• Wash hands with soap and water after toileting
• Cleaning and disinfecting frequently touched surfaces and soiled items, including toys with a diluted solution of chlorine-contained bleach (approximately ¼ cup of bleach with 1 gallon of water).
• Avoiding close contact such as kissing, hugging, or sharing eating utensils or cups with people with hand, foot, and mouth disease.

ISB is committed to your child’s overall development, both educationally and health related. Should you have any questions or concerns, please contact your healthcare provider or the ISB Health Clinic (nurse@isb.ac.th).