Schools issue advisories and return to online classes as cases of hand-foot-mouth disease rise across the country

ByMike V. Cooper

Aug 18, 2022

While some schools issued advisories, others opted for online classes after states recorded a spike in hand-foot-mouth disease cases.

Some schools in the NCR of Delhi have issued advisories to sensitize parents about the virus infection which is spreading rapidly among children aged 5 to 10 and mainly in primary grades.


The Indian School of Delhi posted a notice on its website stating that “Parents should refrain from sending the child to school until the rash is completely healed and no fever has returned for at least 24 hours (at least 7 to 10 days from the onset of symptoms).

READ ALSO | NCR schools are witnessing an increase in cases of hand-foot-mouth disease

The notice further stated: ‘Any child with a rash should obtain a medical prescription from the medical officers stating that he or she has no contagious or infectious disease before joining classes.’

Prominent schools in the city such as the Air Force School at Subroto Park and the School of Sanskriti have issued a health advisory on FHMD and infectious diseases in general as well as transmittable diseases as dengue fever and malaria.

There is an increase in the number of cases of HFMD in children. More than 100 cases have already been reported in the NCR. Private and major schools are taking precautions to sanitize school premises and addressing parents’ concerns about infections and their spread. However, Delhi Government Health Department or UP Government Health Department has not issued an opinion on the matter.


The Chandigarh Department of Health has issued an advisory to schools. Schools in Chandigarh, Panchkula and Mohali which were closed due to the contagious disease of hands, feet and mouth have already resumed their normal course for two weeks now.

Some schools have decided to reopen by operating offline again. Chandigarh resident Rajesh Malik in an interview with India Today said two weeks ago that cases had been reported in private schools in Mohali and as a precaution schools were closed and, once again online classes have started, but now things are back to normal.

READ ALSO | Schools reopen in Chandigarh, Panchkula, Mohali after foot and mouth disease scare

Two weeks ago, approximately 24 cases of highly contagious hand-foot-mouth disease (HFMD) were reported in tricity.

Even in Karnataka, a private preschool in Bengaluru has issued a circular to keep the school closed until August 21 due to rising cases of HFMD. Some schools have chosen to go online and continue online classes as there is a significant drop in attendance due to illness.

Here are some facts to know about this disease to avoid anxiety as there are many other viruses like monkeypox, chicken pox and Covid 19.

-It mainly affects children under the age of 7 (normally a school child acquires and spreads to younger siblings)

– Coxsackievirus A16 and enterovirus A71 are the serotypes most frequently associated with MMBP and are responsible for the majority of large epidemics.

Spread– Human enterovirus infection occurs after oral ingestion of a virus excreted through the gastrointestinal or upper respiratory tract of infected persons (i.e. through ingestion of feces, oral secretions or , for some serotypes, respiratory secretions). Human enterovirus infection can also occur from contact with vesicular fluid or oral and respiratory secretions.

Sometimes only the oral cavity is affected, which may be due to hyperangina primary herpetic gingivostomatitis)

Epidemiology– HFMD and herpangina occur worldwide. Outbreaks involving daycares, schools, summer camps, hospital wards, military installations, communities, large geographic areas and entire countries have been reported. Intrafamilial spread occurs in both HFMD and herpangina.

The incubation period for HFMD is usually three to five days, but it has been reported to be as short as two days and as long as seven days.


“HFMD usually presents with complaints of mouth or throat pain (in verbal children) or refusal to eat (in non-verbal children). Fever, if present, is usually below 38.3°C (101°F). The rash begins as a mouth macula followed by an ulcer (usually painful). Exanthema (rash) usually involves the hands (backs of fingers, interdigital area, palms), feet (backs of toes, lateral edge of feet, soles of feet, heels), buttocks, legs (upper thighs ) and arms. . They are usually painless and not itchy,” said Dr Dhiren Gupta, pediatric intensivist at Sir GangaRam Hospital.


Serious complications from HFMD rarely occur except with HFMD caused by enterovirus 71, Dr. Gupta said.

Treatment course– HFMD is usually a mild clinical syndrome. Complete resolution of symptoms and signs usually occurs within 7-10 days maximum.

In a patient with suspected HFMD, if the child is lethargic, constantly vomiting, and has a fever over 100 degrees F for more than three days, the infant is contracting the disease.


“Management is mostly supportive. Children with complications may require hospitalization. No specific antiviral therapy is available for the treatment of enteroviruses. The enterovirus genome does not code for thymidine kinase, the enzyme necessary for the activity of acyclovir. Pain and discomfort due to fever can be managed with ibuprofen or acetaminophen, although these agents should be avoided in dehydrated children until volume correction has been achieved. In severe cases, oral opioids may be needed,” Dr. Gupta explained.

(With contributions from Lalit Sharma)

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