Disease expert can't keep HFMD out

Although Dr Leong Hoe Nam, 43, is a self-professed stickler for hand hygiene, his three children, including Vivianne, six, (pictured) were not spared from the hand, foot and mouth disease two years ago.
PHOTO: Disease expert can't keep HFMD out

SINGAPORE - For the past six years, he has never taken a single day's medical leave.

The last time Dr Leong Hoe Nam, 43, fell sick, it was a mild cough and runny nose.

The infectious disease specialist at Rophi Clinic, which specialises in fever, infectious diseases, vaccinations, wound and stoma care, credited this to regular influenza jabs, and more importantly, frequent handwashing.

"I'm one of those people who know what's clean and dirty, and I mentally conceptualise it," the self-professed stickler for hand hygiene said.

Yet this "occupational hazard", which he tries to impose at home, did not stop his three children from coming down with the hand, foot and mouth disease (HFMD) two years ago, a viral disease that predominantly affects children aged five and below.

A local survey released on World Hand Hygiene Day yesterday showed that HFMD is the costliest among common childhood infections here, be it in terms of the total medical bills or the opportunity cost. (See other report.)

Indeed, Dr Leong's household became a complete mess when the HFMD bug jumped from his second daughter Vivianne, now six, to his elder daughter Marianne, 10, and youngest son Lucas, four, within days, he said.

Vivianne got it from pre-school, he said.

"It's within expectation. I'm not spared this even though I'm a fever specialist and see children with HFMD.

Minimise the risk

"Unfortunately, there is no way of trying to avoid it. We can try to minimise the risk, but getting it is almost certain in life because if the kids don't go to school, they go to childcare centres. They will meet other children and pick (the disease) up," the father of three said.

It was stressful and distressing in the Leong household the week the three kids were infected.

Said Dr Leong: "The strain is on the family. My wife was dishevelled. The house was in a complete mess. The kids just didn't want to do anything. It was very, very stressful."

As doctors - his wife is a part-time paediatrician - they understood the importance of hydration when it comes to HFMD, and did all they could to make sure the kids took in enough fluid.

This ranged from "tempting" them with sweet drinks and ice popsicles, to threatening them.

"By the fourth day, my second daughter, who got quite bad, refused to take anything. We had to threaten her with injections," he said.

All three recovered within a week. Dr Leong gave each a thorough checkup - ensuring that the fever was gone and the sores had dried up - before letting them return to school.

Lamenting how handwashing is down-played here, Dr Leong, who used to work in the Singapore General Hospital, said: "Handwashing is really crucial. This stems from information learnt in the hospital.

"(It) has been the number one fight against multi-drug-resistant bacteria in the hospital."

When the family buys food from drive-through restaurants' for instance, Dr Leong will offer his children wet wipes to make sure their hands are bacteria-free before they tuck in.

"If we forget, they will actually ask us for the wipes," he said.

Both Dr Leong and his wife, Dr Lim Hong Huay are Sars survivors. They were hit by the virus in 2003 as a result of Dr Leong taking care of Singapore's first Sars patient.

fjieying@sph.com.sg

The cost of HFMD

A local study has found the hand, foot and mouth disease (HFMD) to be the costliest among other common childhood infections such as diarrhoea, respiratory infections like the flu and skin infections like rashes.

The study, which surveyed 301 mothers in March, was initiated by Unilever and sponsored by health soap brand Lifebuoy to assess the cost of common childhood infections.

It was conducted in consultation with the Society of Infectious Diseases (Singapore).

The respondents have children who are aged 12 and below, and have had at least an episode of any of the above infections in the last six months.

Professor Paul Anantharajah Tambyah, the president of the Society of Infectious Diseases (Singapore), explained that HFMD costs more to treat compared to other infections because it usually involves two to three trips to the doctor - once before the rashes, once when it's full-blown, and once if childcare centres require clearance from doctors before they return.

TOTAL MEDICAL BILL

Respiratory infection: $121

Diarrhoea: $151

Skin infection: $163

HFMD: $207

OPPORTUNITY COST (due to work days lost)

Respiratory infection: $760

Diarrhoea: $749

Skin infection: $749

HFMD: $1,005

HOW TO PROTECT CHILDREN

Wash hands with soap before eating and after going to the toilet.

Cover mouth and nose when coughing or sneezing.

Do not share eating utensils.

Ensure that toys or appliances that are contaminated by nasal or oral secretions are cleaned thoroughly before they are used again.

Put on a face mask when feeling unwell.

Source: Health Promotion Board

This article was published on May 6 in The New Paper.

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