Hand-Washing: The Main Strategy for Avoiding Hand, Foot and Mouth Disease

Abstract

Epidemics of hand, foot and mouth disease (HFMD) among children have caused concern in China since 2007. We have conducted a retrospective study to investigate risk factors associated with HFMD. In this non-matching case-control study, 99 HFMD patients and 126 control from Guangdong Province were enlisted as participants. Data comprising demographic, socio-economic, clinical and behavior factors were collected from children’s parents through face-to-face interviews by trained interviewers using a standardized questionnaire. Results of the primary logistic regression analyses revealed that age, history of cold food consumption, hand-washing routines, and airing out bedding were significantly associated with HFMD cases. Results of further multivariate analysis indicated that older age (OR = 0.44, 95% CI: 0.34–0.56) and hand-washing before meals (OR = 0.3, 95% CI: 0.13–0.70) are protective factors, whereas airing out bedding more than thrice a month (OR = 4.55, 95% CI: 1.19–17.37) was associated with increased risk for HFMD. Therefore, hand-washing should be recommended to prevent HFMD, and the potential threat of airing out bedding should be carefully considered. However, further studies are needed to examine other possible risk factors.

The epidemiological risk factors of hand, foot, mouth disease among children in Singapore: A retrospective case-control study

“…Ruan et al found that almost always hand washing before meal among children and before feeding child among adults reduced more than 95% risk of HFMD with significantly increased dose-response effect after adjusting for other factors [ 33 ]. Zhang et al reported that often hand washing before meals reduced HFMD risk significantly but not hand washing after toilet use [ 55 ]. Nevertheless, HFMD continued to spread even though hand hygiene education was strongly emphasised.…”

A hand hygiene intervention to decrease hand, foot and mouth disease and absence due to sickness among kindergarteners in China: A cluster-randomized controlled trial

“…Compared to HFMD vaccination, HH interventions are cheaper, safer and easier to implement, so they are more suitable for improving children's health in developing countries. 32 Kindergarten is an ideal place for conducting HH interventions, as many children between the ages of three and six years are gathered in kindergarten classrooms, and teachers and school doctors can contribute to the implementation work. This makes it relatively easier to provide HH products, distribute health education materials and conduct team training sessions in kindergartens than in communities.…”

Transmission and serotype features of hand foot mouth disease in household contacts in Dong Thap, Vietnam

“…There are potential interventions that currently being suggested for reducing HFMD transmission such as hand washing; school closures; clean and disinfect frequently touched surfaces and soiled items, including toys; avoid close contact [17–20]; but school closures have an effect on household and community transmission and the ambiguity about their efficiency and cost-effectiveness. It is necessary to evaluate the impact of households on transmission and the potential for interventions [21].…”