Key facts

Transmission: Direct contact and droplet-borne

Contact with the saliva, nose mucous, blister fluid or faeces of an infected person
Breathing in droplets after an infected person coughs or sneezes
Touching objects and surfaces that have the virus on them (toys, utensils, doorknobs)
Swallowing infected, improperly treated water from swimming pool (rare occurrence)

Most vulnerable to severe consequences

Infants and children younger than five years of age
Adults with weakened immune systems

Most vulnerable to contracting the disease

People living, working or going to school in shared, cramped spaces

Symptoms

Fever
Reduced desire to eat and drink
Feeling tired and unwell
Sore throat
Mouth sores (usually appear a few days after other symptoms)
Skin rash with red spots on the palms of the hands and bottoms of the feet
- Rash may also appear on the knees, elbows, buttocks, or genital area

What can you do to prevent and control an epidemic?

Monitoring the community and identifying sick people

Identify and isolate sick people before they spread the disease to others

Treatment and management

Refer severely ill people (for example, those with severe dehydration) to health facilities
Provide psychosocial support to the sick person and their family members

Appropriate sanitation and waste management

Promote recommended environmental hygiene and cleaning practices
- Clean and disinfect surfaces that are touched frequently and dirty items, including toys
Promote use of appropriate sanitation facilities (sound, clean latrines)

Hand and respiratory hygiene

Promote handwashing with soap (by both caregivers and children)
- BEFORE: preparing food; eating; feeding a child; treating wounds; or caring for sick people
- AFTER: using the toilet or cleaning a baby; touching garbage or waste; touching or feeding animals; blowing nose, coughing or sneezing; treating wounds; or caring for sick people
Promote respiratory hygiene and coughing etiquette (cover cough or sneeze using a sleeve or tissue, wash hands after coughing or sneezing, do not spit onto the ground or in public)

Food and water hygiene and safety

Ensure access to safe, clean drinking water
Encourage exclusive breastfeeding for the first six months of life, and complementary breastfeeding until the age of two years (especially when a child is sick)

Social mobilization and health promotion

Find out the specific advice being given by health and other relevant authorities
Model following this advice and inform community members of current health practice advice
Offer support and encouragement to follow the advice
- Try to gain understanding about if and why health practice advice is not being followed
- With the guidance of your supervisor and health authorities, work with communities to overcome barriers to following health advice and recommended practices

Mapping and community assessment

Make a map of the community.
Mark the following information on the map:
- How many people have fallen sick with HFMD? Where?
- How many people have died? Where? When?
- Who and where are the vulnerable people?
- Where are the local health facilities and services? (include traditional healers)
- Where do people obtain their drinking water?
Record the following information on the back of the map:
- When did people start to fall sick with HFMD?
- How many people live in the affected community? How many are children under five years?
- Is breastfeeding common?
- Is the water source safe?
- Do people do anything to treat their water?
  - Do people know how to treat water?
    - How do they do it?
- What sanitation facilities are available? (put communal toilets/latrines on map)
  - Do people use them?
- What handwashing facilities are available? (put communal handwashing stations on map)
  - Do they have soap?
- What are the community’s habits, practices and beliefs about caring for and feeding sick people? Consider any differences in roles and responsibilities between women and men.
  - When babies and infants are sick, do women continue to breastfeed them?
- Where do people go for water recreation?
  - Is that water likely to be contaminated by faeces?
- Is a social mobilization or health promotion programme in place?
- What are the barriers people face in accessing water points and sanitation and hygiene facilities, of all gender identities, ages, disabilities and backgrounds?
- Which sources do people use/trust the most for information?
  - Are there rumours or misinformation about HFMD? What are the rumours?
- Can people identify the signs and symptoms of dehydration?
- Do people know how to make oral rehydration solution (ORS)?
  - Do they have resources at hand to make it?

Volunteer actions

01. Community-based surveillance 02. Community mapping 03. Communicating with the community 04. Community referral to health facilities 05. Volunteer protection and safety 12. Managing fever 19. Psychosocial support 28. Physical distancing 29. Hygiene promotion 30. Clean, safe household water 32. Sanitation 34. Handwashing with soap 43. Social mobilization and behaviour change