With the Capital reporting cases of hand, foot and mouth disease (HFMD), the government has issued guidelines for doctors, hospitals, and schools to deal with the disease.

Alerting principals, teachers and supervisors to look out for children with fever, rashes or blisters on the palms and soles, the guidelines recommend that infected children should remain away from the institution for at least 10 days after the onset of symptoms and must be certified free from infection by a registered medical practitioner before returning to school. The affected class should be closed if necessary. Closure of the whole school is unnecessary as HFMD in older children is usually very mild. So far, no complication has been documented from this age group, the guidelines issued by the Delhi-based National Centre for Disease Control said.

HFMD is a contagious illness caused by different viruses. Although older children and adults are affected by the disease, infants and children younger than five years are more likely to get affected.

Last week primary classes of a school had to be closed for a few days when several children developed the disease.

Any child with a mouth/tongue ulcer and maculopapular rashes and/or vesicles on palms and soles with or without history of fever can be suffering from HFMD.

The disease usually starts with a fever, poor appetite, a vague feeling of being unwell (malaise), and sore throat. One or two days after fever starts, painful sores usually develop in the mouth and subsequently become ulcers. A skin rash develops over one to two days, particularly on the palms and sole. It may also appear on the knees, elbows, buttocks or genital area.

A person with HFMD is most contagious during the first week of illness and, according to the guidelines, people should always try to maintain good hygiene. There is no vaccine against this disease. The only way to protect the infection is to maintain hygiene, avoid close contact, or sharing eating utensils with people with the disease.