TCM Treatment and Prevention of Hand, Foot and Mouth Disease

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What is Hand, Foot and Mouth Disease (HFMD)? HFMD is a viral infection common among children, though it can also infect adults. Children below 5 years old are more susceptible.

The incubation period of HFMD is 2 to 5 days (with a range of up to 2 weeks). The disease is usually mild and self-limiting, mostly taking less than one week to recover. However, occasionally, serious complications involving the nervous system, heart and brain can occur, which can cause death if not treated immediately and properly.

Symptoms of HFMD

Symptoms of HFMD can include:

  • fever
  • sore throat followed by cough
  • ulcers in the throat, mouth and tongue
  • headache
  • rash with small blisters on palms and sole of feet. They may also appear on the buttocks, arms and legs.
  • running nose
  • loss of appetite
  • vomiting and/or diarrhoea

Symptoms may vary between individuals, and at different stages of the disease. For example, some may not have fever or some only have rashes. One should be alerted of possible complication if fever persists for 5 days or more or when there are severe headaches, irritability, severe thirst, dehydration, fits, disorientation, rapid breathing or skin turning blue. These symptoms warrant immediate medical attention.

Existing conventional treatment for hand foot and mouth disease is limited to symptomatic relief, such as lotion or cream for blisters and ulcers, and pain relief medicine. However, with the use of Chinese medicine, other than relief of symptoms, it also helps to shorten the period of illness and prevent complications.

Using Chinese medicine for HFMD

During the onset of the illness, symptoms can include fever, lethargy, lack of appetite, running nose, cough, diarrhoea or vomitting. After 1-2 days, blisters or sores start to appear in the mouth and on the palms and feet. In some cases skin rashes may appear first. Blisters may break, showing clear liquid.

According Traditional Chinese Medicine (TCM), at this stage, the Lung and Spleen is affected. Herbs commonly used include honeysuckle flower (jin yin hua), forsythia fruit (lian qiao), baical scullcap root (huang qin), indigowoad root (ban lan gen), agastache (huo xiang), oriental wormwood (yin chen), etc, to relieve exterior syndrome, clear heat, and eliminate dampness.

In more severe cases, symptoms show up as persistent fever, thirst and irritation, constipation or very hard stools, densely distributed sores and blisters spreading to hands and hip, with colour turning dark or purplish, severe pain and itch, etc. Such situation warrants close attention and medical treatment. In TCM, herbs used would then include those to clear heat in the Ying System, such as peony root bark (mu dan pi), red peony root (chi shao), water buffalo horn (shui niu jiao), etc.

Tips for managing HFM disease

Here are a few tips for managing the illness:

  • Food should be soft or liquid and easy to take in so as to reduce the time they stay in the mouth. Examples include juices, porridge, soups, soy bean milk, purees, etc.
  • It is useful to use straw to take in liquid food especially when children refuse to eat.
  • Food or drinks should be comfortably warm and not hot or cold.
  • Juices and fruits should be avoided if the stool is soft or watery.
  • Avoid seafood (except fish) during the course of the illness.

TCM recipes for preventing HFMD

Below are two recipes that can be used for preventing HFMD. Note that they are suitable for two different types of body constitutions. If in doubt, do consult a TCM physician before preparing.

1. Gromwell and double bean porridge

This porridge is suitable for those who have a “heaty” constitution, characterised by tendency to feel warm, get sore throat or ulcers, thirst, scanty urine, and active or hyperactive.

Ingredients:

  • Gromwell root (zi cao gen) 5g
  • Licorice root ( gan cao) 10g
  • Small red bean (chi xiao dou) 30g
  • Mung bean 30g
  • Rice 30g

Method:

Wash the above ingredients and cook as porridge. (Items 1-3 can be obtained from traditional Chinese medical halls).

2. Chinese Yam and Astragalus Soup

This soup is suitable for those who are weak in Qi, characterised by tendency to catch cold or sneeze in cold environment, shortness of breath, pale facial and tongue colour, lethargy and tendency to dislike talking, lack of appetite, and soft or loose stool.

Ingredients:

  • Astragalus root (huang qi) 15g
  • Dried Chinese yam (shan yao) 60g (or 120g fresh Chinese yam)
  • Lean pork or chicken meat (cut into small pieces) 120g
  • Salt or soy sauce to taste

Method:

  • Add water to items 1-3 and bring to boil, then turn to low flame and cook for half an hour.
  • Bring to boil again and add in pork/chicken pieces and cook for another 5 minutes.
  • Turn off fire and add in salt or soy sauce.
  • For a more flavourful soup, cook items 1-3 together for 45 minutes. If using pork, switch to using spare ribs.

(by Tan Shiau Tse, TCM Physician, Copyright® HST Medical Pte Ltd)