Guideline on School Functions and Extra-Curricular Activities at the Height of Hand, Foot and Mouth Disease/Enterovirus Activity
1 Background
Hand, foot and mouth disease (HFMD) is a viral infection caused by enteroviruses. It is commonly found in children. While Coxsackie A virus is a major cause of HFMD, enterovirus 71 (EV71) can also lead to HFMD. Most patients with HFMD will have a mild clinical course and recover spontaneously.
HFMD occurs more frequently in summer and may lead to outbreaks.
The activity of HFMD and the number of related outbreaks has been on the rise since March this year. This guidance note provides guidance for schools in organizing functions and summer activities to reduce risk of transmission of infection.
2 General principles to reduce risk of HFMD / Enterovirus transmission
Early recognition of infection: Provide information to participants on HFMD, e.g. through issuance a circular to remind the participants of the early recognition of signs and symptoms of HFMD (e.g. painful blisters and ulcers in oral cavity, blisters over hands and feet, poor appetite, sore throat).
Segregate the sick persons: Persons with HFMD should refrain from gatherings and activities. Advise them to rest at home until fever resolves and all blisters dry up. For persons with EV71 infection, they should wait for 2 weeks more after all blisters dry up. They should duly observe personal hygiene to protect themselves and others.
Enhance awareness on personal hygiene: The important measures include maintain frequent and proper hand hygiene, cough etiquette, avoid touching of eyes, nose or mouth and avoid sharing of personal items.
Maintain good environmental hygiene: Maintain good indoor ventilation.
Clean and disinfect the school premises regularly. Clean frequently touched surfaces more frequently.
3 General advice for schools and activity organizers
Pay attention to announcements from the government on the latest public health policy and advice on public functions.
Ensure adequate ventilation and environmental hygiene.
Facilitate implementation of personal hygiene measures, such as ensure that liquid soap is provided in toilets and make alcohol-based handrub readily
1
available at all times.
Reduce overcrowding, taking into account nature of the venue and the activity, implement crowd control if necessary.
Plan for ways to assist people who have HFMD.
For more information, please refer to the CHP webpage http://www.chp.gov.hk/en/content/9/24/23.html
4 General advice for activity participants
Pay attention to the information on HFMD and recognise the sickness early.
Strict adherence to personal hygienic practice. Wash hands with liquid soap and water and/or use 70-80% alcohol handrub frequently.
Person with HFM disease should refrain from attending gatherings.
5 Special advice for schools, including distribution of examination results, registration procedures, and summer tutorial classes
Preparation of facilities:
Ensure easily accessible hand hygiene facilities (e.g. liquid soap and water, alcohol handrub).
Clean and disinfect frequently-touched areas and items with household bleach on regular basis and immediately when visibly soiled.
Maintain room well-ventilated. If air-conditioner is used, ensure adequate fresh air exchange and cleaning of filters. Choose spacious settings in organising gatherings to avoid overcrowding.
Administrative control
Train staff regarding infection control measures, how to recognise HFMD, and how to handle sick children/ students.
Notify guardians that their children should not attend school activities if they have symptoms of HFMD or fever. Advise participants to stay at home if sick and seek medical care.
Arrange equipment for checking body temperature of participants upon entry to the school if necessary.
2
Designate staff to care for sick persons and limit their interaction with other participants.
Plan in advance with the guardians regarding management of sick children while attending the class.
6 Special advice on extra-curricular activities, including graduation ceremonies, outings and camping
Follow the same advice on promotion of personal hygiene, preparation of facilities and administrative control as listed under “Special consideration for schools”.
Participants with HFMD should refrain from attending such activities.
In addition, organisers should observe the following:
Control the number of participants to avoid overcrowding, especially for indoor activities. The appropriate number of participants varies according to the size, ventilation and hygienic condition of the venue.
Vigilance on personal hygiene for participants engaging in activities with close body contact e.g. ball games.
Avoid sharing of personal items among participants (e.g. towels, water bottles, etc.).
7 Special advice for activities involving young children under 6 years old
Young children have less capacity of taking care of their own personal hygiene and they tend to have a greater intensity of direct physical contact with other children and persons.
Adjust the size of group activities for young children to allow adequate adult supervision to individual child’s hygiene practice.
Arrange adequate adult supervision, preferably parent’s supervision, to ensure personal hygiene of children.
Suspend activities that involve lots of simultaneous sharing of toys among many young children (e.g. ball pools) at the height of HFMD.
Cleanse and disinfect toys and other objects shared by young children frequently and immediately if soiled.
Cleanse the venue between each session of activities before another group of children comes in.
3
4
For details on the recommendations on infection control for schools, kindergartens /kindergartens-cum-child care centres / child care centres, please refer to the CHP ‘Guidelines on Prevention of Communicable Diseases in Schools / Kindergartens /Kindergartens-cum-Child Care Centres / Child Care Centres’ accessible at the website of Centre for Health Protection:
http://www.chp.gov.hk/files/pdf/School_full_eng_20090115.pdf
Centre for Health Protection June 2010
