GOVERNMENT OF GUAM

DEPARTMENT OF PUBLIC HEALTH AND SOCIAL SERVICES

DIPATTAMENTON SALUT PUPBLEKO YAN SETBISION SUSIAT

LOURDES A. LEON GUERRERO ARTHUR U. SAN AGUSTIN, MHR

GOVERNOR, MAGA’HÅGA’ DIRECTOR

JOSHUA F. TENORIO LAURENT SF DUENAS, MPH, BSN

DEPUTY DIRECTOR
LT. GOVERNOR, SIGUNDO MAGA’LÅHI
TERRY G. AGUON
DEPUTY DIRECTOR

PRESS RELEASE PR23-13

February 2, 2023

HEALTH ADVISORY FOR HAND, FOOT AND MOUTH DISEASE (HFMD)

The Department of Public Health and Social Services (DPHSS) has received reports from
Department of Education (DOE) school officials and healthcare providers of an increase in cases
for Hand, Food and Mouth Disease (HFMD) in the past several weeks. There have been 42
cases reported in January 2023 (as of February 1st) including fifteen (15) confirmed and twenty-
seven (27) suspected cases of HFMD. All cases are among children of elementary school age or
younger. HFMD is a highly contagious viral infection common in children under the age of 10
years and is often spread in day care centers. Infection in older children and adults can also occur
and is usually asymptomatic. HFMD is not a reportable illness, but due to the increased number
of reported cases, the DPHSS is issuing this advisory.

HOW IT SPREADS:
• Contact with respiratory droplets containing virus particles after a sick person coughs or
sneezes.
• Touching an infected person or making other close contact, like kissing, hugging, or
sharing cups or eating utensils.
• Touching an infected person’s feces, such as changing diapers, then touching your eyes,
nose, or mouth.
• Touching objects and surfaces that have the virus on them, like doorknobs or toys, then
touching your eyes, nose, or mouth.

SIGNS AND SYMPTOMS:

The first symptoms of HFMD are usually fever, sore throat, and loss of appetite. Other
symptoms include feeling unwell, painful sores usually developed in the mouth (small red spots
often a blister or ulcer), red rash on palm of the hands, feet, or buttocks and maybe itchy. HFMD
symptoms are usually mild and go away on their own in 7 to 10 days.

TREATMENT AND PREVENTION:

There is no specific medicine to treat HFMD. For dehydrated patients, implement supportive
treatment with correction of fluid and electrolyte deficits. Some cases may have difficulty
swallowing due to painful mouth sores. There is no vaccine to protect against HFMD, but you
and your children can lower your risk of becoming sick (or of spreading the infection if already
sick) by observing the following preventive measures:

Department of Public Health & Social Services

155 Hesler Place, Hagatna, Guam 96910
www.dphss.guam.gov
 DPHSS Press Release No. 23-13
Health Advisory for HFMD
Page 2 of 2
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• Always clean hands with soap and water after using the toilet or handling diapers and
other stool-soiled materials.
• Do not share towels or wash cloths, especially at nurseries and other facilities for infants.
• Cover nose and mouth while sneezing or coughing and dispose of nasal and oral
discharges properly.
• Clean shared children's toys and other objects thoroughly and frequently with diluted
household bleach (approximately 1 part Clorox to 10 parts water). Allow to set for a few
minutes and then rinse with clean water or wipe dry with a clean cloth. Regular
disinfectants can also be used instead of Clorox.
• Avoid taking children to overcrowded places if they are sick; avoid exposing young
children to crowds, especially when childhood diseases are prevalent in the community.
• Avoid close contact such as kissing, hugging, or sharing eating utensils or cups with
people who may be sick or have been exposed to sick children.
• Children who are ill should be kept out of school or day care centers until their fever and
rash have subsided and any blisters have dried and become crusted.

If you should experience any of these signs and symptoms, see your healthcare provider for more
information.

For more information on HFMD, refer to the Centers for Disease Control and Prevention (CDC),
see https://www.cdc.gov/hand-foot-mouth/index.html.

To report confirmed or suspected cases of HFMD, please submit morbidity report to DPHSS at
dphss.surveillance@dphss.guam.gov. If you should have any questions regarding this advisory,
please call DPHSS Epidemiology and Laboratory Capacity Program at 671-300-6206.

ROBERT LEON GUERRERO, MD

CHIEF MEDICAL OFFICER

CONCURRED BY:

ARTHUR U. SAN AGUSTIN, MHR

DIRECTOR