Hand-foot-and-mouth disease (HFMD) is caused by a group of enteroviruses, primarily enterovirus 71 (EV71) and coxsackievirus A16 and A6. The virus spreads mainly through two main routes: direct contact with gastrointestinal secretions, such as feces and oral fluids, and contact with upper respiratory secretions like saliva and nasal discharge.

Blowing on food can transmit HFMD to children, even if the adult feels healthy and exhibits no symptoms. The virus survives in the environment and on surfaces for several hours. Food contaminated with saliva becomes a source of transmission as tiny droplets from saliva attach to the child's food, introducing the virus directly into the digestive tract and increasing infection risk.

Safer methods to cool food for children include allowing it to cool naturally at room temperature, placing the food bowl in a larger bowl of cool water, or stirring it with a spoon to quickly dissipate heat.

A doctor examines a child patient during the peak of the hand-foot-and-mouth disease epidemic. *Photo: Tam Anh General Hospital*

Beyond blowing on food, other transmission risks include: kissing children, sharing utensils between adults and children, failing to wash hands before holding or feeding children, not washing hands after changing diapers or using the restroom, and touching a child's face or mouth with unwashed hands.

Discontinuing the habit of blowing on food also protects children from other illnesses, including cytomegalovirus (CMV), hepatitis A, seasonal flu, and Helicobacter pylori bacteria, which causes stomach ulcers.

Children sucking on toys, sharing towels, and putting their hands in their mouths facilitate outbreaks. The virus can survive on toys and doorknobs for several hours. Without regular disinfection, pathogens spread quickly. Even after symptoms disappear, children can shed the virus through their feces for up to one month.

Master, Doctor Le Thi Lan Anh

Deputy Head of Pediatrics

Tam Anh General Hospital Hanoi