Help me be realistic about fomite transmission.
September 8, 2019 1:07 AM   Subscribe

My elder kid is down with HFMD, and we're trying our best to prevent him from spreading it to his sister. How extreme do we need to be about this?

To prevent direct transmission, we're keeping them as far apart as possible. Our main concern is indirect transmission.

We know that the virus (most likely Coxsackievirus A16) can spread through fomites, i.e. if he touches a toy and then she touches it, she can get the virus. And in both cases, I understand it requires that he had some of the virus on his hands (like from his saliva), and that she puts her hands into her mouth.

But is the transmission (for the lack of a better word) transitive across multiple fomites? How should we think about things being "contaminated" versus "safe"? If he touches a toy, and then that toy touches another toy, is that second toy contaminated as well? Or if he sits on the sofa, and then I sit on the sofa, and then I sit on a chair, and she climbs onto the chair? Is this like some kind of inanimate object plague that will curse me into disinfecting everything in the house every hour?

I'm guessing it's probably a probability thing, like some of the viruses on the first toy might transfer to the second if they just happen to touch at the right spot... so by the 3rd or 4th fomite the chances are probably pretty low? Is just practicing frequent hand washing generally going to be good enough? Or is this a fool's errand and whatever we do she's going to get sick anyway, so maybe we should stop stressing out over this?
posted by destrius to Health & Fitness (6 answers total)
It's probably not useful to think of the fomites as infecting each other. However, the cocksackieviris can persist on surfaces for several weeks. In addition to handwashing, you can reduce the odds of transmission by cleaning all the handles-- doors, faucets, toilet, drawers, refrigerator-- things everyone touches. If contaminated toys are washable, wash them, and if not, maybe they get to live in a box for a while.

Short of sending your child away, there's only so much you can do.
posted by zennie at 2:37 AM on September 8, 2019

I was always under the impression they were infectious before you even knew they had it so chances are the sibling has already been exposed. I think it’s a lost cause to try and prevent infection when they live together and it’s so common even if it didn’t come from elder kid, younger kid is likely to get it from someone else. It’s VERY infectious. Sorry.
posted by Jubey at 3:48 AM on September 8, 2019 [5 favorites]

FWIW as anecdata, our youngest (18 months) had it at the start of this summer and our eldest (4 years) didn't get it. Eldest is old enough to be past the putting toys in her mouth stage, so that probably helped, but they definitely were still playing with the same stuff from time to time, and interacting as usual in our relatively small apartment.

I also think I read back then that the infectious period is before sores erupt, so there's relatively little to be done once you're aware that it is HFM.
posted by protorp at 3:53 AM on September 8, 2019

Our daycare let’s kids with HFM attend (if they are otherwise well, no fever) because by the time the sores appear they’ve been infectious for a good long while. Which is to say, I hear you, but it’s probably already beyond your control.
posted by lydhre at 5:08 AM on September 8, 2019 [2 favorites]

It is beyond your control. When my kid had it at age 4 I washed hands constantly, picked up every kid thing using the cuff of my sleeve, and still I caught it. The mouth sores are brutal; I wish you luck and hope you have a different experience.
posted by Morpeth at 5:36 AM on September 8, 2019

Thanks for the replies so far! Yeah I know its kind of impossible... HFMD is somewhat endemic to where we live (Singapore), and its one of those things that happens every now and then. This is the second time my son has gotten it; my nephew contracted it 6 times!

Despite it being beyond my control though, I'm still interested in the science behind the transmission of the virus. Are there any research papers on the topic of fomite-to-fomite transmission? How exactly does the virus transfer from one surface to another? And how does water affect things, e.g. if an infected spoon gets put into a sink full of water, is everything else infected? Most of what I've found seems to be written to be easy for laypeople to interpret and execute correctly, but oftentimes this might be more stringent than is necessary?
posted by destrius at 7:08 AM on September 8, 2019 [1 favorite]

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