With Malaysia recording a spike in hand, foot and mouth disease (HFMD) cases, the Health Ministry has called on parents and pre-school operators to be more vigilant of children under their care.br br As HFMD is usually spread through saliva or nasal mucus, Health Minister Khairy Jamaluddin on Tuesday (May 17) said parents must increase the level of personal hygiene of their little ones, while operators of pre-schools and kindergartens on the other hand should regularly conduct cleaning of their premises, preferably daily after every schooling session.