Facts on Hand, Foot And Mouth Disease

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Here is yet another reason to encourage kids to wash their hands: it can help prevent hand, foot and mouth disease.

Overview

Hand, foot, and mouth disease (HFMD) is a common viral illness of infants and children. The disease causes fever and blister-like eruptions in the mouth and/or a skin rash. There are seasonal variations of this condition and as summer approaches we can expect and have been seeing an increase in the number of cases in Barbados.??

Cause

  • HFMD is caused by viruses that belong to the enterovirus genus (group). This group of viruses includes polioviruses, coxsackieviruses, echoviruses, and enteroviruses.
  • Coxsackievirus A16 is the most common cause of HFMD, but other coxsackieviruses have been associated with the illness.
  • Enteroviruses, including enterovirus 71, have also been associated with HFMD and with outbreaks of the disease.

Symptoms

  • The disease usually begins with a fever, poor appetite, malaise (feeling vaguely unwell), and often with a sore throat.
  • One or 2 days after fever onset, painful sores usually develop in the mouth. They begin as small red spots that blister and then often become ulcers. The sores are usually located on the tongue, gums, and inside of the cheeks.
  • A non-itchy skin rash develops over 1-2 days. The rash has flat or raised red spots, sometimes with blisters. The rash is usually located on the palms of the hands and soles of the feet; it may also appear on the buttocks and/or genitalia.
  • A person with HFMD may have only the rash or only the mouth sores.

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Complications

  • Complications from the virus infections that cause HFMD are not common, but if they do occur, medical care should be sought.
  • Viral or "aseptic meningitis can rarely occur with HFMD. Viral meningitis causes fever, headache, stiff neck, or back pain. The condition is usually mild and clears without treatment; however, some patients may need to be hospitalized for a short time.
  • Even more rarely, diseases such as encephalitis (swelling of the brain) or a polio-like paralysis can occur. There have been reports of fingernail and toenail loss occurring mostly in children within 4 weeks of their having hand, foot, and mouth disease (HFMD). At this time, it is not known whether the reported nail loss is or is not a result of the infection. However, in the reports reviewed, the nail loss has been temporary and nail growth resumed without medical treatment.

Treatment and Medical Management

  • There is no specific treatment for HFMD. Antibiotics are not necessary.
  • Symptoms can be treated to provide relief from pain from mouth sores and from fever and aches:
    • Fever can be treated with antipyretics (drugs that reduce fevers).
    • Pain can be treated with acetaminophen, ibuprofen, or other over-the-counter pain relievers.
    • Mouthwashes or sprays that numb pain can be used to lessen mouth pain.
  • Fluid intake should be enough to prevent dehydration (lack of body fluids). If moderate-to-severe dehydration develops, it can be treated medically by giving fluids through the veins.

Prevention

  • A specific preventive for HFMD is not available, but the risk of infection can be lowered by following good hygiene practices.
  • Good hygiene practices that can lower the risk of infection include
    • Washing hands frequently and correctly (see Clean Hands Save Lives! ) and especially after changing diapers and after using the toilet
    • Cleaning dirty surfaces and soiled items, including toys, first with soap and water and then disinfecting them by cleansing with a solution of chlorine bleach (made by adding 1 tablespoon of bleach to 4 cups of water)
    • Avoiding close contact (kissing, hugging, sharing eating utensils or cups, etc.) with persons with HFMD

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Author: Ministry of Health/Centre for Disease Control
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