Hand, foot, and mouth disease ( HFMD ) is a common infection caused by a group of viruses. It usually starts with a fever and generally feels unhealthy. This is followed a day or two later with flecks or lumps that change color that may blister, in the hands, feet, and mouth, and sometimes the buttocks and crotch. Signs and symptoms usually appear 3-6 days after exposure to the virus. The rash generally goes away by itself in about a week. Nail nails and toenails can appear several weeks later, but will grow back over time.
The virus that causes HFMD spreads through close personal contact, through air from cough, and feces from infected people. Contaminated objects can also spread the disease. Coxsackievirus A16 is the most common cause and Enterovirus 71 is the second most common cause. Other strains of coxsackievirus and enterovirus can also be responsible. Some people can carry and transmit the virus even though it has no symptoms of the disease. Other animals are not involved. Diagnosis can often be based on symptoms. Occasionally throat or stool samples can be tested for viruses.
Hand washing can prevent spreading and those who are infected should not go to work, daycare, or school. No antiviral or vaccine drugs are available, but development efforts are underway. Most cases do not require special care. Simple pain medications such as ibuprofen or numbing mouth gel can be used. Sometimes intravenous fluids are given to children who can not drink enough. Rarely meningitis or encephalitis can complicate the disease.
HFMD occurs in all regions of the world. This often happens in small outbreaks in nursery schools or kindergartens. Large epidemics have occurred in Asia since 1997. Usually occurs during spring, summer, and autumn. Usually it occurs in children younger than five years, but it can sometimes occur in adults. HFMD should not be confused with foot and mouth disease (also known as nail and mouth disease) that mostly affect livestock.
Video Hand, foot, and mouth disease
Signs and symptoms
Common HFMD common constitutional signs and symptoms include fever, nausea, vomiting, fatigue, general discomfort, loss of appetite, and irritability in infants and toddlers. The skin lesions often develop in the form of rashes of discolored spots and bumps that can be followed by vesicular sores with blisters on the palms, soles of the feet, buttocks, and occasionally on the lips. Rashes are rarely itchy for children, but can be very itchy for adults. Painful face ulcers, blisters, or lesions can also occur around the nose or mouth. HFMD usually disappears by itself after 7-10 days. Most cases of the disease are relatively harmless, but complications including encephalitis, meningitis, and paralysis that mimic neurologic symptoms of polio may occur.
Maps Hand, foot, and mouth disease
Cause
The virus that causes the disease is from the family Picornaviridae . Coxsackievirus A16 is the most common cause of HFMD. Enterovirus 71 (EV-71) is the second most common cause. Many other strains of coxsackievirus and enterovirus can also be responsible.
Transmission
HFMD is highly contagious and is transmitted through nasopharyngeal secretions such as mucus or nasal mucus, through direct contact, or through fecal-oral transmission.
Diagnosis can usually be done by showing signs and symptoms alone. If the diagnosis is unclear, throat swabs or stool specimens may be taken to identify viruses based on culture. The general incubation period (time between infection and symptom onset) ranges from three to six days. Early detection of HFMD is important in preventing outbreaks in pediatric populations.
Prevention
Preventive measures include avoiding direct contact with infected individuals (including keeping infected children home from school), cleaning equipment together, cleaning contaminated surfaces, and correct hand hygiene. These measures have been shown to be effective in reducing the transmission of viruses responsible for HFMD.
Protective habits include washing hands and cleaning surfaces in the play area. Breastfeeding has also been shown to decrease severe HFMD levels, although it does not reduce the risk of disease infection.
Vaccines
A vaccine known as the EV71 vaccine is available to prevent HFMD in China by December 2015. There is currently no vaccine available in the United States.
Treatment
Drugs are usually unnecessary because hand, foot, and mouth disease is a viral disease that usually goes away by itself. Currently, there is no specific curative treatment for hand, foot and mouth disease. Disease management usually focuses on achieving symptomatic relief. The pain of the wound can be reduced by the use of analgesic drugs. Infection in older children, adolescents, and adults is usually mild and lasts about 1 week, but can sometimes run longer. Reduced fever and lukewarm bath can help lower body temperature.
A minority of individuals with hand, foot and mouth disease may require hospitalization due to complications such as inflammation of the brain, inflammation of the meninges, or acute flaccid paralysis. Non-neurological complications such as inflammation of the heart, fluid in the lungs, or bleeding to the lungs may also occur.
Complications
Complications of viral infections that cause HFMD are rare, but require immediate medical care if any. HFMD infection caused by Enterovirus 71 tends to be more severe and is more likely to have neurological or cardiac complications including death than infection caused by Coxsackievirus A16. Viral or aseptic meningitis can occur with HFMD in rare cases and is characterized by fever, headache, stiff neck, or back pain. This condition is usually mild and cured without treatment; However, hospitalization for a short time may be necessary. Other serious complications of HFMD include encephalitis (brain swelling), or soft paralysis in rare circumstances.
Nail nails and toe nails have been reported in children 4-8 weeks after the HFMD. The relationship between HFMD and reported nail loss is unclear; however, temporary growth and nail growth without treatment.
Minor complications due to symptoms can occur such as dehydration, due to canker sores that cause discomfort with food intake and fluids.
Epidemiology
Hand, foot and mouth disease is most common in children under the age of 10. This disease tends to occur in spring, summer, and autumn. It is believed to be due to the heat and moisture increasing spread. HFMD is more common in rural areas than in urban areas, however, socioeconomic status and hygiene levels need to be considered. Poor hygiene is a risk factor for HFMD.
Outbreaks have occurred in China, Japan, Hong Kong, the Republic of Korea, Malaysia, Singapore, Thailand, Taiwan, and Vietnam. HFMD most often affects children under 10 years of age and more often under the age of 5, but can also affect adults with various symptoms.
Since 1997 there have been 71 major outbreaks of enterovirus reported, mostly in East and Southeast Asia, especially those affecting children. From 2008 to 2014, more than 1 million HFMD cases have been reported in China each year.
Outbreak
- In 1998, there was an outbreak in Taiwan, affecting mainly children. There were 405 severe complications, and 78 children died. The total number of cases in the epidemic is estimated at 1.5 million.
- In 2008 there was an outbreak in China, starting in March in Fuyang, Anhui, causing 25,000 infections, and 42 deaths, on May 13. Similar outbreaks were reported in Singapore (more than 2,600 cases on April 20, 2008), Vietnam (2,300 cases, 11 deaths), Mongolia (1,600 cases), and Brunei (1053 cases from June-August 2008)
- In 2009, 17 children died in outbreaks during March and April 2009 in eastern Shandong province of China, and 18 children died in adjacent Henan Province. Of the 115,000 cases reported in China from January to April, 773 were severe and 50 fatal.
- In 2010 in China, outbreaks occurred in China's southern Guangxi Autonomous Region as well as Guangdong, Henan, Hebei and Shandong provinces. Until March 70,756 children were infected and 40 died of disease. In June, the peak season for the disease, 537 has died.
- The World Health Organization reporting between January and October 2011 (1,340,259) stated the number of cases in China had decreased by about 300,000 from 2010 (1,654,866) cases, with new cases peaking in June. There were 437 deaths, down from 2010 (537 deaths).
- In December 2011, the California Department of Public Health identified a strong viral form, coxsackievirus A6 (CVA6), where nail loss in children is common.
- In 2012 in Alabama, the United States has an outbreak of an unusual type of disease. It happens in seasons when it is usually not seen and affected teenagers and older adults. There were several hospitalizations due to illness but no deaths were reported.
- In 2012 in Cambodia, 52 of 59 reported cases of child death (as of 9 July 2012) due to mysterious illness were diagnosed due to a malignant form of HFMD. Although a significant degree of uncertainty exists with reference to the diagnosis, the WHO report states, "Based on recent laboratory results, a significant proportion of the samples tested positive for Enterovirus 71 (EV-71), which causes hand and mouth disease (HFMD). -71 has been known to commonly cause severe complications among some patients. "
- HFMD infected 1,520,274 people with up to 431 deaths reported at the end of July 2012 in China.
History
The HFMD case was first described clinically in Canada and New Zealand in 1957. The disease was called 'Hand Foot and Mouth Disease' after a similar outbreak in 1959.
Research
New antiviral agents to prevent and treat infections with viruses responsible for HFMD are currently under development. Early studies have shown inhibitors of the EV-71 virus capsid to have strong antiviral activity.
References
External links
Media related to Hand, foot and mouth disease in Wikimedia Commons News related to the highly contagious Hands, Foot and mouth that killed Chinese children at Wikinews
Source of the article : Wikipedia
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