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| Hand, foot and mouth disease Classification and external resources |
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| Typical lesions around the mouth of an 11 month old male | |
| ICD-10 | B08.4 |
| ICD-9 | 074.3 |
| DiseasesDB | 5622 |
| MedlinePlus | 000965 |
| eMedicine | derm/175 |
| MeSH | D006232 |
Hand, foot and mouth disease (HFMD) is a human syndrome caused by intestinal viruses of the Picornaviridae family. The most common strains causing HFMD are Coxsackie A virus and Enterovirus 71 (EV71).[1]
HFMD usually affects infants and children, and is quite common. It is moderately contagious and is spread through direct contact with the mucus, saliva, or feces of an infected person. It typically occurs in small epidemics in nursery schools or kindergartens, usually during the summer and autumn months. The usual incubation period is 3-7 days.
It is extremely uncommon in adults; however, still a possibility. Most adults have strong enough immune systems to defeat the virus, but those with immune deficiencies are very susceptible. HFMD is not to be confused with foot-and-mouth disease (also called hoof-and-mouth disease), which is a disease affecting sheep, cattle, and swine, and which is unrelated to HFMD (but also caused by a member of the Picornaviridae family).
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Signs & Symptoms
Symptoms of HFMD include: [2]
- Fever
- Headache
- Vomiting
- Fatigue
- Malaise
- Sore throat
- Painful oral lesions
- Non-itchy body rash, followed by sores with blisters on palms of hands and soles of feet
- Oral ulcer
- Sores or blisters may be present on the buttocks of small children and infants
- Irritability in infants and toddlers
- Loss of appetite.
- Diarrhea
The common incubation period (the time between infection and onset of symptoms) is from three to seven days.
Early symptoms are likely to be fever followed by a sore throat. Loss of appetite and general malaise may also occur. Between one and two days after the onset of fever, painful sores (lesions) may appear in the mouth and/or throat. A rash may become evident on the hands, feet, and occasionally the buttocks (but generally, the rash on the buttocks will be caused from the diarrhea.) Not all symptoms will be present in all cases.
Treatment
There is no specific treatment for hand, foot and mouth disease. Individual symptoms, such as fever, lameness, and pain from the sores, may be eased with the use of medication. HFMD is a viral disease that has to run its course; many doctors do not issue medicine for this illness, unless the infection is severe. Infection in older children, adolescents, and adults is normally very mild and lasts around 1 week or sometimes more. Fever reducers will help to control high temperatures. Luke-warm baths will also help bring temperature down.
Only a very small minority of sufferers require hospital admission, mainly as a result of neurological complications (encephalitis, meningitis, or acute flaccid paralysis) or pulmonary edema/pulmonary hemorrhage.
Recorded outbreaks
- In 1997, 34 children died in an outbreak in Sarawak, Malaysia[3].
- In 1998, there was an outbreak in Taiwan, affecting mainly children.[4] There were 405 severe complications, and 78 children died.[5] The total number of cases in that epidemic is estimated to have been 1.5 million.[5]
2006
- In 2006, 7 people died in an outbreak in Kuching, Sarawak (according to the New Straits Times, March 14)]][3].
- In 2006, after an outbreak of Chikungunya in southern and some western parts of India, cases of HFMD were reported. [6]
2008
- An outbreak in China, beginning in March in Fuyang, Anhui, lead to 25,000 infections, and 42 deaths, by May 13th.[7][8][9][10][11][12][13]. Similar outbreaks were reported in Singapore (more than 2,600 cases as of April 20th, 2008)[1], Vietnam (2,300 cases, 11 deaths)[14], and Mongolia (1,600 cases)[15].
References
- ^ a b Suhaimi, Nur Dianah (April 20 2008). "HFMD: 1,000 cases a week is unusual, says doc", The Sunday Times (Straits Times), pp. pp. 1 - 2.
- ^ "Hand, Foot and Mouth Disease: Signs & Symptoms". mayoclinic.com. The Mayo Clinic. Retrieved on 2008-05-05.
- ^ a b See also reports from Sarawak Health Department http://www.sarawak.health.gov.my/hfmd.htm#INFO9
- ^ Centers for Disease Control and Prevention (CDC) (1998). "Deaths among children during an outbreak of hand, foot, and mouth disease--Taiwan, Republic of China, April-July 1998". MMWR Morb. Mortal. Wkly. Rep. 47 (30): 629–32. PMID 9704628.
- ^ a b Ho M, Chen ER, Hsu KH, et al (1999). "An epidemic of enterovirus 71 infection in Taiwan. Taiwan Enterovirus Epidemic Working Group". N. Engl. J. Med. 341 (13): 929–35. PMID 10498487.
- ^ The Hindu : Kerala News : Outbreak of rare child disease in Malappuram
- ^ Viral epidemic maintains grip in China, with three more deaths (accessed May 15th, 2008)
- ^ Mass intestinal virus infection kills 19 children -- XinHuaNet.com (Retrieved on May 2, 2008.)
- ^ Mass intestinal virus infection in east China up to 2,477, kills 21 -- XinHuaNet.com (Retrieved on May 2, 2008.)
- ^ China on alert as virus spreads
- ^ Spreading virus kills 28 children (Retrieved on May 7, 2008.)
- ^ BBC NEWS | World | Asia-Pacific | China virus toll continues rise
- ^ China on alert over deadly child virus (Retrieved on May 3, 2008.)
- ^ Viet Nam News: HFMD cases prompt tighter health screening at airport (accessed May 15th, 2008)
- ^ EV-71 Virus Continues Dramatic Rise (accessed May 23rd, 2008)
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- This page was last modified on 12 September 2008, at 16:02.
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