Hand, foot, and mouth disease: what to expect

Hand, foot, and mouth disease: what to expect

Hand, foot, and mouth disease is a childhood illness. The illness causes rashes on the feet and hands as well as painful blisters around the nose and mouth.

Hand, foot, and mouth disease (HFMD) is the result of a viral infection. The infection usually clears up on its own without medication or hospital treatment. Severe cases may require a higher level of care, however.

Outbreaks of HFMD typically occur in Asia, whereas outbreaks in the United States are fairly uncommon. There is no vaccine to prevent HFMD at present. Experts agree that avoiding close contact with infected people is the best way to avoid HFMD.

What is hand, foot, and mouth disease?

Hand, foot, and mouth disease most commonly affects children under the age of 5.

HFMD was first reported in New Zealand in 1957. Following the study of the coxsackievirus in 1958, the disease was officially named HFMD.

This contagious illness is now known to be caused by the Picornaviridae family of viruses. The coxsackievirus A16 and enterovirus 71 are the most common viruses to cause HFMD.

Children are most commonly affected by the disease, especially those under 5 years of age. HFMD clears up on its own and doesn't usually require medical intervention.

Foot and mouth disease (FMD) is commonly confused with HFMD. These two diseases are not related. FMD only affects animals like cattle, goats, and sheep, while HFMD is a human disease that typically affects infants and children. FMD is contagious among certain types of animals, but it isn't considered a public health threat.

Causes of hand, foot, and mouth disease

Viruses belonging to the enterovirus category of viruses are commonly involved in the development of HFMD. Coxsackievirus A16, as well as other coxsackieviruses, is the most common type of enterovirus to cause HFMD.

These viruses are spread by the oral and fecal route. They are usually found in the infected patient's saliva, nose mucus, feces, and blister fluid.

Common methods of transmission include:

  • Close, personal contact with an infected person
  • Contact with airborne viruses spread by coughing and sneezing
  • Touching contaminated objects
  • Direct or indirect contact with infected feces

Risk factors of hand, foot, and mouth disease

Children under 10 years of age, and especially under 5, are most at risk from HFMD. This is because many haven't yet developed the appropriate antibodies that fight the disease.

Children who are active in childcare centers or schools and have regular contact with other children have an increased risk of being infected.

Symptoms of hand, foot, and mouth disease

One of the main symptoms of hand, foot, and mouth disease is a rash with blisters on the soles of the feet.

Symptoms of HFMD usually occur around 3 to 7 days following first contact with the virus. A 24- to 48-hour fever (100°F to 102°F) or sore throat are often the first noticeable symptoms. These are followed by:

  • Rash with flat, non-itching red blisters on the hands and soles of the feet 1 to 2 days after fever
  • Loss of appetite
  • Headache
  • Throat, mouth, and tongue ulcers

Some patients won't present any symptoms at all. These patients are still capable of infecting others with the virus, however.

Complications of hand, foot, and mouth disease

Complications for HFMD are rare as the disease clears up on its own within a week or two. They can develop if the disease is left untreated in certain individuals, however.

If enterovirus 71 is the virus behind HFMD, the nervous system may be affected. The following conditions may then occur:

  • Meningitis - inflammation of the brain and spinal cord
  • Encephalitis - inflammation of the brain
  • Acute flaccid paralysis - weakening of the respiratory muscles and swallowing

A secondary infection may occur if the blisters or rash on the skin has been scratched. There is also a risk of dehydration for children who have trouble swallowing due to blisters in the throat. In severe cases, cardiorespiratory failure can occur.

Diagnosis of hand, foot, and mouth disease

The diagnosis of HFMD can usually be made by examining the disease's main signs and symptoms.

A doctor might look for sores or blisters on the feet, hands, and genitals. They may also examine other common symptoms of the disease such as fever, headache, and sore throat.

Lab studies may be necessary in some instances where a clinical diagnosis is needed. Doctors may look for related antibodies in the blood, or collect throat or stool samples for examination.

Prevention and treatment of HFMD

Disinfecting surfaces can help reduce the risk of hand, foot, and mouth disease.

There is no vaccine for the prevention of HFMD. Person-to-person contact is how HFMD spreads, but completely avoiding contact with others is not often a viable prevention method.

Some of the best methods for reducing risk include:

  • Disinfecting surfaces
  • Washing hands often with soap and hot water
  • Avoiding sharing eating utensils and drinking cups

For most otherwise healthy individuals, HFMD is a nonthreatening disease that clears up on its own within a week or two.

At present, specific treatments for HFM are nonexistent. Over-the-counter medications that relieve pain and fever may be helpful in some instances. Numbing mouthwashes or sprays may help reduce mouth pain, which can be helpful for increasing fluid and food intake.

A small number of patients may need to go to a hospital if complications develop.

Outbreaks of hand, foot, and mouth disease

Outbreaks of HFMD occur worldwide. The rate at which these outbreaks are occurring tends to be increasing in the Western Pacific region, particularly in countries like Japan and Singapore.

Enterovirus 71, a virus that plays a role in the development of nervous disorders, is often the virus behind these outbreaks.

Although HFMD can sometimes result in hospitalization and even death, most patients that develop HFMD from enterovirus present common symptoms of the disease and usually recover without complications.

Other significant outbreaks across recent history include:

  • A recent outbreak on the Princeton University campus that affected more than a dozen students in 2015.
  • A 1998 outbreak in Taiwan that resulted in the death of 78 children and approximately 405 threatening complications.
  • An outbreak in 2008 led to 30,000 infections and more than 50 deaths across China, Brunei, Mongolia, Singapore, and Vietnam.
  • Alabama reported an outbreak in 2012 during a time of the year where it is not commonly seen. No deaths were reported.

HAND, FOOT and MOUTH DISEASE | Symptoms in Children and Adults (Video Medical And Professional 2020).

Section Issues On Medicine: Medical practice