Hand foot mouth disease

Hand, foot and mouth disease
Not to be confused with Foot-and-mouth disease.

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 (EV-71).

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 less common in adults, 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 separate disease affecting sheep, cattle, and swine (both are caused by members of the picornaviridae family, but are not trans-communicable between humans and livestock).

Symptoms of HFMD include

Fever
Headache
Fatigue
Malaise
Referred ear pain
Sore throat
Painful oral, nasal, or facial lesions, ulcers or blisters
Body rash, followed by sores with blisters on palms of hand, soles of feet, and sometimes on the lips. The rash is rarely itchy for children, but can be extremely itchy for adults
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 often 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 or throat, or both. A rash may become evident on the hands, feet, mouth, tongue, inside of the cheeks, and occasionally the buttocks (but generally, the rash on the buttocks will be caused by the diarrhea).

Treatment

There is no specific treatment for hand, foot and mouth disease. Individual symptoms, such as fever and pain from the sores, may be eased with the use of analgesics. HFMD is a viral disease that has to run its course; many doctors do not prescribe medicine for this illness. Infection in older children, adolescents, and adults is typically mild and lasts approximately 1 week, occasionally longer. Fever reducers and luke-warm baths can help bring temperature down.

Only a very small minority of sufferers require hospital admission, mainly as a result of uncommon neurological complications (encephalitis, meningitis, or acute flaccid paralysis) or pulmonary edema/pulmonary hemorrhage.

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.
Other more serious diseases, such as encephalitis (swelling of the brain), a polio-like paralysis, result even more rarely. Encephalitis can be fatal.
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.[4]