Hand, foot and mouth disease

Hand, foot and mouth disease
Classification and external resources
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 (EV-71).^[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 uncommon 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 disease affecting sheep, cattle, and swine, and which is unrelated to HFMD (but also caused by a member of the Picornaviridae family).

Contents 1 Signs and symptoms 2 Treatment 3 Complications 4 Outbreaks 4.1 1997 4.2 1998 4.3 2006 4.4 2007 4.5 2008 4.6 2009 4.7 2010 4.8 2011 5 References 6 External links

Signs and symptoms

Symptoms of HFMD include:^[2]

• Fever
• Headache
• Vomiting
• Fatigue
• Malaise
• Referred ear pain
• Sore throat

• Painful oral lesions
• Non-itchy body rash, followed by sores with blisters on palms of hand and soles of feet
• Oral ulcer
• Sores or blisters may be present on nose and nostrils
• 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 and/or throat. 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.

^[3]

Outbreaks

1997

• In 1997, 31 children died in an outbreak in the Malaysian state of Sarawak.^[4]

1998

• In 1998, there was an outbreak in Taiwan, affecting mainly children.^[5] There were 405 severe complications, and 78 children died.^[6] The total number of cases in that epidemic is estimated to have been 1.5 million.^[6]

2006

• In 2006, an outbreak in Kuching, Sarawak (according to the New Straits Times, March 14).^[4]
• In 2006, after an outbreak of Chikungunya in southern and some western parts of India, cases of HFMD were reported. ^[7]

2007

• The largest outbreak of HFMD in India occurred in 2007 in the eastern part of the country in West Bengal. Authors found 38 cases of HFMD in and around Kolkata.^[8]

2008

• An outbreak in China, beginning in March in Fuyang, Anhui, led to 25,000 infections, and 42 deaths, by May 13.^{[9][10][11][12][13][14][15]} Similar outbreaks were reported in Singapore (more than 2,600 cases as of April 20, 2008),^[1] Vietnam (2,300 cases, 11 deaths),^[16] Mongolia (1,600 cases),^[17] and Brunei (1053 cases from June–August 2008)^[18]

2009

• 17 children died in an outbreak during March and April 2009 in China's eastern Shandong Province, and 18 children died in the neighboring Henan Province.^[19] Out of 115,000 reported cases in China from January to April, 773 were severe and 50 were fatal.^[20]

• In Indonesia, where the disease is often called Singaporean influenza or flu Singapura,^[21] the disease was reported in the Jakarta area, starting with eight young children.^[22] By late April, health agencies in Jakarta were warning community health centers and advocating preventive steps, including the use of thermal scanners in airports and avoiding travel to Singapore.^[23]

2010

• In China, an outbreak occurred in southern China's Guangxi Autonomous Region as well as Guangdong, Henan, Hebei and Shandong provinces. Until March 70,756 children were infected and 40 died from the disease. By June, the peak season for the disease, 537 have died ^[24]

2011

• In Vietnam, by 04.09 the disease was reported to have claimed 98 lives, 75% of whom were children under 3 years old. Although there was no official declaration of an outbreak, over 42,000 cases have been reported. Over 10,000 new cases were recorded in the second half of August alone.

^[25]

• The World Health Organizationreporting between January to October of 2011 (1,340,259) states the number of cases in China has dropped by approx, 300,000 from 2010's (1,654, 866) cases. With new cases peaking in June. 437 deaths down from 2010 (537 deaths) ^[26][27]

References

External links

Media related to [//commons.wikimedia.org/wiki/Category:Hand,_foot_and_mouth_disease Hand, foot and mouth disease] at Wikimedia Commons

• News related to Highly contagious Hand, foot and mouth disease killing China's children at Wikinews

Infectious skin disease: Viral cutaneous conditions, including viral exanthema (B00–B09, 050–059) DNA virus Herpesviridae Alpha HSV (Herpes simplex, Herpetic whitlow, Herpes gladiatorum, Herpetic keratoconjunctivitis, Herpetic sycosis, Neonatal herpes simplex, Herpes genitalis, Herpes labialis, Eczema herpeticum, Herpetiform esophagitis) · Herpes B virus (B virus infection) VZV (Chickenpox, Herpes zoster, Herpes zoster oticus, Ophthalmic zoster, Disseminated herpes zoster, Zoster-associated pain, Inflammatory skin lesions following zoster infection, Modified varicella-like syndrome) Beta Human herpesvirus 6/Roseolovirus (Exanthema subitum, Roseola vaccinia) Cytomegalic inclusion disease Gamma KSHV (Kaposi's sarcoma) Poxviridae Ortho Variola (Smallpox, Eczema vaccinatum, Alastrim) · MoxV (Monkeypox) · CV (Cowpox) · VV (Vaccinia, Generalized vaccinia, Progressive vaccinia) Buffalopox Para Farmyard pox: Milker's nodule · Bovine papular stomatitis · Pseudocowpox · Orf Sealpox Other Yatapoxvirus: Tanapox · Yaba monkey tumor virus MCV (Molluscum contagiosum) Papillomaviridae HPV (Wart/Plantar wart, Heck's disease, Genital wart (giant), Laryngeal papillomatosis, Butcher's wart, Bowenoid papulosis, Epidermodysplasia verruciformis, Verruca plana, Pigmented wart, Verrucae palmares et plantares ) BPV (Equine sarcoid) Parvoviridae Parvovirus B19 (Erythema infectiosum, Reticulocytopenia, Papular purpuric gloves and socks syndrome) RNA virus Paramyxoviridae MeV (Measles) Togaviridae Rubella virus (Rubella, Congenital rubella syndrome) · Alphavirus infection · Chikungunya fever Picornaviridae CAV (Hand, foot and mouth disease, Herpangina) · FMDV (Foot-and-mouth disease) · Boston exanthem disease Ungrouped unknown/multiple: Asymmetric periflexural exanthem of childhood · Post-vaccination follicular eruption · Lipschütz ulcer · Eruptive pseudoangiomatosis · Viral-associated trichodysplasia · Gianotti–Crosti syndrome M: VIR virs(prot)/clss cutn/syst (hppv/hiva, infl/zost/zoon)/epon drugJ(dnaa, rnaa, rtva, vacc) M: INT, SF, LCT anat/phys/devp noco(i/b/d/q/u/r/p/m/k/v/f)/cong/tumr(n/e/d), sysi/epon proc, drug (D2/3/4/5/8/11)