Enterovirus 71 (EV71) is a single-stranded RNA virus and is one of the causative agents for hand, foot and mouth disease (HFMD). EV71 infection occurs commonly in Southeast Asian areas, especially in summer and early autumn. Outbreaks have been reported in Australia, Mainland China, Malaysia, Singapore, Taiwan, etc.
EV71 infection usually affects young children. Patients commonly present with symptoms of HFMD, characterised by fever, sores in the mouth and a rash with blisters. The illness usually begins with fever, poor appetite, tiredness and sore throat. One or two days after fever onset, painful sores may develop in the mouth. They begin as small red spots with blisters and then often become ulcers. They usually appear on the tongue, gum and inside of the cheeks. There may also be a skin rash that is non-itchy and sometimes accompanied by blisters. The rash usually appears on the palms of the hands and soles of the feet and may also appear on the buttocks and/or genitalia. A person with HFMD may not have symptoms, or may only have rash or mouth ulcers. EV71 may cause more serious diseases, such as viral (aseptic) meningitis, encephalitis, poliomyelitis-like paralysis and myocarditis.
Mode of transmission
The disease mainly spreads by contact with an infected person’s nose or throat discharges, saliva, fluid from vesicles or stool, or after touching contaminated objects. The disease is contagious during the acute stage and perhaps longer, as faecal shedding of virus can continue for several weeks.
The incubation period commonly ranges from 3 - 5 days.
Currently, no specific treatment is available for EV71 infection. Symptomatic treatment can relieve fever and pain from the ulcers. In most cases, the illness is self-limiting and symptoms including fever, rash and ulcers usually subside in a week. Parents should pay attention to the health of their children and seek medical advice immediately if their children having HFMD develop the following symptoms:
Infected children are advised to refrain from schools or group activities such as parties, interest classes and swimming until 2 weeks after fever has subsided and all the vesicular lesions have dried and crusted to prevent the spread of disease. Protect other family members, especially children, from getting the infection through strict personal and environmental hygiene (see advice on prevention below).
Vaccine to prevent EV71 infection is not available in Hong Kong at the moment. Good personal and environmental hygiene are the mainstay of prevention.
1. Maintain good personal hygiene
2. Maintain good environmental hygiene
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