Enterovirus 71 (EV71) is a single-stranded RNA virus and is one of the causative agents for hand, foot and mouth disease (HFMD). The disease 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 is usually found among young children. It commonly presents with symptoms of HFMD, characterised by fever, sores in the mouth, and a rash with blisters. It usually begins with fever, poor appetite, tiredness and sore throat. One or two days after fever onset, painful sores develop in the mouth. They begin as small red spots with blister and then often become ulcers. They are usually located on the tongue, gum, and inside of the cheeks. There may also be skin rash that is non-itchy and, some with blisters. The rash is usually located on the palms of the hands and soles of the feet; it may also appear on the buttocks and/or genitalia. A person with HFMD may not have symptoms, or may have only the rash or only 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 illness 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. Some symptomatic treatments can relieve fever and pain from the ulcers. In most cases, the illness is self-limiting. Symptoms including fever, rash and ulcers subside in 1 week. Parents should pay attention to the health of their children and seek medical advice immediately if their children having HFMD developing the following symptoms:
Infected children are advised to refrain from schools or group activities such as parties, interest classes, 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 is not available at the moment. Good personal and environmental hygiene are the most important measures to prevent EV71 infection. While in Hong Kong or during travel, members of the public are advised to:
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