Hand, foot and mouth disease (HFMD) is a common disease in children caused by enteroviruses such as coxsackieviruses and enterovirus 71 (EV71). HFMD caused by EV71 is of particular concern as it is more likely associated with severe complications (such as viral meningitis, encephalitis and poliomyelitis-like paralysis) and even death. The usual peak season for HFMD in Hong Kong is from May to July and a smaller peak may also occur from October to December.
The disease is mostly self-limiting and resolves in 7 - 10 days. It usually begins with fever, poor appetite, tiredness and sore throat. One to 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.
HFMD will result in immunity to (protection against) the specific virus that has caused the infection. However, subsequent infections with a different virus may result in further episodes of HFMD.
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 most contagious during the first week of the illness and the viruses can be found in stool for weeks.
The incubation period is about 3 - 7 days.
There is no specific drug treatment for HFMD. Patients should drink plenty of water and take adequate rest, and may receive symptomatic treatment to reduce fever and pain from oral ulcers.
Sick children should stay away from school or gatherings till all vesicles have dried up to avoid spreading the disease. If the infection is caused by EV71, the patient is advised to stay at home for two more weeks after recovery from the disease (i.e. fever and rash have subsided, and vesicles have dried and crusted).
Parents should monitor the child’s condition closely and seek medical advice immediately if there is persistent high fever, decrease in alertness or deterioration in general condition.
There is no effective vaccine to prevent HFMD. Good personal and environmental hygiene are the mainstay of prevention.
1. Maintain good personal hygiene
2. Maintain good environmental hygiene
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