Hand-foot-and-mouth disease (HFMD)

Overview

Hand-foot-and-mouth disease (HFMD) is a common, mild viral infection primarily affecting young children, although it can occur in individuals of any age. Characterized by sores in the mouth and a distinctive rash on the hands and feet, this infection is most frequently caused by the coxsackievirus, a member of the enterovirus family. The disease is highly contagious, spreading through close contact with infected individuals or contaminated surfaces. Despite its prevalence, HFMD generally resolves on its own within a week or two, and severe complications are rare. Understanding the symptoms, causes, and preventive measures can help manage and reduce the spread of HFMD.

Types of Hand-foot-and-mouth disease (HFMD)

HFMD is primarily caused by two types of viruses:

1. Coxsackievirus A16: This is the most common cause of HFMD and is typically associated with the classic symptoms of the disease, including mouth sores and a rash on the hands and feet.
2. Enterovirus 71 (EV71): Although less common, this virus can also cause HFMD. It is associated with more severe symptoms and complications in some cases.

Both types of viruses spread through fecal-oral routes, respiratory droplets, and contaminated surfaces, leading to outbreaks in community settings such as schools and daycare centers.

Causes of Hand-foot-and-mouth disease (HFMD)

HFMD is caused by viruses belonging to the enterovirus family. The primary causative agents include:

1. Coxsackievirus A16: This virus is the most prevalent cause of HFMD. It leads to the characteristic symptoms of the disease, including mouth sores and rashes.
2. Enterovirus 71 (EV71): This virus is less common but can cause more severe cases of HFMD. It is also associated with neurological complications in some instances.
3. Coxsackievirus A6 and A10: These less common strains can also cause HFMD and are sometimes linked to more severe symptoms or atypical rashes.
4. Other Enteroviruses: Various other enteroviruses can cause HFMD, though they are less frequently reported.

The viruses responsible for HFMD spread through direct contact with an infected person’s secretions or by touching contaminated surfaces.

Risk Factors of Hand-foot-and-mouth disease (HFMD)

Several factors can increase the likelihood of contracting HFMD:

1. Age: Children under 5 years old are at the highest risk due to their developing immune systems and close contact in communal settings.
2. Close Contact Settings: Children attending daycare centers, preschools, or schools are more likely to contract and spread the virus.
3. Weakened Immune System: Individuals with compromised immune systems may be more susceptible to infection and experience more severe symptoms.
4. Poor Hygiene Practices: Inadequate hand-washing and improper sanitation can increase the risk of spreading HFMD.

Symptoms of Hand-foot-and-mouth disease (HFMD)

Preventions of Hand-foot-and-mouth disease (HFMD)

Preventive measures are crucial in reducing the spread of HFMD:

1. Frequent Hand-Washing: Regular hand-washing with soap and water, especially after using the toilet and before eating, helps prevent virus transmission.
2. Avoid Close Contact: Keep children away from others who are infected with HFMD to minimize the risk of spreading the disease.
3. Disinfect Contaminated Surfaces: Clean and disinfect frequently-touched surfaces and objects, such as toys and doorknobs, to reduce the risk of spreading the virus.
4. Avoid Sharing Personal Items: Do not share utensils, towels, or other personal items with infected individuals.
5. Stay Home When Sick: Children with HFMD should remain at home until their fever is gone and their mouth sores and rashes have healed to prevent spreading the infection to others.

Diagnosis of Hand-foot-and-mouth disease (HFMD)

Diagnosing HFMD involves a combination of clinical evaluation and laboratory tests:

1. Medical History and Physical Examination: A healthcare provider will assess symptoms, such as the presence of mouth sores and rash, and inquire about recent exposure to infected individuals.
2. Laboratory Tests: Diagnostic tests, including throat swabs, stool samples, or blood tests, can identify the specific virus causing the infection.
3. Imaging Tests: In rare cases, imaging tests may be used to rule out other conditions if complications are suspected.

Evaluation

Evaluation of HFMD involves assessing the severity of symptoms and ruling out other potential causes of similar symptoms. This includes:

1. Symptom Assessment: Evaluating the intensity and duration of symptoms such as fever, rash, and mouth sores.
2. Clinical Examination: Performing a thorough physical examination to confirm the presence of HFMD-related symptoms and rule out other infections.
3. Follow-Up: Monitoring the progress of the disease and ensuring that symptoms resolve without complications.

Treatment for Hand-foot-and-mouth disease (HFMD)

There is no specific antiviral treatment for HFMD. Management focuses on relieving symptoms and supporting recovery:

1. Pain Relief: Over-the-counter pain relievers, such as acetaminophen or ibuprofen, can help alleviate fever and discomfort from mouth sores.
2. Hydration: Ensuring adequate fluid intake is crucial, especially if the child has a reduced appetite. Oral rehydration solutions may be used if necessary.
3. Soft Foods: Offering soft, bland foods can reduce discomfort while eating. Avoid spicy, acidic, or rough foods that may irritate mouth sores.
4. Topical Treatments: Applying topical ointments or gels to mouth sores can provide temporary relief from pain.

When to seek medical attention ?

Consult a healthcare provider if:

1. High Fever Persists: If the child has a high fever that does not improve with over-the-counter medications.
2. Severe Symptoms Develop: If symptoms such as severe headache, neck stiffness, or signs of dehydration occur.
3. Complications Arise: If there are concerns about possible complications like persistent vomiting or unusual drowsiness.