Hand, Foot and Mouth Disease

Alternative Name: Coxsackievirus infection

Definition:
Hand-foot-mouth disease is a relatively common infection viral infection that usually begins in the throat.

A similar infection is herpangina.

Many people panic when they’re told they have hand, foot and mouth disease. They think they’ve got the infection that affects cattle, sheep and pigs, but the animal infection is called foot-and-mouth disease and is completely unrelated.

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It is a mild, contagious viral infection common in young children. Characterized by sores in the mouth and a rash on the hands and feet, hand-foot-and-mouth disease is most commonly caused by a coxsackievirus.

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There’s no specific treatment for hand-foot-and-mouth disease. You can reduce your risk of infection from hand-foot-and-mouth disease by practicing good hygiene, such as washing your hands often and thoroughly

Symptoms:
Hand-foot-and-mouth disease may cause all of the following signs and symptoms or just some of them. They include:

*Feeling of being unwell (malaise)
*Painful, red, blister-like lesions on the tongue, gums and inside of the cheeks
*A red, nonitchy, possibly blistery rash on palms of the hands and soles of the feet, and sometimes the buttocks
*Irritability in infants and toddlers
*Fever
*Headache
*Loss of appetite
*Rash with very small blisters on hands, feet, and diaper area; may be tender or painful if pressed
*Sore throat
*Ulcers in the throat (including tonsils), mouth, and tongue

The usual period from initial infection to the onset of signs and symptoms (incubation period) is three to seven days. A fever is often the first sign of hand-foot-and-mouth disease, followed by a sore throat and sometimes a poor appetite and malaise. One or two days after the fever begins, painful sores may develop in the mouth or throat. A rash on the hands and feet and possibly on the buttocks can follow within one or two days.

Causes:
Hand-foot-and-mouth disease (HFMD) is most commonly caused by coxsackievirus A16, a member of the enterovirus family.

The disease is not spread from pets, but it can be spread by person to person. You may cacth it if you come into direct contact with nose and throat discharges, saliva, fluid from blisters, or the stools of an infected person. You are most contagious the first week you have the disease.

The time between infection and the development of symptoms is about 3 – 7 days.

Oral ingestion is the main source of coxsackievirus infection and hand-foot-and-mouth disease. The illness spreads by person-to-person contact with nose and throat discharges, saliva, fluid from blisters, or the stool of someone with the infection. The virus can also spread through a mist of fluid sprayed into the air when someone coughs or sneezes.

Hand-foot-and-mouth disease is most common in children in child care settings because of frequent diaper changes and potty training, and because little children often put their hands in their mouths.

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Although your child is most contagious with hand-foot-and-mouth disease during the first week of the illness, the virus can remain in his or her body for weeks after the signs and symptoms are gone. That means your child still can infect others.

Some people, particularly adults, can pass the virus without showing any signs or symptoms of the disease.

Outbreaks of the disease are more common in summer and autumn in the United States and other temperate climates. In tropical climates, outbreaks occur year-round.

Risk Factors:
The most important risk factor is age. The infection occurs most often in children under age 10, but can be seen in adolescents and occasionally adults.

Children in child care centers are especially susceptible to outbreaks of hand-foot-and-mouth disease because the infection spreads by person-to-person contact, and young children are the most susceptible.

Children usually develop immunity to hand-foot-and-mouth disease as they get older by building antibodies after exposure to the virus that causes the disease. However, it’s possible for adolescents and adults to get the disease

Diagnosis:
A history of recent illness and a physical examination, demonstrating the characteristic vesicles on the hands and feet, are usually sufficient to diagnose the disease.

However the doctor will likely be able to distinguish hand-foot-and-mouth disease from other types of viral infections by evaluating:

*The age of the affected person
*The pattern of signs and symptoms
*The appearance of the rash or sores
*A throat swab or stool specimen may be taken and sent to the laboratory to determine which virus caused the illness.(this test may not always needed)

Treatment:
There is no specific treatment for the infection other than relief of symptoms.Most people need no specific medical treatment and are better within a week or so. Complications are rare, but occasionally it can lead to mild viral meningitis.

Treatment with antibiotics is not effective, and is not indicated. Over-the-counter medicines, such as Tylenol (acetaminophen) can be used to treat fever. Aspirin is no longer recommended for children under 16, because of a possible link with a serious problem called Reye’s syndrome.

Salt water mouth rinses (1/2 teaspoon of salt to 1 glass of warm water) may be soothing if the child is able to rinse without swallowing. Make sure your child gets plenty of fluids. Extra fluid is needed when a fever is present. The best fluids are cold milk products. Many children refuse juices and sodas because their acid content causes burning pain in the ulcers.

You can also try giving them soft cold foods such as yoghurt or ice cream, and plenty of cold drinks, to ease the discomfort of a soft mouth.

Children are sometimes excluded from nursery or school during the first few days of the illness in an attempt to prevent it spreading, but this can be difficult as the viruses that cause it are widespread in the community.

Prognosis: Generally, complete recovery occurs in 5 to 7 days.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://www.bbc.co.uk/health/physical_health/conditions/handfootmouth.shtml
http://www.mayoclinic.com/health/hand-foot-and-mouth-disease/DS00599
http://healthtools.aarp.org/adamcontent/hand-foot-mouth-disease?CMP=KNC-360I-GOOGLE-HEA&HBX_PK=hand_foot_mouth_disease&utm_source=Google&utm_medium=cpc&utm_term=hand%2Bfoot%2Bmouth%2Bdisease&utm_campaign=G_Diseases%2Band%2BConditions&360cid=SI_148905163_5812331101_1

http://www.hpb.gov.sg/health_articles/hfmd/

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