Hand, foot and mouth disease

Hand, foot and mouth disease
Not to be confused with Foot-and-mouth disease.
Hand, foot and mouth disease
Classification and external resources

Typical lesions around the mouth of an 11 month old male
ICD-10 B08.4
ICD-9 074.3
DiseasesDB 5622
MedlinePlus 000965
eMedicine derm/175
MeSH D006232

Hand, foot and mouth disease (HFMD) is a human syndrome caused by intestinal viruses of the Picornaviridae family. The most common strains causing HFMD are Coxsackie A virus and Enterovirus 71 (EV-71).[1]

HFMD usually affects infants and children, and is quite common. It is moderately contagious and is spread through direct contact with the mucus, saliva, or feces of an infected person. It typically occurs in small epidemics in nursery schools or kindergartens, usually during the summer and autumn months. The usual incubation period is 3–7 days.

It is uncommon in adults, but those with immune deficiencies are very susceptible. HFMD is not to be confused with foot-and-mouth disease (also called hoof-and-mouth disease), which is a disease affecting sheep, cattle, and swine, and which is unrelated to HFMD (but also caused by a member of the Picornaviridae family).

Contents

Signs and symptoms

Rash on the hands.
Rash on the feet

Symptoms of HFMD include:[2]

  • Painful oral lesions
  • Non-itchy body rash, followed by sores with blisters on palms of hand and soles of feet
  • Oral ulcer
  • Sores or blisters may be present on nose and nostrils
  • Sores or blisters may be present on the buttocks of small children and infants
  • Irritability in infants and toddlers
  • Loss of appetite.
  • Diarrhea

The common incubation period (the time between infection and onset of symptoms) is from three to seven days.

Early symptoms are likely to be fever often followed by a sore throat. Loss of appetite and general malaise may also occur. Between one and two days after the onset of fever, painful sores (lesions) may appear in the mouth and/or throat. A rash may become evident on the hands, feet, mouth, tongue, inside of the cheeks, and occasionally the buttocks (but generally, the rash on the buttocks will be caused by the diarrhea.)

Treatment

There is no specific treatment for hand, foot and mouth disease. Individual symptoms, such as fever and pain from the sores, may be eased with the use of analgesics. HFMD is a viral disease that has to run its course; many doctors do not issue medicine for this illness. Infection in older children, adolescents, and adults is typically mild and lasts approximately 1 week, occasionally longer. Fever reducers and luke-warm baths can help bring temperature down.

Only a very small minority of sufferers require hospital admission, mainly as a result of uncommon neurological complications (encephalitis, meningitis, or acute flaccid paralysis) or pulmonary edema/pulmonary hemorrhage.

Complications

  • Complications from the virus infections that cause HFMD are not common, but if they do occur, medical care should be sought.
  • Viral or aseptic meningitis can rarely occur with HFMD. Viral meningitis causes fever, headache, stiff neck, or back pain. The condition is usually mild and clears without treatment; however, some patients may need to be hospitalized for a short time.
  • Other more serious diseases, such as encephalitis (swelling of the brain), a polio-like paralysis, result even more rarely. Encephalitis can be fatal.
  • There have been reports of fingernail and toenail loss occurring mostly in children within 4 weeks of their having hand, foot, and mouth disease (HFMD). At this time, it is not known whether the reported nail loss is or is not a result of the infection. However, in the reports reviewed, the nail loss has been temporary and nail growth resumed without medical treatment.

[3]

Outbreaks

1997

1998

  • In 1998, there was an outbreak in Taiwan, affecting mainly children.[5] There were 405 severe complications, and 78 children died.[6] The total number of cases in that epidemic is estimated to have been 1.5 million.[6]

2006

2007

  • The largest outbreak of HFMD in India occurred in 2007 in the eastern part of the country in West Bengal. Authors found 38 cases of HFMD in and around Kolkata.[8]

2008

  • An outbreak in China, beginning in March in Fuyang, Anhui, led to 25,000 infections, and 42 deaths, by May 13.[9][10][11][12][13][14][15] Similar outbreaks were reported in Singapore (more than 2,600 cases as of April 20, 2008),[1] Vietnam (2,300 cases, 11 deaths),[16] Mongolia (1,600 cases),[17] and Brunei (1053 cases from June–August 2008)[18]

2009

  • 17 children died in an outbreak during March and April 2009 in China's eastern Shandong Province, and 18 children died in the neighboring Henan Province.[19] Out of 115,000 reported cases in China from January to April, 773 were severe and 50 were fatal.[20]
  • In Indonesia, where the disease is often called Singaporean influenza or flu Singapura,[21] the disease was reported in the Jakarta area, starting with eight young children.[22] By late April, health agencies in Jakarta were warning community health centers and advocating preventive steps, including the use of thermal scanners in airports and avoiding travel to Singapore.[23]

2010

  • In China, an outbreak occurred in southern China's Guangxi Autonomous Region as well as Guangdong, Henan, Hebei and Shandong provinces. Until March 70,756 children were infected and 40 died from the disease.

2011

  • In Vietnam, by 04.09 the disease was reported to have claimed 98 lives with 3/4 were children under 3 years old. Although there was no official declaration of an outbreak, over 42,000 cases have been reported. Over 10,000 new cases were recorded in the second half of August alone.

[24]

References

  1. ^ a b Suhaimi, Nur Dianah (April 20, 2008). "HFMD: 1,000 cases a week is unusual, says doc". Singapore: The Sunday Times (Straits Times). pp. 1–2. 
  2. ^ "Hand, Foot and Mouth Disease: Signs & Symptoms". mayoclinic.com. The Mayo Clinic. http://www.mayoclinic.com/health/hand-foot-and-mouth-disease/DS00599/DSECTION=2. Retrieved May 5, 2008. 
  3. ^ http://www.cdc.gov/ncidod/dvrd/revb/enterovirus/hfhf.htm#10
  4. ^ a b See also reports from Sarawak Health Department http://www.sarawak.health.gov.my/hfmd.htm#INFO13
  5. ^ Centers for Disease Control and Prevention (CDC) (1998). "s among children during an outbreak of hand, foot, and mouth disease--Taiwan, Republic of China, April–July 1998". MMWR Morb. Mortal. Wkly. Rep. 47 (30): 629–32. PMID 9704628. http://www.cdc.gov/mmwr/preview/mmwrhtml/00054640.htm. 
  6. ^ a b Ho M, Chen ER, Hsu KH, et al. (1999). "An epidemic of enterovirus 71 infection in Taiwan. Taiwan Enterovirus Epidemic Working Group". N. Engl. J. Med. 341 (13): 929–35. doi:10.1056/NEJM199909233411301. PMID 10498487. http://content.nejm.org/cgi/pmidlookup?view=short&pmid=10498487&promo=ONFLNS19. 
  7. ^ "Outbreak of rare child disease in Malappuram". The Hindu (Chennai, India). November 17, 2005. http://www.hindu.com/2005/11/17/stories/2005111706880700.htm. 
  8. ^ Epidemic of hand, foot and mouth disease in west bengal, India in august 2007: a multicentric study
  9. ^ Viral epidemic maintains grip in China, with three more deaths (accessed May 15, 2008)
  10. ^ Mass intestinal virus infection kills 19 children – XinHuaNet.com (Retrieved on May 2, 2008.)
  11. ^ Mass intestinal virus infection in east China up to 2,477, kills 21 – XinHuaNet.com (Retrieved on May 2, 2008.)
  12. ^ China on alert as virus spreads
  13. ^ Spreading virus kills 28 children (Retrieved on May 7, 2008.)
  14. ^ "China virus toll continues rise". BBC News. May 5, 2008. http://news.bbc.co.uk/1/hi/world/asia-pacific/7383796.stm. Retrieved May 4, 2010. 
  15. ^ China on alert over deadly child virus (Retrieved on May 3, 2008.)
  16. ^ Viet Nam News: HFMD cases prompt tighter health screening at airport (accessed May 15, 2008)
  17. ^ EV-71 Virus Continues Dramatic Rise (accessed May 23, 2008)
  18. ^ http://www.bt.com.bn/en/home_news/2008/11/07/1_053_hfmd_cases_recorded
  19. ^ "Hand-foot-mouth disease death toll rises to 17 in East China's Shandong Province". China View. April 9, 2009. http://news.xinhuanet.com/english/2009-04/09/content_11159556.htm. Retrieved September 29, 2009. 
  20. ^ "Health Ministry: Hand-foot-mouth disease claims 50 lives this year". China View. April 10, 2009. http://news.xinhuanet.com/english/2009-04/10/content_11165126.htm. Retrieved September 29, 2009. 
  21. ^ http://www.infeksi.com/articles.php?lng=in&pg=44 (Indonesian)
  22. ^ http://www.tempo.co.id/hg/nasional/2009/04/15/brk,20090415-170465,uk.html
  23. ^ http://www.wikiberita.com/pendeteksi-suhu-panas-bandara-soekarno-hatta/22816
  24. ^ "Childhood Virus Kills 70 In Vietnam". NPR. July 29, 2011. http://www.bbc.co.uk/vietnamese/vietnam/2011/09/110908_hand_foot_mouth.shtml. Retrieved September 11, 2011. 

External links

Media related to Hand, foot and mouth disease at Wikimedia Commons

v · d · eInfectious skin disease: Viral cutaneous conditions, including viral exanthema (B00–B09, 050–059)
HSV (Herpes simplex, Herpetic whitlow, Herpes gladiatorum, Herpetic keratoconjunctivitis, Herpetic sycosis, Neonatal herpes simplex, Herpes genitalis, Herpes labialis, Eczema herpeticum, Herpetiform esophagitis) · Herpes B virus (B virus infection)
Human herpesvirus 6/Roseolovirus (Exanthema subitum, Roseola vaccinia)
Variola (Smallpox, Eczema vaccinatum, Alastrim) · MoxV (Monkeypox) · CV (Cowpox) · VV (Vaccinia, Generalized vaccinia, Progressive vaccinia)
Sealpox
Other
Yatapoxvirus: Tanapox · Yaba monkey tumor virus
Papillomaviridae
HPV (Wart/Plantar wart, Heck's disease, Genital wart (giant), Laryngeal papillomatosis, Butcher's wart, Bowenoid papulosis, Epidermodysplasia verruciformis, Verruca plana, Pigmented wart, Verrucae palmares et plantares )
BPV (Equine sarcoid)
Parvovirus B19 (Erythema infectiosum, Reticulocytopenia, Papular purpuric gloves and socks syndrome)
CAV (Hand, foot and mouth disease, Herpangina) · FMDV (Foot-and-mouth disease) · Boston exanthem disease
Ungrouped
unknown/multiple: Asymmetric periflexural exanthem of childhood · Post-vaccination follicular eruption · Lipschütz ulcer · Eruptive pseudoangiomatosis · Viral-associated trichodysplasia · Gianotti–Crosti syndrome

M: VIR

virs(prot)/clss

cutn/syst (hppv/hiva, infl/zost/zoon)/epon

drugJ(dnaa, rnaa, rtva, vacc)

M: INT, SF, LCT

anat/phys/devp

noco(i/b/d/q/u/r/p/m/k/v/f)/cong/tumr(n/e/d), sysi/epon

proc, drug (D2/3/4/5/8/11)

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Look at other dictionaries:

  • hand, foot and mouth disease — n a usu. mild contagious disease esp. of young children that is caused by an enterovirus (species Human enterovirus A, esp. serotype Human coxsackievirus A16) and is characterized by vesicular lesions in the mouth, on the hands and feet, and… …   Medical dictionary

  • Hand-foot-and-mouth disease — A viral syndrome with a rash on the hands and feet and in the mouth. The internal rash (the enanthem) consists of blisters and little ulcers that may involve not only the lining of the mouth but also the gums, palate, and tongue. The external… …   Medical dictionary

  • hand, foot and mouth disease — noun Date: 1966 a usually mild contagious disease especially of young children that is caused by an enterovirus (species Human enterovirus A, especially serotype Human coxsackievirus A16) and is characterized by vesicular lesions chiefly in the… …   New Collegiate Dictionary

  • Foot-and-mouth disease — Infobox Disease Name = Foot and mouth disease Caption = DiseasesDB = 31707 ICD10 = ICD10|B|08|8|b|00 ICD9 = ICD9|078.4 ICDO = OMIM = MedlinePlus = eMedicineSubj = eMedicineTopic = MeshID = D005536 Taxobox color = violet name = Foot and mouth… …   Wikipedia

  • Hand-foot-and-mouth syndrome — A clinical pattern consisting of a rash on the hands and feet and in the mouth due to a viral infection. The internal rash (the enanthem) consists of blisters and little ulcers that may involve not only the lining of the mouth but also the gums,… …   Medical dictionary

  • Foot-and-mouth disease — A highly infectious virus that can infect people but affects them most by infecting livestock cattle, pigs, sheep and goats. The virus is in the same family of viruses as those causing the common cold. The virus is spread by many routes by… …   Medical dictionary

  • Disease, hand-foot-and-mouth — A viral syndrome with a rash on the hands and feet and in the mouth. The internal rash (the enanthem) consists of blisters and little ulcers that may involve not only the lining of the mouth but also the gums, palate, and tongue. The external… …   Medical dictionary

  • foot-and-mouth disease — noun Date: 1862 an acute contagious febrile disease especially of cloven footed animals that is caused by serotypes of a picornavirus (species Foot and mouth disease virus of the genus Aphthovirus) and is marked by ulcerating vesicles in the… …   New Collegiate Dictionary

  • hand, foot, and mouth disease — a self limiting disease, mainly affecting young children, caused by Coxsackie virus A16. A feeling of mild illness is accompanied by mouth ulcers and blisters on the hands and feet …   Medical dictionary

  • hand, foot, and mouth disease — a self limiting disease, mainly affecting young children, caused by Coxsackie virus A16. A feeling of mild illness is accompanied by mouth ulcers and blisters on the hands and feet …   The new mediacal dictionary

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