Viruses and other infections affect young children more often than adults, as their immune systems are still developing and maturing. One such type of infection is the hand-foot-and-mouth disease.
This is a contagious infection which, when breaks out, can cause an epidemic. The most common victims are young children in day care facilities or school.
Outbreaks may be so severe they can lead to precautionary school closures. It is then one of the most closely monitored children's diseases at the Child’s Health Institute at Samitivej Hospital.
Hand-foot-and-mouth disease is a common infectious illness in infants and children. It is characterized by a mild fever, painful sores in the mouth, and rashes with blisters.
The illness generally begins with fever, accompanied by poor appetite, the feeling of being unwell and, usually, a sore throat. These may cause infected infants and toddlers to be irritable.
One or two days after the onset of fever, characteristic painful sores develop in and around the mouth.
They begin as small red spots that blister and then often become ulcers on the tongue, gums and the inside of the cheeks.
The skin rash starts out as flat, red spots that may turn into blisters also appear after one or two days.
The rash does not itch, and usually appears on the palms of the hands and soles of the feet.
It may also be seen on the buttocks. Not all symptoms will be present in all cases; an infected person may only have the rashes or the mouth sores.
What causes hand-foot-mouth disease?
This disease is caused by viruses that belong to the enterovirus group. The group includes polioviruses, coxsackieviruses, echoviruses, and enteroviruses.
Coxsackie A16 is the viral strain that most commonly causes hand-foot-and-mouth disease.
However, there have been reports of the isolation of the enterovirus 71 strain in some outbreaks of the disease.
Hand-foot-and-mouth disease should not be confused with foot-and-mouth disease of cattle, sheep, and swine. Although the names are similar, these two diseases are not related at all and are caused by different viruses.
How is it transferred from one person to another?
This disease can be highly contagious as it is spread through direct contact with the mucus, saliva, fluid from blisters or feces of an infected person.
The use of unwashed, virus-contaminated hands especially in children may facilitate the spread of the infectious virus. A person is most contagious during the first week of the illness.
However, despite the disappearance of the symptoms, the virus may remain dormant in the infected person’s body for weeks.
A previously infected child may thus become a carrier and may continually be the source of infection for other children, spreading the virus, even if he or she already appears well.
It typically occurs in localized outbreaks in nursery schools or kindergartens. The virus cannot be transmitted from pets or other animals.
Who is most at risk?
Children younger than 10 years of age most frequently suffer the disease though there have been reported occasional cases in adolescents and adults.
Children are more likely to become infected as they have yet to develop antibodies against the viruses causing hand-foot-and-mouth disease.
Not all persons infected manifest notable symptoms of the disease. Some may not present symptoms, yet remain able to transmit the virus to others.
Though a person develops immunity after being infected, he may contract the infection again
because there are other strains of the virus.
What is the treatment?
There is no specific treatment for hand-foot-and-mouth disease. Treatment is given to provide relief from symptoms such as fever, aches, or pain from the mouth ulcers. Antibiotics are not helpful since it is caused by virus.
You can reduce your risk of infection by practicing good hygiene and washing your hands often and thoroughly.
Is it dangerous?
Hand-foot-mouth disease caused by coxsackievirus A16 infection is a mild disease and nearly all patients recover within seven to 10 days. Complications are uncommon.
Rarely, the patient with coxsackievirus A16 infection may develop viral meningitis while those with enterovirus 71 may develop viral meningitis and more serious diseases such as encephalitis.
Dr. Nuthaitip Kashemsri
Na Aydhaya, M.D., is from Samitivej Sukhumvit Hospital.
She is a diplomate of the Thai Board of Paediatrics and the Thai Board of Family Medicine.
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