What is hand, foot, and mouth
Hand, foot, and mouth disease (HFMD) is a common illness of infants
and children caused by a virus. It most often occurs in children
under 10 years old. It is characterized by fever, sores/ulcers in
the mouth, and a rash with blisters. The blisters may appear in the
mouth, palms of the hands and soles of the feet. The rashes may also
appear on buttocks and on the legs and arms. The ulcers in the mouth
usually appear on the tongue, the sides of the cheeks, gums or near
What causes HFMD?
The most common causes of Hand, Foot and Mouth disease are coxsackie
virus A16, enterovirus 71 (EV71) and other enteroviruses. The
enterovirus group includes polioviruses, coxsackieviruses,
echoviruses and other enteroviruses.
When and where does HFMD occur?
Individual cases and outbreaks of HFMD occur worldwide, more
frequently in summer and early autumn (in temperate countries). In
the recent past, major outbreaks of HFMD attributable to enterovirus
EV71 have been reported in Malaysia in 1997 and in Taiwan in 1998.
HFMD is endemic in Malaysia and occurs every year. In Sarawak, the
number of cases of HFMD tends to increase from February to June.
Is HFMD serious?
HFMD caused by coxsackie virus A16 infection is a mild disease and
nearly all patients recover within 7 to 10 days. Complications are
uncommon. HFMD caused by Enterovirus EV71 may be associated with
neurological complications such as aseptic meningitis and
encephalitis. Cases of fatal encephalitis which occurred during
outbreaks of HFMD in Malaysia in 1997 and in Taiwan in 1998 were
caused by EV71.
Is HFMD contagious?
Yes, HFMD is moderately contagious. A person is most contagious
during the first week of the illness. The virus can be transmitted
from person to person via direct contact with nose and throat
discharges, saliva, fluid from blisters, or the stool of infected
persons. The virus may continue to be excreted in the stools of
infected persons up till 1 month. HFMD is not transmitted to or from
pets or other animals.
How soon will someone become ill after getting infected?
The usual period from infection to onset of symptoms (incubation
period) is 3 to 7 days. Fever is often the first symptom of HFMD
followed by blister/rash.
Blister on the palms on the hand, foot
and ulcer on the inner gums
What are the clinical signs and
HFMD begins with a mild fever, poor appetite, malaise ("feeling
sick"), and frequently a sore throat. One or 2 days after the fever
begins, painful sores develop in the mouth. They begin as small red
spots that blister and then often become ulcers. They are usually
located on the tongue, gums, and inside of the cheeks. The skin rash
develops over 1 to 2 days with flat or raised red spots, some with
blisters on the palms of the hand and the soles of the feet. A
person with HFMD may have only the rash or the mouth ulcers.
How is hand, foot and mouth
Hand, foot and mouth disease is usually diagnosed based on a
complete history and physical examination of your child. It is
generally suspected on the appearance of blister-like rash on hands,
feet and mouth in children with a mild febrile illness.
Usually, the doctor can distinguish between HFMD and other causes of
mouth sores based on the age of the patient, the pattern of symptoms
reported by the patient or parent, and the appearance of the rash
and sores on examination. A throat and/or blister swab collected
preferably within 2 days of onset of HFMD may be sent to a
laboratory to determine which enterovirus caused the illness.
How is HFMD treated?
Presently, there is no specific effective antivirul drugs and
vaccine available for the treatment of HFMD. Symptomatic treatment
is given to provide relief from fever, aches, or pain from the mouth
ulcers. Dehydration is a concern because the mouth sores may make it
difficult and painful for children to eat and drink. Should their
affected children be having fever, the parents are advised to dress
their children in light, thin clothing, to do tepid sponging with
water (room temperature) as often as necessary, and to expose them
under the fan. Taking enough liquids is very important apart from
body temperature monitoring.
Who is at risk for HFMD?
HFMD occurs mainly in children under 10 years old, but may also
occur in adults too. Everyone is at risk of infection, but not
everyone who is infected becomes ill. Infants, children, and
adolescents are more likely to be susceptible to infection and
illness from these viruses, because they are less likely than adults
to have antibodies and be immune from previous exposures to them.
Infection results in immunity to the specific virus, but a second
episode may occur following infection with a different virus
belonging to the enterovirus group
Can HFMD be prevented?
Specific prevention for HFMD or other non-polio enterovirus
infections is not available, but the risk of infection can be
lowered by good hygienic practices. Preventive measures include:
hand washing, especially after diaper changes, after using
toilet and before preparing food
cleanliness of house, child care center, kindergartens or
schools and its surrounding
of contaminated surfaces and soiled items with soap and water,
and then disinfecting them with diluted solution of
chlorine-containing bleach (10% concentration)
are advised not to bring young children to crowded public places
such as shopping centers, cinemas, swimming pools, markets or
children to the nearest clinic if they show signs and symptoms.
Refrain from sending them to child care centers, kindergartens
of close contact (kissing, hugging, sharing utensils, etc.) with
children having HFMD illness to reduce of the risk of infection.
consult a physician regarding health problems or medical conditions
Other health related articles:
Dengue Fever info,
symptoms, transmission prevention, treatment in Malaysia
Chikungunya fever, symptoms and the prevention
Bird/Avian Flu information and facts
Services in Malaysia for Expatriates
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