Everything is recovering, the temperature is rising, and the season of hand, foot and mouth disease is coming. Hand, foot and mouth disease (HFMD) is a common acute infectious disease in children under 5 years of age, and there is a high risk of clustering in crowded places such as kindergartens and schools.
1. What is Hand, Foot and Mouth Disease?
Hand, foot and mouth disease (HFMD) is a common infectious disease in children caused by enterovirus infection, which is more common in children under 5 years of age. Hand, foot and mouth disease (HFMD) is a global disease that occurs throughout the continent throughout the year, mostly in summer and autumn.
2. Pathogenesis
Enteroviruses belong to the genus Enteroviruses in the family Small RNA Viridae. There are more than 20 kinds of enteroviruses that cause hand, foot and mouth disease, among which CV-A16 and EV-A71 are the most common, and most severe cases and deaths are caused by EV-A71.
3. Epidemiology
- Source of infection: Children and people with latent infection are the main sources of infection, and the rate of latent infection of hand, foot and mouth disease is high. Enteroviruses can spread widely through the feces, throat secretions, saliva, and herpes fluid of infected people.
- Mode of transmission: Close contact is an important mode of transmission of HFMD, which can be caused by contact with contaminated hands, towels, handkerchiefs, dental cups, toys, eating utensils, milk utensils, bedding, underwear, etc., respiratory droplets, and drinking or eating water and food contaminated with the virus.
- Susceptible population: Infants and children are generally susceptible, mainly children under 5 years of age.
4. What are the manifestations of HFMD?
The vast majority of children have common HFMD. The main manifestations are fever, rash on the hands, feet, mouth, buttocks and other parts, and may be accompanied by cough, runny nose, loss of appetite and other symptoms. The rash typically manifests as maculopapular rashes, papules, and herpes. There is inflammatory redness around the rash, there is less fluid in the herpes, it is not painful or itchy, and the rash does not scab over and does not leave scars when it recovers. The atypical rash is usually small, thick, hard, and few, and sometimes petechiae and ecchymosis are seen. Most children have a good prognosis, usually within 1 week with no sequelae. A small number of children rapidly involve the nervous system after the onset of the disease, manifesting as brainstem encephalitis, encephalomyelitis, cerebrospinal meningitis, etc., and the mortality rate of children who develop circulatory failure and neurogenic pulmonary edema is high.
5. How to identify severe HFMD cases early?
If the child has persistent high fever, listlessness, vomiting, convulsions, limb shaking, sucking weakness, rapid breathing, slow breathing or irregular rhythm, cold sweats, cold extremities, and blistering skin, it indicates that it may develop into a severe case of hand, foot and mouth disease, and it is recommended to go to the hospital immediately.
What should I do to prevent hand, foot and mouth disease on a daily basis?
(1) Vaccination, the only vaccine used to prevent HFMD is EV-71 inactivated vaccine, which can prevent HFMD caused by EV-71 and effectively prevent the occurrence of severe disease and death, and it is recommended that children aged 6 months ~ 5 years old be vaccinated as soon as possible.
(2) Wash your hands frequently Wash your hands frequently, especially before eating, after using the toilet, and after going out with soap or hand sanitizer to disinfect your hands.
(3) Pay attention to diet, do not drink raw water, do not eat raw food, and eat leftovers after heating.
(4) Pay attention to the environmental hygiene of young children, and the room should be ventilated frequently. Enteroviruses are afraid of ultraviolet rays and high temperature disinfection, so frequent drying of clothes and quilts is also an effective preventive measure.
(5) During the epidemic of hand, foot and mouth disease, do not take children to crowded public places with poor air circulation, and avoid contact with sick children. During the epidemic season, children should also be observed for rash symptoms on their hands, feet, mouth, buttocks, etc.
(6) In life, it is necessary to develop a good life routine, supplement nutrition, appropriate physical exercise, and enhance physical fitness.
Bibliography: Hand, Foot and Mouth Disease 诊疗指南 (2018 edition)
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Text: Guan Jun, Department of Infectious Diseases
Reviewer: Zhao Huiru
Editor: Ji Bingbing
Editor-in-charge: Zhang Limin
Review: Hua Xiaoya