Recently, the infectious disease of herpangina has entered a high incidence period. Herpangina is an acute upper respiratory tract infection in children caused by enterovirus infection, with the main pathogens being Coxsackievirus⁃A (CV⁃A) and enterovirus 71 (EV-A71).
The disease has a high incidence and is sporadic in all seasons, with spring and summer being the epidemic season, and it is infected through the fecal⁃oral route, respiratory droplets, contact with oral and nasal secretions, and contaminated hands and objects.
The disease is more common in preschool children under 6 years old, the incubation period is 3-5 days, and the clinical manifestations are often fever, sore throat, sore mouth, pharyngeal isthmus herpes, small infants are affected by stokou pain, and a few can be complicated by febrile convulsions, encephalitis, etc. Some children with HFMD present with herpangina in the early stages of the disease, followed by a red rash or herpes on the palms, soles, buttocks, and knees.
Pathogen: caused by enterovirus, the main pathogenic serotypes are CV-A2, 4, 5, 6, 8, 10, 16 and EV-A71, CV-B group 1~5 can also cause disease, relatively rare, echovirus 3, 6, 9, 16, 17, 25, 30 can also cause this disease.
Epidemic characteristics: It can occur in all seasons, mainly in spring and summer, and generally shows sporadic epidemics or regional outbreaks. Childcare institutions, early education institutions, communities and other places where susceptible populations are concentrated are prone to cluster cases.
Infectivity: The incubation period is 3~5 days. Viral excretion in the respiratory tract generally lasts for 1~3 weeks, and fecal excretion of virus can last for up to 2~3 months.
Source of infection: Sick children and people with latent infection.
Mode of transmission: gastrointestinal (fecal⁃oral route), respiratory transmission, or transmission through contact with oral and nasal secretions, skin or mucosal herpes fluid, contaminated hands and objects, etc., as well as drinking or eating water and food contaminated with the virus.
Susceptible population: The population is generally susceptible, and the clinical symptoms of preschool children aged 1~6 years old are more obvious after infection.
Clinical presentation
1. Fever: acute onset, high fever onset, body temperature can reach 39-40 °C or higher, and drop after about 2-5 days. Febrile seizures can even occur when the body temperature is particularly high.
2. Sore throat: pharyngeal isthmus congestion is particularly obvious, there are gray-white vesicles on the tongue and palate arch, soft palate, hard palate and uvula, with a diameter of 1-2 mm and a red halo around, which breaks into ulcers in 2-3 days, and herpes and ulcers often exist at the same time.
3. Refusal to eat and drooling: After 1-2 days of pharyngeal angina, the child will break down and form a small ulcer, causing pharyngeal pain, which infants and young children will not complain, usually manifested as refusal to eat and increased saliva (caused by reduced swallowing).
Differentiating hand, foot and mouth disease from herpangina
Hand, foot and mouth disease and herpangina are very close, and they are both enterovirus infections, some babies present with herpangina, and some present with hand, foot and mouth disease. Their main differences are twofold:
(1) The location of herpes is different
Herpangina only has herpes in the mouth, while hand, foot and mouth disease can cause herpes in the mouth, hands, feet, and buttocks.
(2) The risk of morbidity is different
Herpangina usually does not cause very serious complications and sequelae, but hand, foot and mouth disease does not. According to the statistics of relevant departments, patients with hand, foot and mouth disease have a 1% chance of infection complications, especially children under the age of three, common myocarditis, pulmonary edema, aseptic meningitis, etc., sometimes often life-threatening;
Treatment of herpangina
1. Symptomatic treatment
(1) If the high fever is controlled, and the body temperature is above 38.5 °C, physical cooling should be given, and antipyretic drugs and other drugs can also be given according to the doctor's instructions to cool down.
Commonly used antipyretic drugs are: ibuprofen oral, acetaminophen, the shortest interval between two doses is 4 hours, and no more than 4 times in 24 hours.
(2) Anticonvulsive treatment, cases of febrile convulsions need timely anticonvulsive treatment.
2. Treatment of the cause
There are no specific anti-enterovirus drugs. Drugs such as acyclovir, ganciclovir, and adenosine iotarabine monophosphate should not be used to treat herpangina, and ribavirin is not routinely recommended for herpangina.
3. Intensive treatment
Those with the following complications are critically ill and need to be hospitalized.
(1) brainstem encephalitis, (2) acute flaccid paralysis, (3) aseptic meningitis, (4) myocarditis.
For the intensive treatment of herpangina, see Hand, foot and mouth disease.
Scientific prevention
Herpetic phistitis
Herpangina is not terrible
Herpangina is a self-limiting disease that focuses on prevention, usually symptomatic and supportive. Most children recover spontaneously in about a week and generally have a good prognosis.
There is currently no targeted vaccination for herpangina. Children aged 6-5 years can go to the vaccination clinic for consultation and vaccination of enterovirus EV71 inactivated vaccine (hand, foot and mouth vaccine) to prevent hand, foot and mouth disease and herpangina caused by enteric virus 71 virus infection, and reduce the occurrence of severe cases and deaths.
Note: If enteroviruses other than enterovirus type 71 invade, children will also get herpangina.
Prevention
Herpangina is highly contagious, and we focus on prevention.
1. Pay attention to oral hygiene: Herpangina is mainly transmitted through fecal-oral or respiratory tract, which is highly contagious and spreads quickly, so attention should be paid to keeping the oral cavity clean and hygienic in daily life, such as frequent gargling with light salt water, correct toothbrushing, etc.
2. Prevention of infection: Herpangina is caused by viral infection, if there are patients with the disease or hidden infections around, you should pay attention to keeping a distance, such as avoiding eating together, using the same items, and being in the same confined space for a long time, so as not to cause cross-infection.
3. Improve the body's resistance: In addition to the viral infection, the occurrence of herpangina also needs to be caused when the body's resistance is reduced, so in the prevention of the disease, it is necessary to enhance the physique, improve one's own immunity, and help prevent the invasion of the virus through adequate rest, attention to warmth and appropriate physical exercise.
4. Frequent ventilation: pay attention to family environmental hygiene, open windows frequently for ventilation, and keep the room clean and the temperature and humidity appropriate.
How parents can care for herpetic sex
Kids with angina?
Pay attention to isolation treatment
1. Disinfect the tableware, toys and other items used by the child to prevent cross-infection.
2. Children should reduce unnecessary outings, preferably isolate for another week after normal body temperature and herpes subside.
3. Parents should wash their hands before and after contact with their children, and try to avoid visiting the house, because parents may also become vectors of herpangina.
Cooling treatment
1. Physical cooling method is preferentially selected for low heat, which can help children wipe the bath with warm water, appropriately reduce the heat dissipation of the clothes, it is not recommended to wipe with cold water, and it is forbidden to wipe alcohol to cool down.
2. Children with high fever can use drugs to reduce fever under the guidance of doctors. (Children with a history of heat shock have an anal temperature of more than 38.5°C; children without a history of heat shock can choose to physically cool down first, and then use drugs to reduce fever when it exceeds 39°C).
Oral and dietary care
If you have abnormalities such as persistent high fever, poor spirits, headache, vomiting, irritability, trembling limbs, irritability, paleness, rapid heart rate, breathing difficulties or breathing, cold hands and feet, and basking skin, you should seek medical attention in time.
Tips!
Frequent ventilation, frequent hand washing, and frequent cleaning
Take precautions
Eat a healthy diet and exercise scientifically
Improves autoimmunity
(Source: Basic Public Health Service Project Publicity Platform)
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