Hand, foot and mouth disease

Hand, foot and mouth disease (HFMD) is caused by a number of enteroviruses in the family Picornaviridae. The most common cause is the Coxsackie A virus. HFMD is not to be confused with 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).

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

Additional recommended knowledge

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Symptoms

Symptoms of HFMD include:

• low grade fever
• malaise
• abdominal pain
• upper respiratory symptoms
• painful oral lesions starting as pink macules and papules that progress to vesicles with surrounding erythema
• sores with blisters on palms of hands and soles of feet
• mouth ulcers
• sores or blisters may be present on the buttocks of small children and infants

Not all symptoms may be present.

Treatment

There is no specific treatment for hand, foot and mouth disease. Individual symptoms, such as fever, lameness and pain from the sores, may be eased with the use of medication. HFMD is a viral disease that has to run its course; many doctors do not issue medicine for this illness, unless the infection is severe. It is usually in the affected child's best interest to be kept home until the infection clears. Fever reducers will help to control high temperatures. Luke-warm baths will also help bring temperature down.

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

Recorded outbreaks

• In 1997, 34 children died in an outbreak in Sarawak, Malaysia.
• In 1998, there was an outbreak in Taiwan, affecting mainly children^[1]. There were 405 severe complications, and 78 children died^[2]. The total number of cases in that epidemic is estimated to have been 1.5 million^[2].
• In 2006, 7 people died in what seems to be a new outbreak in Kuching Sarawak (according to the New Straits Times, 14th of March).
• In 2006, after the outbreak of Chikungunya in Southern and some Western parts of India cases of HFMD were reported. ^[3]
• In 2007, during the week of April 15-21 alone, Singapore recorded 688 cases of the disease. ^[4]
• In 2007, 30th May 2007, outbreak in the Maldives. ^[5]
• In 2007, Oct, outbreak in Hornsby shire, NSW, Australia
• In 2007, Nov, out break in Albury, NSW, Australia
• In 2007, Nov, out break in Yangon, Myanmar
• In 2007, Dec, out break in Greensborough, Vic, Australia

References