Hand foot and mouth disease

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A common viral illness of infants and children.

Hand, foot, and mouth disease (HFMD), is a common, often self-limiting viral illness which typically affects infants and children, however, it may also occur in adults.

It is characterized by low grade fever and maculopapular rash on palms of the hands, soles of the feet, and around mouth.

It is caused by the human enteroviruses and coxsackieviruses, a positive-sense single-stranded RNA viruses.

Occurs worldwide.

Occurs most often in summer or early fall.

Causes fever and blister-like eruptions in the mouth and/or a skin rash.

Usually begins with a fever, poor appetite, malaise and often with a sore throat.

One or 2 days following fever, painful sores develop in the mouth involving the tongue, gums, and buccal mucosa.

Characterized by oral ulcerative lesions, vesicular exanthema on distal extremities, with mild constitutional symptoms and commonly occurs during warm weather.

Associated rash develops over 1-2 days and is usually located on the palms of the hands and soles of the feet;.

The rash may also appear on the buttocks and/or genitalia.

Patients may experience only oral lesions or only skin involvement.

Caused by viruses that belong to the enterovirus genus.

Coxsackievirus A16 is the most common cause in the United States.

Enteroviruses, including enterovirus 71, have also been associated with HFMD and with outbreaks of the disease.

Infection is spread by direct contact with the infectious virus found in the nose and throat, saliva, blister fluid, and stool of infected persons.

The virus is most often spread by contaminated hands and by contact with virus-contaminated surfaces.

Patients are most contagious during the first week of the illness.

Infected person can pass the infection after symptoms resolve.

Some infected individuals excrete the virus and have no symptoms.

Not transmitted to or from pets or other animals.

Not all infected patients are symptomatic.

Occurs mainly in children under 10 years old but can also occur in adults.

There is no specific treatment for HFMD.

Symptoms can be treated to provide relief from pain from mouth sores and from fever and aches.

Mouthwashes or sprays that numb pain can be used to lessen mouth pain, and dehydration should be prevented.

Risk of infection can be lowered by following good hygiene practices, especially after changing diapers and after using the toilet

Cleaning dirty surfaces and soiled items, including toys, first with soap and water, and avoiding close contact with infecte andd persons can decrease the spread of the andinfection.

No vaccine is available.

Complications are uncommon.

Viral meningitis can rarely occur, and it is usually mild in severity.

Encephalitis or a polio-like paralysis van very rarely occur.

Coxsackievirus A16 infection is a mild disease with recovery in nearly all patients in 7 to 10 days.

Enterovirus 71 infection has a higher incidence of neurologic involvement.

Systemic infection usually secondary to coxsackievirus A16, a member of the enterovirus.

Hand-foot-mouth disease is a relatively common infection viral infection that usually begins in the throat.

Spread by person to person by direct contact with nose and throat secretions, saliva, fluid from blisters, or the stools of an infected person.

Most contagious during the first week of the illness.

The time between infection and the development of symptoms is about 3 – 7 days.

Infection occurs most often in children under age 10, but can be seen in adolescents and occasionally adults.

Symptoms include fever, headache, anorexia, sore throat, rash with very small blisters on hands, feet, and diaper area, ulcers in the throat, mouth, and tongue.

Diagnosis suggested by history and physical findings.

Treatment is supportive, and complete recovery occurs in 5-7 days.

Not associated with target skin lesions.