Symptoms
Hand-foot-and-mouth disease manifests itself in the following possible symptoms:
- Initially, there are nonspecific complaints such as mild fever, headache, feeling sick, lack of appetite and sore throat.
- Subsequently, painful, red rashes form on the tongue, palate and oral mucosa, which turn into blisters and ulcers.
- A rash develops on the palms of the hands and soles of the feet and possibly on the buttocks. This may be spots, papules, blisters and ulcers surrounded by a red yard. The rash is usually not itchy, but can be painful.
Children under 10 years of age are most commonly affected and the usual duration of illness is about 7 to 14 days. Hand-foot-and-mouth disease can occur less frequently in adults. An important possible complication is dehydration because children do not want to drink because of the pain in their mouths. About a month after the end of the disease, nail growth disorders may occur. Often the whole finger or toe nails detach from the nail bed. Because of the delay, the connection is not always made. The nails grow back within weeks to months. Very rarely, the central nervous system can be affected, leading to encephalitis, meningitis, and paralysis.
Causes
The cause of the disease is infection with various viruses from the family of , particularly coxsackievirus A16 and enterovirus 71. Humans form the sole reservoir. The viruses are transmitted directly from person to person, fecal-oral, as droplet infection, and through objects and surfaces. Contagious are:
- Physical contact
- Coughing, sneezing, kissing
- Bowel movements (Faezes)
- Contaminated objects and surfaces
- Skin lesions: Fluid from the blisters
The children are very infectious and can pass the disease to family members and to other children. Therefore, smaller or larger local outbreaks are also observed, for example in schools or day care centers. The incubation period is usually only a few days. It is true that contagiousness is greatest during the acute illness. But children can remain contagious for days to weeks after they have healed! This is because they excrete the virus in their stool.
Diagnosis
Diagnosis is usually made in medical treatment on the basis of the patient’s history, physical examination, symptoms, and, rarely, with laboratory testing. Possible differential diagnoses include oral thrush, oral thrush, dyshidrotic eczema, and other childhood diseases such as chickenpox.
Drug treatment
No causative antiviral treatment is available. For symptomatic therapy, pain relievers such as ibuprofen and acetaminophen can be used. In the mouth, local anesthetics and antiseptics, lozenges, rinses, and mouth gels can be used for pain. Skin lesions can be treated with wound-healing, disinfecting, tanning, and pain-relieving ointments. Regrowth of the nails takes weeks to months. It can possibly be supported by taking nutritional supplements. However, therapy is not absolutely necessary.
Non-drug measures
- Ensure adequate fluid intake.
- Suck on ice, eat ice cream.
- Drinking cold drinks.
- Avoid hot and hot spices, eat “boring”.
- Good oral hygiene.
- Grind food.
Prevention
- Avoid contact with sick people, isolate sick people.
- Good hand hygiene with soap and water, especially after defecation or when changing diapers.
- Clean or disinfect contaminated objects and surfaces.
