1.What is HFMD (Hand, Food and Mouth Disease)?
HFMD or Hand, Foot and Mouth Disease (not to be confused with Foot and Mouth disease in animals) is seen to occur mainly in infants and children and occasionally in adults. It is caused by a virus called Coxsakie virus. Enterovirus is also said to be another causative agent of HFMD.
2. What are the signs and symptoms of HFMD?
HFMD is characterised by rashes on the skin of hands (palms especially), feet (soles) and mouth, occasionally on buttocks and genitalia. It is accompanied in most cases with fever. Infants are usually found to be irritable and when the infection affects the mouth/throat, it makes it difficult for them to swallow food. These symptoms appear about 3-5 days after exposure to virus.
3. How does it spread?
HFMD is a contagious disease and spreads through direct contact with saliva, mucous or even faeces of the infected person. HFMD occurs as small epidemics in nursery, kindergartens. The rashes usually disappear on their own in about a week’s time. Most often no treatment is required however medicines/ointment is given to provide symptomatic relief (e.g. paracetamol for fever). There is no vaccine so far for this disease. Infected persons are most contagious during the first week of the illness, but contagiousness can last for several weeks (as the virus persists in stool).
4. Can you be infected with HFMD more than once?
Yes, infection only results in immunity to one specific virus, other episodes may occur following infection with a different virus type.
5. How do I keep prevent myself from getting infected?
Hygiene is of prime importance when it comes to keeping infection at bay. Preventive measures include:
- Frequent handwashing with soap and water especially after touching any blister or sore, before preparing food and eating, before feeding young infants, after using the toilet and after changing diapers;
- Cleaning contaminated surfaces and soiled items (including toys) first with soap and water, and also if possible, disinfecting them
- Avoiding close contact (kissing, hugging, sharing utensils, etc.) with children with HFMD may also help to reduce of the risk of infection;
- Keeping infants and sick children away from kindergarten, nursery, school or gatherings until they are alright;
- Monitoring the sick child's condition closely and seeking prompt medical attention if persistent high fever, decrease in alertness or deterioration in general condition occurs;
- covering mouth and nose when sneezing and coughing;
- Disposing properly of used tissues and nappies into waste bins that close properly;
- Maintaining cleanliness of home, child care centre, kindergartens or schools.
6. The viruses are said to stick around in the body for a long, long time as mentioned here. Coxsackievirus A16 has been found in the stool of infected children for upto six weeks. Enterovirus 71 can last for 10 weeks. Contagion diminishes during this time, however paediatricians do not concur on just how long children ought to be kept away. Some doctors feel it is OK to send the child back to school once the fever subsides, while some others feel it is not ok to let the child out until the blisters are gone. The best thing to do is to look at each child’s symptoms and use your best judgment.
7. How serious is HFMD?
Most people with HFMD recover fully after the acute illness.
- HFMD is usually a mild disease, and nearly all patients recover in a week to 10 days’ time without medical treatment and complications are uncommon.
- Dehydration is the most common complication of HFMD infection caused by Coxsackie viruses; it can occur if intake of liquids is limited due to painful sores in the mouth.
- Rarely, patients develop "aseptic" or viral meningitis, in which the person has fever, headache, stiff neck, or back pain, and may need to be hospitalized for a few days.
- HFMD caused by EV71 has been associated with meningitis and encephalitis, and on certain occasions can cause severe complications, including neurological, cardiovascular and respiratory problems. Cases of fatal EV71 encephalitis have occurred during outbreaks.
Where does HFMD occur?
Individual cases and outbreaks of HFMD occur worldwide. In tropical and subtropical countries, outbreaks often occur all year-round. In recent years HFMD has occurred more in Asia.
Centre for Diseases, Control and Prevention
World Health Organisation – Western Pacific region
by Hridya Anand
A biochemist by education who could never put what she studied to good use, finally found GetDoc as a medium to do what she loved - bring information to people using a forum that is dedicated to all things medical. View all articles by Hridya Anand.