Hand Foot and Mouth Disease is a viral syndrome that mostly occurs in infants and children, but can affect adults as well. As the name so describes, it usually affects the hands, feet, and mouth, but can affect other areas such as the genitals and buttocks. It occurs commonly worldwide. Outbreaks usually occur in places where children congregate, such as daycare centers, schools, summer camps, hospital wards, military camps, or between family members in households with affected children. Summer and autumn are prime seasons for outbreaks. The viruses that cause Hand Foot and Mouth Disease can be shed in the stool, and therefore household contacts are highly susceptible to infection. This article will focus on some of the basics about hand foot and mouth disease so that hopefully you and your family won’t have to deal with it.
Causes of Hand Foot and Mouth Disease
Coxsackieviruses and Enteroviruses are the main culprits in Hand Foot and Mouth Disease. The most common virus serotypes of Hand Foot and Mouth Disease are Coxsackievirus A16 and enterovirus A71. Viral particles are spread via the respiratory system through coughing and spreading of aerosols and oral secretions, or via the gastrointestinal system through the stool. Infectious particles can even be detected in the stool weeks after the initial infection, causing prolonged outbreaks. Person-to-person spread is common, as is fecal-to-oral contamination. Ingested enterovirus particles replicate in the lower intestine and throat. After replication, the viral particles are carried throughout the body to various organs, including the heart, liver, brain, and skin, via the lymphatic system. The virus further replicates in these organs, causing widespread inflammation and cellular damage.
Symptoms of Hand Foot and Mouth Disease
In children, Hand Foot and Mouth Disease should be suspected when they develop symptoms such as throat pain, and refusal to eat or drink due to pain. A look at the back of the throat could reveal vesicles. There may also be painful vesicles on the tongue and sides of the mouth. As the name suggests, similar lesions are usually found on the hands, feet, and sometimes buttock area. Prior to the development of lesions, children may have typical viral symptoms, such as fever, irritability, abdominal pain, vomiting, and diarrhea. The fever is usually low grade, or below 101 degrees Fahrenheit. More serious symptoms may be a change in mental status, neck pain, headache, fever, seizures, which may indicate aseptic meningitis, which causes inflammation in the brain. It can also cause Guillain-Barre Syndrome, in which there is loss of strength and sensation due that travels from the feet and up, due to involvement of the nerves.
Getting Treatment
Most cases of Hand Foot and Mouth disease are self-limited, meaning the symptoms will go away on their own without medical treatment. In mild cases, supportive care is needed, such as taking medication for fever and pain. In children, it is very important to maintain hydration, since many will refuse to eat or drink due to pain. Some over the counter medication and ice pops may help the children maintain enough fluid intake. Most cases will resolve within seven to ten days with supportive treatments. In severe cases such as cases of aseptic meningitis caused by enterovirus 71, a few medications have been approved for use. Nonetheless, outcomes for most patients with Hand Foot and Mouth Disease remain excellent, with very few people having long-lasting effects. Most people recover well, including young infants.