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on Thursday, May 15, 2008 - 06:19 PM AST - 1918 Reads

Hand, Foot and Mouth Disease (HFMD) Information Sheet

Dr. Charu Palta, Pediatrician
Shanghai East International Medical Center

From the beginning of March this year, Hand, Foot and Mouth Disease (HFMD) started to spread from Anhui Province. On May 9th, there were 25,000 cases reported in China, and 34 reported dead. From the beginning of this year to May 6th, there have been 1988 reported cases in Shanghai, but no deaths. It is thought that this disease will reach it's peak in the coming summer months, and the Ministry of Health has advised that good personal hygiene will help to prevent the spread of this disease.



  • HFMD is caused by one of several types of viruses
  • HFMD is a virus mostly caused by coxsackie virus A16, enterovirus 71 (EV71) viruses

  • HFMD is usually spread through person-to-person contact
  • It can spread through bodily secretions, feces, fluid from skin blisters, and any food and water that have been infected. The most common place for the spread of this disease is via children in day-care centers or schools, especially from toys and unclean hands. It is not transmitted from pets or other animals.

  • The symptoms are similar to the common cold with a rash
    1. Low-grade fever
    2. Sore throat
    3. Painful red blister-like lesions on the tongue, mouth, palms of the hands or soles of the feet
    4. Headache
    5. Fatigue
    6. Irritability in infants and toddlers
    7. Loss of appetite, and loss of willingness of infants to eat solid food
  • HFMD symptoms are similar to the common cold but with a rash and may include all or some of the following:

    Fever is often the first sign of the disease, accompanied by a feeling of malaise and a sore throat, often with poor appetite. One or two days after the fever begins, sores may develop in the mouth or throat. The initial infection or incubation time usually lasts for 7-10 days and is the time to be most careful not to pass it on to others. Rash on the hands and feet and/or buttocks can follow which looks similar to chickenpox but without the itching.

  • Adults as well as children can catch HFMD
  • Young children are primarily affected, but it also may be seen in adults who will more than likely show milder symptoms. Most cases occur in the summer and early fall. Outbreaks may occur among groups of children especially in childcare centers or nursery schools.  Symptoms usually appear 3 to 5 days after exposure.

  • HFMD is very contagious but usually a mild infection
  • HFMD is definitely contagious especially during the first month. The fever and spots usually clear within a few days, but can be quite uncomfortable. In a very small number of cases, the virus affects the heart muscle or brain to cause a serious inflammation of the brain (meningoencephalitis) or heart (myocarditis) which can be fatal.

  • Screening and diagnosis will involve a throat swab taken by your doctor
    1. The age of the affected person
    2. The pattern of the signs and symptoms
    3. The appearance of rash or sores
  • Diagnosis depends on these things:

    A throat swab or stool specimen may be taken and sent to the laboratory to determine which virus caused the illness. However, your doctor probably won't need this type of testing to diagnose HFMD.

  • Treatment does not yet include a vaccine
  • Currently there is no vaccine or anti-viral treatment for this disease, although symptoms, such as headaches, fever, ulcers etc, can be treated to provide temporary relief. Dehydration is usually the most common problem since it can be difficult and painful to swallow with ulcers and sores in the mouth.

  • Pregnant women must pay particular attention
  • Most enterovirus infections during pregnancy cause mild or no illness in the mother, however if a mother is infected during the time of delivery, there could be a chance of passing it to the newborn child. Pregnant women are urged to be very particular when it comes to hygiene, especially if you are around children of a young age.

  • Improved hygiene will help prevent HFMD
    1.  
      • Washing hands frequently, especially after going to the bathroom, changing diapers and/or handling diapers or other stool‑soiled material
      • Covering mouth and nose when coughing or sneezing
      • Disinfecting toys and work surfaces
      • Avoid touching your mouth with your hands
      • Avoid over-crowded places
      • Keep ventilation clean and open windows where possible
      • Excluding children from child care or school settings if the child has a fever, uncontrollable “hand to mouth” behavior, not able to contain their secretions, such as ulcers in the mouth and the child is drooling, or draining sores that cannot be covered.
  • Help prevent and control the spread of hand, foot, and mouth disease by:

Dr Charu Palta, the Pediatrician at Shanghai East International Medical Center in Pudong is keeping up-to-date information on the virus and is happy to answer any questions about HFMD. She is also available for consultations should you have any concerns regarding the symptoms or prevention of this disease. Although Shanghai is taking proactive action with preventative measures already set in place, please be aware that this virus is highly contagious, so in order to prevent any further spread of HFMD, early detection is essential.

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