Definition of Hand, foot, and mouth disease
< b>Hand, foot, and mouth disease: A common illness of infants and children
under 10 years old characterized by fever, sores in the mouth, and a rash with blisters
due to infection most commonly with coxsackievirus A16 or less often enterovirus
71 or another enterovirus.
The disease begins with a mild fever, poor appetite, malaise ("feeling sick"),
and frequently a sore throat. One or 2 days after the fever begins, sores develop
in the mouth. They begin as small red spots that blister and then often become ulcers.
They are usually located on the tongue, gums, and inside of the cheeks. The skin
rash develops over 1 to 2 days with flat or raised red spots, some with blisters.
The rash does not itch, and it is usually located on the palms of the hands and
soles of the feet. It may also appear on the buttocks. One may have only the rash
or the mouth ulcers.
Hand, foot, and mouth disease caused by coxsackievirus A16 infection is a mild
disease and children usually recover with no medical treatment in 7 to 10 days.
Rarely, this illness may be associated with "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.
Another cause of hand, foot, and mouth disease, enterovirus 71 may also cause
viral meningitis and, rarely, more serious diseases, such as encephalitis, or a
poliomyelitis-like paralysis. Enterovirus 71 encephalitis may be fatal.
Hand, foot, and mouth disease is moderately contagious. Infection is spread from
person to person by direct contact with nose and throat discharges or the stool
of infected persons. A person is most contagious during the first week of the illness.
The incubation period (from infection to onset of symptoms) is 3 to 7 days. Everyone
is susceptible to infection. Infection results in immunity to the specific virus,
but a second episode may occur following infection with a different member of the
enterovirus group.
Individual cases and outbreaks of occur worldwide, more frequently in summer
and early autumn. No specific treatment is available. Symptomatic treatment is given
to provide relief from fever, aches, or pain from the mouth ulcers. Preventive measures
include frequent handwashing, especially after diaper changes; disinfection of contaminated
surfaces by household cleaners (such as diluted bleach solution made by mixing 1
capful of household bleach containing chlorine with 1 gallon water), and washing
soiled articles of clothing. Children are often excluded from child care programs,
schools, or other group settings during the first few days of the illness. These
measures may reduce the spread of infection, but they will not completely interrupt
it.
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