What exactly is Hand, Foot, and Mouth Disease?
Hand, Foot, and Mouth Disease is a contagious disease caused by infection with enteroviruses, commonly including Coxsackievirus and Enterovirus 71 (EV71). This disease is common in young children, with those under 5 years old being at higher risk of severe illness compared to older children.
Symptoms of Hand, Foot, and Mouth Disease
The disease presents as a syndrome consisting of fever and rash characterized by clear blisters or red spots, with inflammation on the tongue, gums, cheeks, palms, fingers, and soles. Sometimes, the rash may appear on the trunk, arms, and legs. Mouth ulcers are small, round, scattered sores on the tongue, gums, cheeks, and palate. Some cases may have neurological complications and severe symptoms that can be fatal, such as meningitis, encephalitis, paralysis, flaccid muscle weakness, myocarditis, and acute pulmonary edema.
How is Hand, Foot, and Mouth Disease transmitted?
It is transmitted through contact with saliva, nasal mucus, or contact with the rash, clear blisters, and feces of infected patients and asymptomatic carriers. The virus can spread via hands that have touched the infected person and then touch other children, such as during diaper changes. The virus may also be present on environmental surfaces like children’s toys, eating utensils, spoons, or drinking glasses. Sharing these items can lead to indirect contact transmission.
Even after symptoms improve, the virus can still be transmitted because it is shed intermittently in feces for 6-8 weeks. Therefore, it is considered highly contagious since the virus can survive in the environment for a long time and, lacking an envelope, is resistant to alcohol-based disinfectants.
Severe symptoms of Hand, Foot, and Mouth Disease
Although most patients generally have mild symptoms such as fever and rash, with fever usually resolving in 2-3 days and rash improving over 7-10 days, severe cases can occur, including:
- Children with severe complications and death mostly caused by Enterovirus 71 (EV71) infection.
- Severe cases may result in death, and survivors may have neurological abnormalities.
- Some cases may have neurological complications such as seizures, lethargy, vomiting, meningitis, encephalitis, paralysis, acute flaccid muscle weakness, myocarditis, and acute pulmonary edema.
When does Hand, Foot, and Mouth Disease occur during the year?
In Thailand, Hand, Foot, and Mouth Disease occurs sporadically throughout the year, with outbreaks most common from June to September or during the rainy season. Some years may see outbreaks at different times; for example, in 2020, there was a significant outbreak from September to December. Since the disease can occur year-round, it is very difficult to avoid exposure or prevent transmission.
Prevention and treatment of Hand, Foot, and Mouth Disease
1. Isolate patients and prevent contact with infected individuals
Sick children should stay home and avoid playing with other children. Sometimes, temporary closure of schools or daycare centers may be necessary during outbreaks. Avoid taking young children to crowded public places such as playgrounds or shopping malls.
2. Maintain personal and environmental hygiene
Since this disease commonly occurs among infants and young children in schools or daycare centers, emphasis should be placed on handwashing and cleaning toys and the environment.
3. Prevention with EV71 vaccine
This vaccine prevents Hand, Foot, and Mouth Disease caused by Enterovirus 71 (EV71), which is the main cause of severe and potentially fatal cases.
Treatment
Currently, there is no specific treatment; care is symptomatic based on the disease presentation.
How should the vaccine be administered?
- Two doses are given, with a one-month interval between doses.
- The recommended age for vaccination is 6 months to 5 years.
For more information, please contact:
Child Health Center
Phyathai 3 Hospital, 4th Floor
Tel. 02-467-1111 ext. 3419