About
Hand, foot and mouth disease (HFMD) is a contagious infection caused by certain types of viruses, most often the Coxsackievirus A16. It is most common in infants and young children, but can affect people of any age. Symptoms of HFMD include fever, sore throat, and a rash on the hands, feet, and/or mouth. This rash can look like blisters or red spots and may be accompanied by a loss of appetite. In more severe cases, there can be difficulty swallowing and dehydration. Treatment for HFMD is generally supportive, such as getting rest and drinking plenty of fluids, although antiviral medications can be prescribed in severe cases.
Symptoms
The symptoms of Hand, Foot, and Mouth Disease (HFMD) include fever, sore throat, painful sores in the mouth, and a rash on the palms of the hands and soles of the feet. Other symptoms may include swollen glands in the neck, loss of appetite, headache, fatigue, and a general feeling of being unwell.
Causes
Hand, foot and mouth disease is caused by a virus called enterovirus, specifically the Coxsackievirus A16 and other related enteroviruses. It is most commonly spread through contact with saliva, mucus from the nose, fluid from blisters, and stool from an infected person. The virus may also be spread through contact with objects that an infected person has recently touched and through contact with items contaminated by an infected person’s stool, such as changing tables, toys, and doorknobs.
Risk factors
The primary risk factor for hand, foot and mouth disease is contact with the virus that causes it, most commonly the coxsackievirus A16. Other risk factors may include:
- Having close contact with another person who has the virus
- Poor hygiene, such as not washing your hands frequently
- Participating in activities that involve close contact with saliva
- Living in crowded, unsanitary conditions
- Being a young child (age 6 or younger)
- Having a weakened immune system
- Exposure to contaminated surfaces or objects
Diagnosis
Hand, foot and mouth disease can be diagnosed through a physical examination of the affected areas and the symptoms. If necessary, a doctor or healthcare provider may also perform laboratory tests to confirm the diagnosis. These tests may include a throat swab or a stool sample to detect the virus that causes the disease. In some cases, a blood test may be used to check for antibodies that are produced by the body to fight the virus.
Sub-types
Hand, foot and mouth disease (HFMD) is an infectious, mild childhood illness caused by certain strains of viruses, most commonly the Coxsackie virus. It usually affects children under 10 years of age, but can also occur in adults. HFMD is spread through direct contact with nasal and throat secretions, saliva, fluid from blisters, or stool of an infected person.
The most common subtypes of HFMD are coxsackievirus A16, coxsackievirus A6, enterovirus 71, and enterovirus 71-like.
Coxsackievirus A16 is the most common cause of HFMD in the United States, and is typically characterized by fever, sore throat, sores in the mouth, rash on the hands and feet, and occasionally an overall body rash.
Coxsackievirus A6 is often associated with more severe symptoms than A16, including the development of large blisters on the hands, feet, and mouth.
Enterovirus 71 is a type of virus that is most often associated with severe cases of HFMD, and can cause neurological symptoms such as limb weakness and paralysis, as well as swelling in the brain.
Enterovirus 71-like is a strain of enterovirus 71 that is known to cause milder symptoms than the full enterovirus 71 strain and is typically milder and less severe.
Overall, each strain of HFMD can produce different symptoms and intensity of illness, so it is important to determine the specific subtype and seek medical attention if necessary.
Treatments
The treatment for hand, foot and mouth disease usually involves taking steps to relieve the symptoms and helping the body to fight off the virus. Treatment options include:
- Taking over-the-counter medications, such as ibuprofen, to reduce fever and pain
- Drinking plenty of fluids to prevent dehydration
- Taking antiviral medications, such as acyclovir, if prescribed by your doctor
- Taking lysine supplements to reduce viral replication
- Applying calamine lotion to the rashes to reduce itching and inflammation
- Getting lots of rest
- Taking antiviral drugs (if prescribed, such as amantadine or oseltamivir) to reduce virus levels in the body
- Applying a warm compress to the affected area to reduce pain and inflammation
- Washing hands often, especially after contact with an infected person
- Practicing good hygiene to avoid spreading the virus to others
- Bathing in lukewarm water that contains baking soda to provide relief from the itching and discomfort caused by the rash.
Prevention
To reduce the risk of Hand, foot and mouth disease, people should practice thorough hand washing with soap and water, avoid touching their eyes, nose and mouth with unwashed hands, avoid close contact with people who are infected, stay home when feeling ill, and clean and disinfect any surfaces that may have been contaminated with the virus. Vaccines are also available in some countries for certain strains of the virus. Additionally, people should ensure that children are up to date on their vaccinations.
Gender differences?
Yes, there are gender-specific differences in the presentation and management of Hand, foot and mouth disease. While both genders can develop Hand, foot and mouth disease, research has shown that girls tend to have fewer symptoms and a milder case than boys. Girls are also more likely to develop irritability than boys and more likely to experience complications such as meningitis or encephalitis. Furthermore, boys tend to experience more severe cases of Hand, foot and mouth disease and are more likely to require hospitalization than girls. As far as management of Hand, foot and mouth disease, boys are more likely to require antiviral therapy, steroid therapy, and/or intravenous fluids. In contrast, girls may only require symptomatic management of their symptoms.
Nutrition
Nutrition is an important factor in the management of Hand, Foot and Mouth Disease (HFMD). Proper nutrition, such as a balanced diet that is rich in essential vitamins and minerals, can help the body remain strong and healthy, and can help fight the virus. Eating foods rich in Vitamin C and essential minerals, such as leafy greens, fruits, and yogurt, can help boost immunity and promote healing. Additionally, plenty of fluids should be consumed to stay hydrated. Drinking water, juice, and even warm soups can help replace lost fluids and prevent dehydration. Eating soft, easily digestible foods can also help soothe sore throats and reduce the risk of dehydration. Taking nutritional supplements may also be beneficial, as long as they are taken under the direction of a health care provider.
Physical Activity
Physical activity can increase the risk of spreading Hand, Foot, and Mouth Disease (HFMD). HFMD is highly contagious and spread quickly through direct contact with saliva, nasal secretions, or fecal matter. Therefore, activities such as playing contact sports, touching each other while playing, or sharing objects can spread the disease from person to person. Additionally, since the virus that causes HFMD can survive on surfaces for up to a week, engaging in physical activities in poorly maintained facilities can also increase the risk of infection. Therefore, it is recommend that people with HFMD stay out of shared spaces and refrain from direct physical contact with others to reduce the risk of spreading the virus.
Further Reading
- https://www.cdc.gov/hand-foot-mouth/index.html
- https://www.ncbi.nlm.nih.gov/books/NBK431082/
- https://www.mayoclinic.org/diseases-conditions/hand-foot-and-mouth-disease/symptoms-causes/syc-20353035
- https://raisingchildren.net.au/guides/a-z-health-reference/hand-foot-mouth-disease
- https://mydoctor.kaiserpermanente.org/ncal/structured-content/Condition_Hand_Foot_and_Mouth_Disease_-_Pediatrics.xml?co=/regions/ncal
- https://www.healthline.com/health/hand-foot-mouth-disease