Hand, foot and mouth disease (HFMD) is a viral infectious disease classified as an acute enteroviral disease that primarily affects young children, but can also occur in adults. The main causative agents are viruses of the Enterovirus family, most commonly enterovirus 71 (EV71) and Coxsackievirus. The disease is characterized by fever, painful skin rashes, inflammatory changes in the oral cavity, and can lead to various complications, including meningitis and myocarditis. Transmission occurs primarily through the feco-oral route, as well as direct contact with the rash or fluid from blisters, making it particularly contagious in crowded conditions.
History of the disease and interesting historical facts
The first description of hand, foot and mouth disease was reported in 1957 in Tennessee, USA, when an outbreak occurred. However, many researchers point out that cases of the disease may have been known long before. In the 1990s, HFMD became widely known after outbreaks in China and other countries in Southeast Asia. The most serious outbreaks occurred in 1998 and 2008 in Malaysia, where cases with severe consequences, including deaths, were reported. These events attracted the attention of international organizations, which began to study the issue of prevention and control methods of infection, which gave impetus to deeper scientific development of diagnostic and treatment standards.
Epidemiology
Studies show that the incidence of HFMD has a pronounced seasonal pattern, with peak outbreaks in the summer-autumn period, especially in tropical and subtropical regions. According to the World Health Organization (WHO), the incidence has increased in a number of countries in recent years. For example, in some countries in Southeast Asia, up to 50,000 cases have been reported per year. In 2021, according to reports, more than 70,000 cases were registered in China among children under 5 years of age, confirming the high susceptibility of this population to the disease.
Genetic predisposition to this disease
At present, research shows that no genetic predisposition to HFMD has been established. The viruses that cause the disease do not have specific mutations associated with specific human genes. However, some evidence suggests that the body's immune response may influence the development and severity of the disease. Interest in this area of research is growing, and scientists suggest that genetic markers that predispose to viral infections in general may also influence susceptibility to HFMD.
Risk factors for the development of this disease
There are several key risk factors that contribute to the development of HFMD:
- Age: the highest incidence is recorded in children under 5 years of age.
- Habitat: crowding in children's groups (kindergartens, schools) increases the risk of infection transmission.
- Immune status: Children with weakened immune systems are more susceptible to the disease.
Physical and chemical risk factors can also influence the likelihood of infection, such as poor sanitation and hygiene in educational institutions and playgrounds.
Diagnosis of this disease
The main symptoms of HFMD include:
- Fever, usually not higher than 38°C-39°C.
- Painful aphthous ulcers in the mouth.
- A rash on the palms, feet and buttocks in the form of blisters.
Laboratory testing includes isolation of the virus from oral or skin samples. Radiological examinations are not required in most cases, as clinical manifestations are sufficient for diagnosis. It is important to conduct a differential diagnosis with other diseases, such as scarlet fever, chickenpox, and other viral infections.
Treatment
General treatment of HFMD is predominantly symptomatic:
- Pharmacological treatment: use of antipyretics (paracetamol or ibuprofen) to reduce body temperature and relieve pain.
- Hydration: Maintain adequate fluid levels, especially if fever or oral ulcers are present.
- Specialized treatment is not required, since the disease usually proceeds without complications and is self-limiting.
Surgery is not indicated because the disease is viral. It is important to note that antibiotics are not effective against HFMD because it is a viral infection.
List of medications used to treat this disease
The medications used include:
- Paracetamol
- Ibuprofen
- Antiseptics for treating mouth ulcers
- Preparations to reduce itching and inflammation in skin rashes (eg, calamine emulsion)
Disease monitoring
Control stages in the treatment of HFMD include regular monitoring of the patient's condition over time. The prognosis for most children is good, with symptoms lasting from a few days to a week. Potential complications may include meningitis, myocarditis, and polyneuritis, but these are rare and are mostly associated with the more severe form of the disease caused by the EV71 virus.
Age-related features of the disease
Young children may experience more severe symptoms than adolescents and adults. Children may have more severe infectious manifestations and a more severe course of the disease, while adults may have milder forms, often without significant symptoms.
Questions and Answers
- How is hand, foot and mouth disease transmitted? – The infection is transmitted through the feco-oral route, as well as through direct contact with ulcers or secretions of the patient.
- How long does the disease last? – Usually the symptoms of the disease go away within 7-10 days.
- Is it possible to prevent the disease? – There are currently no vaccines for HFMD, but good hygiene practices and regular hand washing can reduce the risk of transmission.
- What are the complications of HFMD? – Rare complications include meningitis and myocarditis; they require special monitoring even after the infectious period.
- Can I get sick again? – Possibly, since there are many types of viruses that cause HFMD.
Advice from Dr. Oleg Korzhikov
Dr. Oleg Korzhikov recommends paying special attention to hygiene during HFMD outbreaks. “It is important to wash your hands frequently, use antiseptics, and avoid contact with sick people,” he says. He emphasizes that when the first symptoms of the disease appear, it is necessary to consult a doctor to confirm the diagnosis and receive appropriate treatment recommendations.
