Hand, foot and mouth disease

Dr KK Aggarwal
Padma Shri and Dr B C Roy National Awardee
President, Heart Care Foundation of India

We have been seeing a rise in the number of cases of hand, foot and mouth disease inDelhi among school children. These may be mistaken for chicken pox.

Hand, foot and mouth disease: Salient facts:

*Hand, foot and mouth disease is a viral illness most commonly caused by the Coxsackie virus A6.
*Enteroviruses 71 (EV71) can also cause hand, foot and mouth disease.
*Both adults and children can develop this infection. But young children below 5 years old are more susceptible.
*It is a moderately contagious illness.
*The incubation period is 5 days.
*The illness begins with fever, which lasts for 24-48 hours.

*Fever is followed by appearance of painful sores in mouth. They begin as small red spots that blister and then often become ulcers. Tongue is involved.
*There are peripherally distributed small tender non itchy rash with blisters on palms of the hands, and soles of feet and buttocks.
*The sores hurt on touch and swallowing is difficult.
*There is proximal separation of nail from the nail bed.
*The virus is present in mucus from nose, saliva, fluid from sores and traces of bowel movements.
*The virus spreads in the first week of infection.
*The infection spreads from person to person by direct contact with nasal discharge, saliva or blister fluid or from stool of infected persons.
*The virus can persist in the stool for weeks.
*The illness is not transmitted to or from pets or other animals
*The illness stays for 2-3 days. It is usually mild and self limited.
*Entero 71 virus is associated with brain involvement (meningitis and encephalitis), lungs and the heart.
*The patient remains infectious after the symptoms have gone.
*Test is not necessary.
*There is no specific treatment.
*Paracetamol tablet can be taken to relieve pain and fever.
*Aspirin is to be avoided in children.
*Dehydration should be avoided.
*Eat ice cream to numb the pain.
*Using mouthwashes or sprays that numb mouth
*Regularly wash your hands with soap and water.
*Avoid exposure to infected person.
*Maintain touch hygiene to reduce your risk of acquiring the infection.
*During first week of illness, the child should be kept in isolation.
*Schools should be closed.
*There is no vaccine currently available