Hand, Foot, and Mouth Disease (HFMD)

Hand, Foot, and Mouth Disease (HFMD)

Hand, Foot, and Mouth Disease (HFMD) is an infectious illness that primarily affects children. It is important for parents to observe flu-like symptoms in their infected child. The initial symptoms of HFMD are similar to those of a cold, including many blisters or ulcers in the mouth. Additionally, a child may develop a red rash or small blisters on the palms, fingers, soles, or buttocks, along with a fever that can last for 5-7 days. It is crucial to note that HFMD can lead to severe complications such as meningitis, encephalitis, paralysis, weakness, myocarditis, and even death. The severity of complications is not necessarily related to the number of mouth ulcers or lesions found on the palms and soles of the feet. In severe cases, there may be only a few sores in the neck or a few blisters on the palms and soles of the feet. Therefore, parents should closely supervise their children during the first 1-2 weeks. Over time, the rashes and mouth ulcers will disappear

Warning signs of severe complications include:

  • Lethargy, loss of interest in playing, and decreased appetite or thirst in the child.
  • Complaints of severe headache and unbearable pain.
  • Delirium symptoms such as hallucinations or seeing strange images.
  • Neck pain, stiff neck, confusion, lethargy, and vomiting.
  • Startling, body tremors, arm or hand tremors.
  • Cough, rapid breathing, tired appearance, paleness, excessive phlegm, with or without fever.

Causes of Hand, Foot, and Mouth Disease (HFMD) are attributed to enterovirus infections, with more than 100 strains identified. The most common strains responsible for the disease are coxsackievirus A16 and enterovirus 71. Infants and young children under 5 years of age are at a higher risk of developing more severe symptoms compared to older children.

Currently, a vaccine is available specifically targeting enterovirus 71, which can cause severe symptoms leading to death. However, it is important to note that the vaccine does not provide complete protection against other strains of the virus. Therefore, treatment for HFMD focuses on managing the patient's symptoms. If the child experiences a sore throat and difficulty eating, supportive measures such as providing water, milk, and soft foods should be taken. In cases of fatigue, hospitalization and intravenous fluid administration, along with antipyretic and analgesic drugs, may be necessary. Anesthetic drops can also be used to alleviate the pain caused by mouth ulcers, while close monitoring for symptoms of brain and heart complications is crucial.

Prevention measures for HFMD include:

  • Avoiding close contact with sick individuals.
  • Maintaining personal hygiene, particularly handwashing before handling food for children. Children should consume clean water and freshly cooked food without exposure to flies.
  • Avoiding sharing eating utensils, especially spoons, plates, bowls, glasses, and milk bottles.
  • Promptly washing hands after wiping snot or saliva.
  • Swiftly washing diapers or clothing soiled with excrement, ensuring proper disposal in the toilet and not the drain.
  • Seeking immediate medical attention if the child exhibits symptoms of HFMD. Upon diagnosis, the child must stay away from school for at least 1 week or until the wounds are healed. In severe cases, such as enterovirus 71, nurseries or schools may need to implement additional prevention measures, including closing the facility for at least 2 weeks for cleaning, separating sick children from others, and maintaining regular handwashing and cleaning of classrooms and toys.

Ultimately, parents are the closest individuals to an infected child and should be vigilant in monitoring symptoms. If the child experiences unusual symptoms, seeking medical attention promptly is advised.

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พญ. อภิภัสร์ สุทธิพันธุ์

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