Syndrome hand foot mouth enterovirus

Syndrome hand-foot-mouth is a highly contagious viral disease. A typical display is represented vesicular rash on the hands (palm) and foot (affected foot) and the presence of aphthous lesions of the oral cavity.

As a rule, the syndrome hand-foot-mouth (enteroviral disease) occurs in children (a typical patient is a child under 5 years – 95% of cases), but can sometimes occur in adults. This disease is usually characterized by short-term flow and quality. However, in some cases, can also cause serious neurological complications. An increased risk of these complications present in children under 3 years. These include:

1. Meningitis.
2. Encephalitis affecting the brain stem.
3. Peripheral paresis (polio).
4. Neurogenic pulmonary edema.

Rare, but the disease can even lead to death. More serious consequences of infection can be in women during the first trimester of pregnancy, when there is a risk of miscarriage.

Disease hand-foot-mouth lately experiencing a revival, despite the fact that for a long time did not show any signs of existence. Although the figures relating to the number of diseases that grow, they are not dramatic, and while it is not necessary to fear of the epidemic. Despite the uncomfortable symptoms, treatment is usually effective.

The disease affects in particular children's age. The most risky group includes children aged 1-4 years. But, of course, the disease may occur in older child. It is a viral disease which, as already mentioned, affects the hands, feet, mouth, infection, Coxsackie (virus – enterovirus) is the culprit of the disease.

This is a problem of dirty hands

The bacteria is transmitted through contact with the object on which it is situated, and by the oral route. They can be transmitted through microscopic remnants of the chair, so it is extremely important to observe proper hand hygiene after using the toilet. Because young children (e.g., kindergarten) in such situations, it is difficult to keep track, therefore, it is advisable to observe, at least, mandatory hand washing before every meal. Otherwise, the transmission capability is increased and, thus, can be infected and the entire children's team. The incubation period is about 6 days.

Immediately after manifestation of this disease, it is recommended to isolate the child from other peers. Otherwise, you get to increase the risk of proliferation. Therefore, it is especially important to promptly consult a doctor.

The disease manifests itself in the following way:

1. The bubbles that appear in the locations indicated in the very name of the disease (suffering, both upper and lower limb, baby's leg, particularly the foot, blisters often.). The symptoms are very annoying as they cause trouble walking and eating. Despite the fact that the bubbles look unpleasant, they are not dangerous. First and foremost, the blisters appear in the mouth.
2. In the early days, the disease manifests itself as the flu. The child's temperature rises, there is pain in the muscles throughout the body. These symptoms are associated with General malaise.
3. Occurs intense itching of the affected areas.
4. Blisters in the mouth can lead to loss of appetite and increased salivation.
5. Children become irritable and restless.
6. There is a feeling of numbness and tingling in the extremities.
7. You may feel pain in the throat.

Do not confuse this disease with other diseases!

As blisters in some cases are not so pronounced, the disease hand-foot-mouth can be confused with other diseases. The disease can be presented in different diagnoses and, consequently, the exact number of incidence difficult to determine. It has been sporadic, or there is a small seasonal epidemics, with a peak in late summer. Are suffering illness, mostly children and teenagers. Except in summer, the disease also occurs in the spring.

Therapy

Treatment is usually symptomatic.

1. For the treatment of painful canker symptoms in the oral cavity use of antiseptic action of benzydamine, it is theoretically possible topical application of lidocaine.
2. The problems associated with food intake in children due to pain in the throat, can be reduced by the introduction of conventional analgesics, such as Paracetamol.
3. If there is itching of the skin, the relief may bring the administration of antihistamines.

Bubbles on the skin should not be damaged because of the risk of transmission!

For severe EV71 infections with neurologicalcomplications there is no effective therapy. The possibility of using natural chemicals – geranina or lycorine, which, when introduced into the body of laboratory mice significantly reduced the morbidity and mortality from this disease. Some studies suggest that effective therapeutic method can be use of corticosteroids, NSAIDs and intravenous immunoglobulins. The effect of this treatment, however, has still not been demonstrated.

Vitamin therapy

The primary goal of treatment is to reduce itching, which is a big trouble for children. In particular, doctors prescribe antihistamines. In addition, to relieve the symptoms there are other drugs. Disease hand-foot-mouth continues, high, within 10 days (usually during the week), and treated in the following ways:

1. Increased consumption of vitamins. Maximum attention to the sources of vitamins b and C.
2. The decrease in body temperature. Ensure fluid intake, do compresses and if the temperature is not reduced, give the child syrup or antipyretic drugs.
3. In addition to taking antihistamines RUB the damaged area with a gel that has a soothing effect and relieves itching.
4. Cook easy food which does not irritate the skin. Avoid spices, fried foods and many sweets.
5. Should be more relax, so the body was able to fight the virus.
6. Avoid exposure to the sun, which affects the state of the blisters.

The disease can only in rare cases can lead to other complications. This occurs especially in children with a weak immune system, where there is a risk of developing meningitis. Blisters can occur painful lifting of nails on the hands and feet.

Prevention

Limiting contact with the sick person and thorough hand-washing, despite its limited effectiveness, to date, is the only means to protect against spread of the disease. Due to the risk of developing serious complications, some States have joined the mandatory reporting of the occurrence of this highly contagious disease.

The development of an effective vaccine at the present time is the most important task of the research devoted to the disease. The vaccine should be available soon. Already conducted the first randomized study involving a control group with placebo. The study involved 12,000 children ages 6-71 months. The vaccine in inactivated EV71 were administered intramuscularly in two doses with an interval of 4 months. The vaccine showed efficacy was 97.4% for the first 11 months. Side effect of vaccination was presented by fever, which often occurred within the first week after injection. The vaccine is not effective against disease caused by Coxsackie A16.

Forecast

In most cases, the disease is characterized by a relatively uncomplicated course and rapid recovery. All manifestations of the disease including rash usually disappear within 7 days. If, however, that rarely happens, it affects the Central nervous system, the prognosis worsens, especially for children under 3 years. The most serious complication is paretic form with bulbar syndrome and rapidly progressive neurogenic pulmonary edema. In these cases, there is a high risk of death. In the case of paralysis of the cranial nerves, there is a risk of irreversible neurological deficit. Based on the experience of large epidemics, it is possible to generalize the symptoms, in which there is a high risk of CNS lesions. These include, in particular fever above 38.5-39°C, the duration of which is more than 3-4 days, neurological disorders, vomiting, no canker symptoms in the oral cavity.