How the HFMD Virus Spreads and Ways to Prevent It

Author :-

Dr.Sreejaya

General Medicine & Diabetology

Introduction to Hand, Foot, and Mouth Disease (HFMD)

What is HFMD?

The enterovirus family Coxsackievirus typically causes hand, foot, and mouth illness. Most often blamed are coxsackievirus A16 and enterovirus A71.

Understanding the HFMD Virus and How It Affects the Body

Clinicians diagnose hand, foot, and mouth illnesses. The stool virus sheds six weeks after infection, while the oropharynx virus sheds in less than four weeks. Light microscopy of biopsies or vesicle scrapings distinguishes HFMD from varicella-zoster and herpes simplex viruses. Serology cannot diagnose HFMD, although IgG levels can track recovery.

For prognostic purposes, serology distinguishes enterovirus 71 from coxsackieviruses in certain centres. Most centres use polymerase chain reaction tests to diagnose coxsackieviruses. A lesion swab can identify coxsackievirus or enterovirus using real-time PCR.

How HFMD Spreads: Understanding Transmission

Ways the HFMD Virus Spreads

The spread of the human enterovirus occurs through vesicle fluid, oral secretions, or oral absorption from the gastrointestinal or upper respiratory tract. Incubation lasts 3–6 days, and patients are most infectious in the first week. After ingestion, the virus replicates in the lymphoid tissue of the lower intestine and pharynx, then travels to regional lymph nodes. The virus may affect the central nervous system, heart, liver, and skin.

Contagiousness is highest in the first week of sickness. Even healthy individuals can spread the virus. Individuals with the virus, such as most adults, may not exhibit symptoms. Pets and other animals do not spread HFMD.

Common Sources of Infection: Schools, Daycares, and Public Spaces

How Long HFMD is Contagious and Risk of Spread

Direct contact with the mucus, saliva, or faeces of an infected individual spreads this moderately infectious disease. Small outbreaks frequently occur in infant schools and kindergartens between summer and fall. Incubation typically lasts 3–7 days.

HFMD symptoms: recognising early signs

Key Symptoms of Hand, Foot, and Mouth Disease

Fever, appetite loss, and malaise might indicate hand, foot, and mouth illness. Mouth or throat soreness from the enanthem is the most frequent hand, foot, and mouth disease symptom. Eventually, vesicles rupture and create superficial ulcers with a grey-yellow foundation and erythematous border. Vesicular, macular, or papular exanthems. These non-pruritic, 2–6-mm lesions are rarely unpleasant. They burst in 10 days and leave painless, superficial sores without scars. Exanthema can affect the hands, feet, buttocks, legs, and arms. Buccal, tongue, and soft palate ulcers represent oral lesions.

Stages of HFMD symptoms and how they progress

Early HFMD

Many confuse early HFMD for a cold or flu. These symptoms may appear initially:

Fever • Sore throat • Fatigue

Satiety loss

The incubation period is 3-6 days following viral exposure. Infected people are infectious at this stage.

Initial Fever and discomfort

Rapid fever, pain, and irritability are the early symptoms of HFMD. Fevers last 1–2 days and range from mild to severe. At this stage, you may also experience the following symptoms:

Common symptoms: headache, muscle pains, sore throat

Mouth Sores

Blisters appear on the tongue, gums, and inner cheek after a fever. Some sores can cause dehydration and make eating and drinking uncomfortable. Remember to hydrate the patient throughout this time.

Rash

Finger and toe rashes appear a day or two after mouth sores. The rash has red patches and blisters. The rash may also affect the back, knees, elbows, and genital areas. The rash is painful but not annoying. Stage characteristics:

Hand, foot, and other blisters.
Bruised, non-itchy.
Knees, elbows, and buttocks may spread.

Blistering/Ulceration

As the condition advances, blisters may get stronger and ulcerate. This period is painful, but careful cleanliness prevents further infections. Keep blisters dry and don't scratch them.

Regaining

When symptoms fade, healing starts. Usually, the fever occurs first, followed by mouth sores and blisters. While the rash and blisters may take longer to heal, they will eventually fade without leaving any scars. Nutrition and hydration are essential for healing in this period.

Timeline of HFMD

The HFMD symptoms timeline might help you predict illness development and manage symptoms.

The individual is contagious but has no symptoms.

Day 1-2: Fever, sore throat, lethargy, and poor appetite
After 3–5 days, sore mouths make eating and drinking difficult.
Day 4–7: Hands, feet, and other regions are rash.
Blisters may ulcerate, and symptoms subside day 7–10.
The symptoms progressively fade on days 10–14.

Differentiating HFMD symptoms from other common illnesses

Measles symptoms: Include fever, cough, runny nose, and conjunctivitis, which are followed by a rash that starts on the head and spreads. Measles rash is more widespread and does not blister like HFMD.

Chickenpox: causes fever, intense fatigue, and a blistering, fluid-filled rash. Chickenpox can affect the scalp, trunk, arms, and legs, while HFMD only affects the hands, feet, and mouth.

Eczema: Atopic dermatitis causes chronic skin irritation and itching. Eczema seldom causes fever or mouth sores like HFMD.

Impetigo: This causes red, breaking, weeping lesions with a yellow-brown crust. Most occurrences of impetigo do not produce fever or affect the hands or feet.

Complications of HFMD: When to Seek Medical Help

Possible Complications from Hand, Foot, and Mouth Infection

HFMD seldom causes pneumonia, myocarditis, pancreatitis, pulmonary oedema, or serositis in other important organs. Lethargy, pneumo-oedema/pneumorrhagia, seizures, dyspnoea, and coma put children with HFMD at risk of mortality, according to a major meta-analysis.

Severe HFMD symptoms and high-risk cases

Rarely severe, HFMD has few consequences. Most people recover in 7–10 days without medical care.

Dehydration

Dehydration can occur in children and others. Painful mouth sores might prevent them from swallowing adequate drinks. Make sure your youngster drinks enough to avoid dehydration.

Toenail and finger loss

Though rare, HFMD can cause nail loss. Most fingernail and toenail loss is in children. In these instances, nail loss frequently occurs within weeks of illness. Nail growth normally occurs naturally. No evidence links HFMD to nail loss.

Aseptic viral meningitis

Few HFMD patients have viral meningitis. The symptoms include fever, headache, stiff neck, and back discomfort. The sick person may need several days in the hospital.

Brain inflammation or paralysis

A very few HFMD patients develop encephalitis or paralysis.

HFMD in Children vs. Adults: Symptom Differences

There are no HFMD treatments. Many moderate instances of HFMD resolve within a week to 10 days. 10

Experts prescribe OTC and at-home therapies for painful or annoying symptoms to help your kid feel better. Among them: 11

Fever Tylenol (acetaminophen)
For headaches, Advil or Motrin (ibuprofen).
Oral or topical antihistamines for itching
Oral painkillers
Fluid-rich drinking
Plenty of sleep
Eating soft food

Adults

Adult HFMD recovery includes addressing painful symptoms. In addition to over-the-counter remedies for headache, sore throat, and itching rash, consider the following:

Relieving sore throats using lozenges
Avoid consuming hot and acidic foods.
Drink cold water.
Ice sucking
Gargling warm salt water

Ways to Prevent HFMD

Effective Hygiene Practices to Prevent HFMD

Our findings have academic and practical importance. Epidemiological research supports handwashing to avoid HFMD and other infectious illnesses. This study also found that airing bedding might be harmful, unlike earlier studies. The final logistic model separated high-risk HFMD children from the control group with an AUC of 0.895. This study improved its conclusion by including demographic characteristics, birth and feeding situations, and child and carer living habits.

How to Reduce the Risk of HFMD in Schools and Public Places

Good hand hygiene prevents HFMD. After using the bathroom, touching public items, saliva, or respiratory secretions, and before eating, children should wash their hands with hand sanitisers or soap. After changing nappies or handling faeces, parents and carers should wash their hands before processing meals.
Avoid ill children and share dinnerware, towels, and other personal objects to avoid cross-contamination.
Keep homes clean and ventilated. Sanitise counters, door knobs, and kids' toys regularly.
Clean and disinfect infant and toddler bottles and teats, as well as utensils, before and after use. Regularly wash or disinfect infant and toddler nappies. Children should not drink untreated water or eat uncooked or cold food.
During the HFMD pandemic, avoid crowded, poorly ventilated public locations with children.

Educating Children on Preventing Hand, Foot, and Mouth Sickness

Regularly wash your hands with soap and water. It's crucial to wash your hands after using the restroom, changing nappies, eating, and cooking..

Clean and disinfect regularly touched objects, such as toys and doorknobs.

Limit hand contact with eyes, nose, and mouth.
Avoid close contact with those with HFM. Please avoid embracing, kissing, and eating together.
Cover your mouth and nose with a tissue or sleeve while coughing or sneezing, and advise youngsters to do likewise.

HFMD Disease and Immunity: Can You Get HFMD More Than Once?

Immunity to HFMD After Infection

EV71 infection protection depends on antibody response, according to animal studies. Several seroepidemiological studies in humans have shown that the prevalence of EV71 antibodies rises with age. This suggests that adults may not get infected with EV71 because they have humoral immunity. Thus, it is crucial to understand how humans respond to EV71 infection and how humoral immune responses affect it.

Potential for Recurrence and Re-Infection

We examined HFMD recurrence in children using Kaplan-Meier survival analysis. To compute HFMD recurrence, we kept just the event of interest and filtered extraneous events at the end of observation. We estimated recurrence probability in all suspected and laboratory-confirmed HFMD recurrent cases. Censoring single-HFMD patients. For reinfection estimates, we considered only case patients with an initial EV-A71 infection who were reinfected. We censored EV-A71-infected individuals with CV-A16 or other enteroviruses, probable HFMD, or first infection. Similar methods calculated other enterovirus serotypes' reinfection likelihood.

Treatment options for HFMD symptoms and relief

Home Remedies to Relieve HFMD Symptoms

Washing hands
Avoid touching eyes.
Disinfection
Use tissues
Avoiding the infected person or child

Medical Treatments and When to Consult a Doctor

Without therapy, children recover from HFMD in 7–10 days. HFMD is viral; hence, antibiotics don't work. Treatments decrease symptoms and prevent dehydration. If someone's situation worsens, they should go to the doctor's office or Ovum Hospital for better care from competent professionals.

Tips for Soothing Painful Sores and Rash

Treat mouth discomfort to help your kid drink and avoid dehydration. Tylenol and ibuprofen, Motrin, and Advil are excellent painkillers.

Toddlers and older youngsters can eat yoghurt, spaghetti, pudding, smoothies, and ice pops to ease discomfort.

Offer your kid a variety of fluids, but remember that water alone does not supply energy or salt to maintain blood pressure if they are not eating.

Managing HFMD in Daycare and School Settings

Guidelines for Handling HFMD Cases in Group Settings

Specific hospitals for treating EV71-infected patients:

Moderate cases are referred to neighbouring hospitals, while serious cases are referred to specialised hospitals.
Setting up or expanding paediatric ICUs.
We provide top-level national and state ICU staff training.
specialised medical staff and 24-hour operations.
We monitor and assess severe cases based on clinical symptoms.
Clinical surveillance enables early diagnosis of severe cases and takes action to reduce mortality.

There are protocols for quarantine and reducing spread in children's facilities.

Contagious HFMD. Stay home from school or work if you or your kid have HFMD to avoid its spread.

HFMD patients must feel well, be fever-free for 24 hours, and have all blisters healed to end isolation. For most individuals, this implies avoiding others for 7 days.

Viral HFMD is a prevalent Trusted Source disease. Spit, dung, respiratory particles, and virus-infected surfaces spread it. Notify your child's daycare, nursery, or school immediately if they have HFMD. HFMD patients must be isolated.

Conclusion

HFMD is a common, contagious condition that causes red bumps on your hands, feet, and lips. You must stay home and avoid people until your HFMD symptoms subside, which might take a week. Saying it out is simple, but doing it is hard. Ovum Hospital provides top-notch care for children and adults with such diseases.

FAQs

1 Are hand, foot, mouth, and foot-and-mouth diseases the same?

No. HFMD is sometimes mistaken for cow, sheep, and swine foot-and-mouth disease.

2 Can HFMD be averted?

Good cleanliness helps reduce the incidence of HFMD and other non-polio enterovirus infections, but there is no specific prevention.

3: Is anyone at risk for HFMD?

Infants, children, and teenagers are less resistant to these viruses, making them more prone to infection and sickness. Q. 8. Pregnancy hazards

4 How soon does HFMD infection cause illness?

Symptoms usually appear 3–7 days after infection. HFMD usually starts with fever.

5: What treats HFMD?

Another enterovirus infection has no therapy. Mouth ulcer fever, aches, and discomfort are treated symptomatically.