Hand, foot, and mouth disease (HFMD) is a common viral illness which usually affects infants and children but can affect adults. The infection usually involves the hands, feet, mouth, and sometimes, even the genitals and buttocks. The cause is coxsackievirus A type 16 in most cases, but the infection can also be caused by many other strains of coxsackievirus.
This viral infection is seen all around the world. As it’s commonly seen children younger than seven years of age , the outbreaks are seen in day-cares, summer camps or within the family. These outbreaks are usually during the summer and early autumn.
The spread of the human enterovirus is mediated by oral ingestion of the shed virus from the gastrointestinal or upper respiratory tract of infected hosts, or via vesicle fluid or oral secretions. After ingestion, the virus replicates in the lymphoid tissue of the lower intestine and the pharynx and spreads to the regional lymph nodes.
Hand, foot and mouth disease can start with a low-grade fever, reduced appetite, and general malaise. The most common hand, foot, and mouth disease presenting symptom is usually mouth or throat pain secondary to ulcers in mouth. The rash can be a patch, pimple or ulcer. The rashes are not painful and not associated with itching.
Dr. Pradeep Kumar MBBS, MD (Pediatrics), PGPN, RCPCH fellowship in Neonatology ( Imperial College London, UK) Consultant - Neonatology & Pediatrician, Rainbow Children ‘s Hospital, Hebbal, Bengaluru.
Hand, foot and mouth disease caused by specific strain type 71 can involve brain and nervous system causing headache, paralysis etc but this is rare.
The diagnosis of hand, foot, and mouth disease is usually made by clinical observation by paediatricians and generally no lab investigations are necessary.
Hand, foot, and mouth disease is a mild clinical syndrome and will resolve within 7 to 10 days. Treatment is primarily supportive. Pain and fever can be managed with paracetamol and pain killers. Child should be offered plenty of liquids to prevent dehydration.
The prognosis for the majority of patients with hand, foot, and mouth disease is excellent. Most patients recover within a few weeks without any residual sequelae. The acute illness usually lasts 10 to 14 days, and the infection rarely recurs or persists. Serious complications like ulcers in stomach, infection of brain , pneumonia may be seen in but are very rare.
