HFMD

Hand-Foot-And-Mouth Disease On The Rise: Experts Beg Parents To Know The Signs

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Every parents worries about the infectious childhood illness that sweep through classrooms and after-school programs this time of year.

Most kids get their inoculations early on to avoid old-fashioned diseases like mumps and rubella that used to effect huge swathes of children every year.

Even better, there’s now an annual flu shot for tackling one of the winter’s most contagious illnesses — even Ellen knows how important it is to get your flu shot!

Still, some diseases are proving harder to tackle than others. One of the most resistant is hand-foot-and-mouth disease, which still affects about 200,000 Americans in the USA every year.

This year, experts at the West Central Health District in Georgia warn that it could be a record-breaking year for the disease, which is already causing outbreaks among school kids and college students.

Scroll through below to learn more about the disease, and what you can do to head it off.

Hand-foot-and-mouth disease — or HFMD for short — is an incredibly common ailment that affects hundred of thousands of people every single year.

Part of the reason it’s so very common? It’s highly contagious, and can spread easily from contact with saliva or mucus.

In other words, you can’t get it from simply being in the same room as someone with the infection, but you can get it from a sneeze, a kiss, or a handshake.

That’s part of the reason it runs rampant in kindergartens and preschools, where the kids tend to be grabby with one another, and are usually a little bit covered in spit and snot.

It also spread quickly on college campuses, where food and drinks are shared frequently, and students tend to be overtired and not at peak physical health.

Senior citizens or folks with weakened immune systems are also vulnerable, especially if they live communally, like in a nursing home.

Of course, even a perfectly healthy adult in the prime of life can get this disease; it all depends on what germs you’re exposed to.

Fortunately, the symptoms are unpleasant, but usually mild and not life-threatening.

They include flu-like symptoms, like fever and sore throat, but HFMD is most characterized by the itchy red spots that appear on — you guessed it — your hands, feet, and mouth.

Sores may sometimes also appear on the legs and genitals.

The virus looks alarming, especially if you’re sporting spots, but fortunately it usually clears up on its own within a week or two.

Still, if you suspect you or another member of your family has the disease, go to the doctor straight away.

Because it’s so contagious, this illness usually requires you to stay home until the virus is fully out of your system, to keep it from spreading to other folks in your community.

Though the symptoms of the virus are usually mild, there can be serious side effects, especially in people with weakened immune systems from another illness or from age.

In some rare cases, HFMD can lead to serious brain infections like meningitis and encephalitis.

More commonly, kids who don’t shake the symptoms for a few weeks may lose some of their fingernails or toenails.

According to the CDC, outbreaks of HFMD are not common in the USA, but that might be changing this year.

A large outbreak has been sweeping through Georgia, and may affect the wider South Eastern US, and could even spread to other regions of the country.

If you happen to live in an area affected by this year’s HFMD outbreak, it’s important to be extremely vigilant about hygiene practices.

 make sure everyone is washing their hands after leaving the bathroom, and before touching any food.

If you suspect HFMD, make sure to keep your kiddos home from school until they have been cleared by a doctor.

If you or someone you know does contract the illness, the best treatment is rest and plenty of fluids, even if the sores make swallowing a little painful.

Enterovirus 71 Vaccine Is Safe and Efficacious.

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Two doses of an enterovirus 71 vaccine had an efficacy of 80% against EV71-associated disease in Chinese children.

 

Enterovirus 71 (EV71) is associated with hand, foot, and mouth disease (HFMD) and other, more-serious conditions. Infants and young children are most affected; epidemics have been especially severe in Asia (JW Infect Dis Jan 30 2013).

Investigators (with partial manufacturer support) recently conducted a multicenter, double-blind, phase III trial of an inactivated alum-adjuvanted EV71 vaccine based on genotype C4, the predominant strain in mainland China. Healthy children in that country, aged 6 to 35 months, were randomized to receive vaccine or placebo (alum adjuvant), administered on days 0 and 28. Of 10,245 enrollees, 96% received both doses.

During active surveillance (from day 56 to month 14), vaccine efficacy in the per-protocol population was 80% against EV71-associated disease and 90% against EV71-associated HFMD. Among 52 participants with laboratory-confirmed EV71-associated disease, 51 were seronegative; all EV71 isolates were genotype C4. Eight placebo-group and no vaccine-group participants were hospitalized for EV71-associated disease. Most participants with clinical HFMD were infected with Coxsackie A virus 16 or other enteroviruses; only 2.1% of episodes were associated with EV71. In the subset studied for immunogenicity, antibody titer was significantly higher in vaccine-group than placebo-group participants. The rate of serious adverse events was similar between groups (1.2% and 1.5%, respectively).

Comment: The authors caution that although EV71 vaccine could help to prevent severe cases of EV71-associated disease, its role in reducing the overall incidence of hand, foot, and mouth disease might be limited because EV71 is only one cause of this syndrome. They also note the need to assess whether the vaccine’s immunogenicity and efficacy are affected by concomitantly administered routine vaccines. Editorialists observe that future studies should examine cross-protection against other genotypes and — because neonatal EV71 infection can be particularly severe — vaccination of infants aged <6 months. Cost-effectiveness analyses can help in setting priorities among the several new vaccines that are efficacious and have acceptable safety profiles.

 

Source: Journal Watch Infectious Diseases

Outbreak of Illness and Death Among Children in Cambodia.

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The outbreak appears to have been caused by enterovirus 71.

In early July 2012, an outbreak of severe illness with high mortality was reported by the Ministry of Health in Cambodia. According to a WHO report dated July 13, 78 cases in 14 provinces had been identified since April, mostly in children aged ❤ years.

Investigation focused on the 61 children who met the case definition, of whom 54 had died. Illness manifestations included respiratory symptoms, fever, and generalized neurological abnormalities; children who died usually did so within 24 hours after hospital admission. Samples from 31 patients were tested for a variety of pathogens by Institut Pasteur du Cambodge, and “most” tested positive for enterovirus 71 (EV-71); a few also tested positive for dengue virus or Streptococcus suis. On July 15, 2012, authorities announced that no additional cases had been noted in Cambodia. Investigators believed that the use of steroids, which can suppress the immune system, worsened the illness in many of the patients.

Comment: EV 71 — a member of the picornavirus family — was first isolated in the late 1960s. It has been associated with outbreaks worldwide, most recently in Asia. Infection with EV 71, like that with other enteroviruses, ranges from asymptomatic to lethal and can manifest as rashes, diarrhea, respiratory symptoms, meningitis, hand-foot-mouth disease (HFMD), or myocarditis. Less commonly, it has been associated with acute flaccid paralysis, encephalitis, Guillain-Barré syndrome, and pulmonary edema and hemorrhage.

HFMD is most often caused by coxsackievirus A16 (another enterovirus) but is also caused by EV 71. According to the WHO, HFMD usually begins with fever, poor appetite, malaise, and sore throat. One or 2 days after fever onset, painful sores develop on the tongue, gums, and inside of the cheeks, beginning as small red blistering spots and then often becoming ulcers. A nonitchy skin rash develops over 1 or 2 days, with flat or raised red spots that may blister. Usually located on the palms of the hands and soles of the feet, the rash can also appear on the buttocks or genitals. Generally, HFMD is spread from person to person by direct contact with nose or throat discharges, saliva, fluid from blisters, or stool of infected persons. Transmissibility is greatest during the first week of the illness but can last for several weeks. No vaccine or antiviral agent has proven effective in preventing or treating EV 71 infection.

Source: Journal Watch Infectious Diseases