Prevent Enteroviral infection

Enteroviruses comprise mainly four types of viruses namely 'Coxsackie viruses', 'Echoviruses', 'Enteroviruses' and 'Polioviruses'. The viruses can cause a variety of diseases ranging from mild and common illnesses such as Hand, Foot and Mouth Disease, conjunctivitis to severe but rare conditions like paralysis, myocarditis and aseptic meningitis. A seasonal trend with higher activity during summer months was sometimes observed. To prevent infection, we need to observe. . .


Hand, foot and mouth disease

(Clinical photo : courtesy of Department of Paediatrics and Adolescent Medicine, Princess Margaret Hospital.)



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Hand, foot and mouth disease

Causative agent

HFMD is a viral infection. The most common causative agents are Group A Coxsackie viruses which belong to the group of Enteroviruses. HFMD tends to be most common in summer and early autumn.

Clinical features

Flu-like symptoms may develop during the early stage of the infection. Fever may persist for 4-5 days. A painless rash or vesicles may also develop over the palms, soles and sometimes buttocks. There may be loss of appetite especially if there are painful mouth ulcers causing difficulty in swallowing. Disappearance of the rash and healing of vesicles usually occur within 7-10 days. Complications are uncommon. Rarely, this illness may be associated with viral meningitis.

Mode of transmission

HFMD is mainly transmitted by the faecal-oral route. Direct contact with open and weeping skin vesicles may also spread the virus. A person is most contagious during the first week of the illness and the infectious agent can be found in stools for weeks.

Incubation period

The incubation period is 3-7 days.

Management

In most cases, the fever, rash and ulcers subside spontaneously in one week and full recovery is usual. There is currently no effective treatment for the infection. Symptomatic treatment is given to provide relief from fever, aches or pain from the ulcers. Those who handle nose or throat discharges, faeces and soiled articles should wash hands promptly afterwards. Parents are advised to seek prompt medical attention if their children develop a high fever, decrease in alertness or deterioration of general condition.

Prevention

Strict personal hygiene is of utmost importance in preventing HFMD.
1. Maintain good air circulation.
2. Wash hands before meals and after going to toilet, handling diapers, or other stool soiled material.
3. Keep hands clean and wash hands properly.
4. Wash hands when they are dirtied by respiratory secretions e.g. after sneezing.
5. Cover nose and mouth while sneezing or coughing and dispose of nasal and mouth discharge properly.
6. Clean children's toys and other objects thoroughly and frequently.
7. Children who are ill should be kept out of school until their fever and rash have subsided and all the vesicles have dried and crusted.
8. Avoid going to overcrowded places.