Hand Foot and Mouth Disease

							Hand Foot and Mouth Disease



             Danielle Hann
             ST2 GPVTS 2010
Hand foot and mouth

   Typically children <10 years
   Commonly <4 years
   Common to have outbreaks
Causes

   Most common is coxsackie A16
   Less common but more serious Enterovirus 17
Incubation/Infectivity

   Incubation 3-5 days
   Infectious <7 days
   Transmission via
    –   Direct contact of secretions or fluid in blisters
    –   Faeco-oral
    –   Vertical spread
Signs/Symptoms
   Prodrome – 12-36 hours
   Sore throat
   Fever
   Mouth
    –   2-8mm macules and papules
        progressing to vesicles
   Skin
    –   Macules and papules on
        hands and feet
    –   Buttocks and groin may also
        be affected
Treatment

   Reassurance
   Prevention of transmission
   Fluid intake
   Analgesia
    –   Oral
    –   Topical
   School exclusion
    –   Until symptoms resolve, blisters dried
Complications

   Dehydration
   Secondary bacterial infection
   EV17
    –   Encephalitis
    –   Aseptic meningitis
    –   Acute flaccid paralysis
    –   Fatal neurogenic pulmonary oedema
Referral

   Dehydration
   Urgently if neurological complications
    –   Severe headache, persistent fever, myoclonic jerks
   Persistent oral ulcers
    –   Unexplained oral ulcers >3 weeks
Prognosis

   Coxsackie A16
    –   Nearly always resolve 5-10 days
   Immunity to further infection but can recur with
    different virus