How to prevent pediatric hand, foot and mouth disease

  HFMD is an infectious disease caused by an enterovirus, mainly in preschool children, with the highest incidence in the ≤3-year-old age group. It can cause fever and rashes and ulcers on the hands, feet, buttocks, and mouth, and individual patients can suffer from complications such as myocarditis, pulmonary edema, and aseptic meningoencephalitis. There are more than 20 types of enteroviruses that cause HFMD, among which Coxsackievirus A16 (Cox A16) and Enterovirus 71 (EV 71) are the most common.  The main modes of infection transmission are: close contact with people is an important mode of transmission, and children are infected through contact with virus-contaminated hands, towels, handkerchiefs, tooth cups, toys, eating utensils, milk utensils, bedding, underwear, etc.; the virus in the throat secretions and saliva of patients can be transmitted through the air (droplets), so close contact with sick children can cause infection; drinking or eating the virus can cause infection. Infection can be caused by close contact with sick children; infection can also occur by drinking or eating water or food contaminated with the virus. During the epidemic, kindergartens and nurseries are prone to collective infections.  HFMD is an enteroviral disease with common features of enteroviral infections. It can occur from the most common asymptomatic or mild discomfort to severe complications or even death. The incubation period is generally 3-7 d, with no obvious prodromal symptoms, and most patients have a sudden onset of illness. About half of the patients have fever, mostly around 38°C, 1 to 2 d before or at the same time as the onset of the disease. The rash has the four characteristics of no pain, no itching, no crusting and no scarring. Some patients initially have mild upper sensory symptoms, such as cough, runny nose, nausea, vomiting, etc. Due to the painful mouth ulcers, the affected children salivate and refuse to eat.  Oral mucosal rash appears relatively early, initially as corn-like papules or blisters surrounded by a red halo, mainly on the tongue and both cheeks, and often on the lateral side of the lips and teeth. The rash is not itchy, and the papules turn from red to dark in about 5 d and then fade; the herpes is round or oval and flattened with cloudy liquid inside, with a long diameter in line with the direction of the skin lines, such as soybean size, generally without pain and itching, and leaves no trace after healing. Hand, foot and mouth lesions may not all appear in the same patient. Blisters and rashes usually resolve within a week.  HFMD manifests on the skin and mouth, but the virus can invade vital organs such as the heart, brain, and kidneys. If there is a high fever and unexplained increase in white blood cells without detecting other foci of infection, one should be alert for the development of fulminant myocarditis. EV 71 has a higher chance of aseptic meningitis than Cox Al6-induced HFMD, and its symptoms present as fever, headache, stiff neck, vomiting, easy irritability, and restless sleep; the body may occasionally reveal nonspecific erythematous papules or even punctate bleeding spots. Central nervous system symptoms are mostly seen in children under 2 years of age.  Prevention of the disease: 1. Do morning physical examination in childcare institutions, and isolate and treat suspected patients in a timely manner; 2. Disinfect contaminated daily necessities and food utensils, soak feces and excrement of children in 3% bleach clarifying solution, expose clothes to sunlight, and keep ventilation in the room; 3. Parents should let their children go to crowded public places as little as possible to reduce the chance of being infected; 6, pay attention to the nutrition of infants and children, rest, avoid sun exposure, prevent excessive fatigue, reduce the body’s resistance; HFMD is mainly symptomatic treatment, without complications can be cured in about a week, the prognosis is good. Anti-viral treatment can also be used. Family care should regularly let the child rinse the mouth with warm water; forbid cold or spicy stimulating food, do not give salty food, so as not to cause pain and refuse to eat; diet should be easy to digest, eat some light, soft, warm meals, drink more warm water; to let the child have enough rest; to ensure that the child’s clothes are clean, to avoid rash infection. If the child is not in good spirits, high fever does not subside need to promptly seek medical attention.