As we enter the summer season, the number of “small hand patients” (pediatric hand, foot and mouth disease patients) in the outpatient clinic has gradually increased. I had to write this article after today’s surgery in the hope of regaining your awareness of the disease.
The company’s main business is to provide a wide range of products and services to the public. Individual children with severe disease can die if the disease progresses rapidly.
Epidemiology.
HFMD is an infectious disease caused by enteroviruses. There are more than 20 enteroviruses (types) that cause HFMD, among which coxsackievirus type A16 (Cox A16) and enterovirus type 71 (EV 71) are the most common. It is most common from April to September each year.
Close human contact is an important mode of transmission, and children become infected through contact with virus-contaminated hands, towels, handkerchiefs, dental cups, toys, eating utensils, milk utensils, as well as bedding and underwear. At the same time, the virus in children’s throat secretions and saliva can be transmitted through the air (droplets), so close contact with a sick child can cause infection. In addition, infection can also occur when drinking or eating water or food contaminated with the virus.
Clinical manifestations.
After prodromal symptoms such as fever (usually around 38°C) and discomfort, children often develop scattered herpes, the size of a grain of rice, on the oral mucosa, with significant pain; rice-grain sized herpes appear on the palms of the hands or feet, and the buttocks and both knees can be involved. The herpes is surrounded by an inflammatory redness, and the fluid inside the herpes is small.
Mild cases have early symptoms similar to upper respiratory tract infections such as coughing and drooling, and some children may have reactions such as nausea and vomiting. Most of them recover within a week as their body temperature drops and the rash subsides.
In severe cases, the disease progresses rapidly, with meningitis, encephalitis, encephalomyelitis, pulmonary edema and circulatory disorders appearing in about 1-5 days after the onset of the disease, and in a very small number of cases, the disease is critical and can lead to death. Severely ill children exhibit poor mental health, drowsiness, startle, headache, vomiting, and even coma; shaking of the limbs, myoclonus, eye movement disorders; shortness of breath, dyspnea, blue lips, coughing, coughing up white, pink or bloody foamy sputum; pale gray face, cold limbs, cyanosis of fingers (toes); shallow, rapid or weakened pulse or even disappearance, and elevated or decreased blood pressure.
In mild cases, antiviral, anti-infective and systemic supportive treatment can be given; in severe cases, changes in the condition should also be closely monitored, especially the function of the brain, lungs, heart and other important organs; in critically ill patients, special attention should be paid to monitoring blood pressure, blood gas analysis and chest X-ray.
Treatment.
Antiviral therapy, commonly used are acyclovir, valacyclovir, famciclovir, Chinese herbal medicine, etc. They are highly effective and broad-spectrum antiviral drugs, which have the effect of significantly shortening the fever and healing time of skin lesions and reducing the pain of oral herpes. In addition, improving the immunity of the body can resist viral infection and prevent the recurrence of viral diseases. Commonly used drugs include transfer factor, thymidine and other drugs.
In severe cases, it is necessary to enhance nutrition and rehydration. And enhance symptomatic treatment and good oral care. Hospital treatment is recommended.
Prevention.
1.Wash your hands, drink boiled water, eat cooked food, ventilate diligently and dry your clothes and blankets.
2, to pay attention to the environment, food hygiene and personal hygiene.
3, do not drink raw water, do not eat raw and cold food, wash hands before and after meals, and keep indoor air circulation.
4, try not to take babies and children to crowded places.
5.Breastfeeding mothers should bathe and change clothes regularly, and wash the nipples before breastfeeding.
6, if the age of <3 years old, appear persistent high fever, depression, shallow breathing, rapid heart rate, small arms and hands become cold (poor peripheral circulation), cough cough pink foamy sputum, sleep convulsions and other signs of serious tendency, parents must first take the child to the hospital.
Finally, I would like to give you the “four words” to detect the true face of HFMD.
The “four parts” —- mainly invade the four parts of the hands, feet, mouth and buttocks.
The “four unlike” —- rash is not like mosquito bites, not like drug rash, not like mouth, lips and gums herpes, not like chicken pox.
The “four unlike” characteristics —- are not painful, not itchy, not crusty, and not scarred.