Understanding HFMD Hand, foot, and mouth disease is an infectious disease caused by enteroviruses. There are more than 20 types of enteroviruses that cause HFMD, among which human enterovirus 71 (EV-71) or coxsackievirus A16 (CA-16) infections are the most common, and humans are the only host of human enteroviruses. Transmission HFMD can be transmitted through the gastrointestinal tract (fecal-oral route), through the respiratory tract (droplets, sneezing, etc.), or through contact with the patient’s oral and nasal secretions, skin or mucosal herpes fluid, and contaminated hands and objects. Most children with HFMD complain of sore throat or mouth pain, while younger children only cry, salivate and refuse to eat as the main manifestations. Examination of the oral cavity may reveal multiple pinpoint to 1 mm sized herpes on the isthmus of the pharynx or isthmus, gingiva or tongue, some of which fuse to form blisters and then become ulcers. In addition, on the hands and feet, multiple firm rashes consisting of a mixture of papules and herpes, surrounded by a red halo, may be seen. The palms of the hands or soles of the feet can sometimes be seen, and when the rash is numerous, it can extend to the extremities and around the buttocks and anus. In milder cases, the rash usually subsides after 7-10 days. Some children with severe HFMD may have direct symptoms of startle (similar to being startled), recurrent convulsions (i.e., seizures), shock or even multi-organ dysfunction syndrome, and in severe cases, pulmonary hemorrhage (coughing up pink frothy sputum). Severe cases of HFMD start with pulmonary hemorrhage (coughing up pink frothy sputum) and the appearance of these symptoms even precede the rash, but the test is positive for EV-71 antibodies in venous blood or positive for EV-71 in anal swabs. Children with severe HFMD may have a rapid onset and progression, and severe cases may progress within a short period of time, with circulatory collapse and pulmonary hemorrhage being common causes of death. Preventive and control measures HFMD is transmitted in many ways, and infants and children are generally susceptible. Good hygiene for children’s personal, family and child care institutions is the key to preventing infection from this disease. Children should wash their hands thoroughly with soap or hand sanitizer before and after meals and after going out, refrain from drinking raw water, do not allow children to eat raw and cold food, and avoid contact with children who have been diagnosed. Caregivers should change diapers before and after contact with children; bottles and pacifiers should be disinfected by boiling after being fully washed; children should not be taken to crowded places as much as possible during the epidemic season; and rooms should be frequently ventilated. Children with mild HFMD do not need to be hospitalized and can be treated at home in isolation and rest to reduce cross-infection. However, it is recommended that children with persistent high fever or frequent jumping should seek immediate medical attention and be hospitalized to avoid delaying the best time for resuscitation.