HAND, FOOT, MOUTH DISEASE (HFMD)

Hand, foot, and mouth disease (HFMD) is a common illness of infants and children caused by a virus. It most often occurs in children under 10 years old. It is characterized by fever, sores/ulcers in the mouth, and a rash with blisters. The blisters may appear in the mouth, palms of the hands and soles of the feet. The rashes may also appear on buttocks and on the legs and arms. The ulcers in the mouth usually appear on the tongue, the sides of the cheeks, gums or near the throat.

HAND, FOOT, MOUTH DISEASE (HFMD)

HAND, FOOT, MOUTH DISEASE (HFMD)

The most common causes of Hand, Foot and Mouth disease are coxsackie virus A16, enterovirus 71 (EV71) and other enteroviruses.The enterovirus group includes polioviruses,coxsackieviruses, echoviruses and other enteroviruses
HAND, FOOT, MOUTH DISEASE (HFMD)

Figure 1. A). Positive immunostaining of EV71 antigens in neuron and neuronal process. Original magnification, X158. B). Positive immunostaining of EV71 antigens in necrotic area. Original magnification, X158. C). An array of picornavirus particles in a neuron (electron micrograph).

PV1:CD155

HRV:ICAM-1

HAND, FOOT, MOUTH DISEASE (HFMD)

Individual cases and outbreaks of HFMD occur worldwide, more frequently in summer and early autumn (in temperate countries). In the recent past, major outbreaks of HFMD attributable to enterovirus EV71 have been reported in Malaysia in 1997 and in Taiwan in 1998. HFMD is endemic in Malaysia and occurs every year. In Sarawak, the number of cases of HFMD tends to increase from February to June.
HAND, FOOT, MOUTH DISEASE (HFMD)

HAND, FOOT AND MOUTH DISEASE STATISTICS FOR 29/02/2012 IN SARAWAK DIVISION

Source Sarawak Health Department

HAND, FOOT, MOUTH DISEASE (HFMD)

HAND, FOOT, MOUTH DISEASE (HFMD)

Fever Headache Vomiting Fatigue Malaise Referred ear pain Sore throat Painful oral lesions

HAND, FOOT, MOUTH DISEASE (HFMD)

 Non-itchy body rash, followed by sores with blisters on palms of hand and soles of feet Oral ulcer Sores or blisters may be present on nose and nostrils Sores or blisters may be present on the buttocks of small children and infants Irritability in infants and toddlers Loss of appetite. Diarrhea

HAND, FOOT, MOUTH DISEASE (HFMD)

The common incubation period (the time between infection and onset of symptoms) is from three to seven days. Early symptoms are likely to be fever often followed by a sore throat. Loss of appetite and general malaise may also occur. Between one and two days after the onset of fever, painful sores (lesions) may appear in the mouth and/or throat. A rash may become evident on the hands, feet, mouth, tongue, inside of the cheeks, and occasionally the buttocks (but generally, the rash on the buttocks will be caused by the diarrhea).

HAND, FOOT, MOUTH DISEASE (HFMD)

HAND, FOOT, MOUTH DISEASE (HFMD)

HAND, FOOT, MOUTH DISEASE (HFMD)

LEPUH DI TAPAK TANGAN

HAND, FOOT, MOUTH DISEASE (HFMD)

By direct contact with infected people or direct contact with saliva, nasal secretions, throat discharge, stools or blister secretions of infected persons.

HAND, FOOT, MOUTH DISEASE (HFMD)

HAND, FOOT, MOUTH DISEASE (HFMD)

HAND, FOOT, MOUTH DISEASE (HFMD)

Hand, foot and mouth disease is usually diagnosed based on a complete history and physical examination of your child. It is generally suspected on the appearance of blister-like rash on hands, feet and mouth in children with a mild febrile illness. Usually, the doctor can distinguish between HFMD and other causes of mouth sores based on the age of the patient,

HAND, FOOT, MOUTH DISEASE (HFMD)

the pattern of symptoms reported by the patient or parent, and the appearance of the rash and sores on examination. A throat and/or blister swab collected preferably within 2 days of onset of HFMD may be sent to a laboratory to determine which enterovirus caused the illness.

HAND, FOOT, MOUTH DISEASE (HFMD)

HAND, FOOT, MOUTH DISEASE (HFMD)

There is no specific treatment for hand, foot and mouth disease. Individual symptoms, such as fever and pain from the sores, may be eased with the use of analgesics. HFMD is a viral disease that has to run its course; many doctors do not prescribe medicine for this illness.

HAND, FOOT, MOUTH DISEASE (HFMD)

Infection in older children, adolescents, and adults is typically mild and lasts approximately 1 week, occasionally longer. Fever reducers and luke-warm baths can help bring temperature down.

HAND, FOOT, MOUTH DISEASE (HFMD)

Only a very small minority of sufferers require hospital admission, mainly as a result of uncommon neurologicalcomplications (encephalitis, meningitis, or acute flaccid paralysis) or pulmonary edema/pulmonary hemorrhage.
HAND, FOOT, MOUTH DISEASE (HFMD)

HAND, FOOT, MOUTH DISEASE (HFMD)

Specific prevention for HFMD or other non-polio enterovirus infections is not available, but the risk of infection can be lowered by good hygienic practices. Preventive measures include Infected children should stay away from school for one week after the rash appears. Proper hygiene practices such as hand washing should be practiced.

HAND, FOOT, MOUTH DISEASE (HFMD)

 Advice should be given for proper disinfection of articles such as toys, eating utensils and towels contaminated by the droplets, saliva or stool of infected cases. Maintain cleanliness of house, child care center,kindergartens or schools and its surrounding Cleaning of contaminated surfaces and soiled items with soap and water, and then disinfecting them with diluted solution of chlorine-containing bleach (10% concentration)

HAND, FOOT, MOUTH DISEASE (HFMD)

 Parents are advised not to bring young children to crowded public places such as shopping centers, cinemas, swimming pools, markets or bus stations Bring children to the nearest clinic if they show signs and symptoms. Refrain from sending centers, kindergartens or schools. Avoidance of close contact (kissing, hugging, sharing utensils, etc.) with children having HFMD illness to reduce of the risk of infection.

HAND, FOOT, MOUTH DISEASE (HFMD)

HAND, FOOT, MOUTH DISEASE (HFMD)

 In conclusion, EV71 infection may have a fulminant clinical course, and particularly because approximately 90% of the fatal cases were in children <5 years of age, effective control measures must be implemented: new antiviral drugs should be developed and mass active vaccination of children <5 years old in diseaseendemic areas should be considered.
HAND, FOOT, MOUTH DISEASE (HFMD)