How to stay away from hand, foot and mouth disease during epidemic season

Recently, many children have been diagnosed with hand, foot and mouth disease in primary and secondary schools in many places, which has made some parents feel a little nervous. What is hand, foot and mouth disease? What are some ways to prevent it?

The main symptoms are rashes on the hands, feet, and mouth

Hand, foot and mouth disease is mainly caused by children being infected with enterovirus EV71 and coxsackievirus CoxA10 and CoxA16. Hand, foot and mouth disease is common in children under 5 years old, but it may also occur in other age groups. After being infected with hand, foot and mouth disease, the main symptoms are rashes on the hands, feet and mouth. Sometimes, the rashes may also appear on the buttocks, limbs and other parts. Typical rashes are herpes, maculopapular rashes, etc. Atypical rashes may appear as ecchymoses and petechiae. They are painless, itchy, and do not form scabs or scars. There is a red halo around the herpes and it contains less fluid.

The course of hand, foot and mouth disease is generally 7 to 10 days. In addition to the rash, it may also be accompanied by fever, cough, runny nose, loss of appetite and other symptoms. It can heal itself during the rash period and has a good prognosis. However, there are still a few severe cases where the disease progresses rapidly, and symptoms of other systems such as the nervous system, respiratory system and circulatory system may appear within 1 to 5 days of onset.

Can be spread by contact or droplets

Hand, foot and mouth disease is a global disease. Warm and humid climates are prone to high incidence, which is more common in spring and summer, but can also be seen in other seasons. The main source of infection comes from children and latently infected people. It can be transmitted through direct contact with children's secretions such as feces, herpes fluid, nasopharyngeal secretions, saliva, and indirect contact with infected toys, milk utensils, tableware, towels, bed sheets, etc. It can also be transmitted through droplets. Therefore, the most common occurrence is clustered outbreaks in kindergartens, primary schools and families.

Since 1997, there have been several major outbreaks of HFMD in my country. In 2008, HFMD was listed as a Class C infectious disease. In recent years, the annual incidence of HFMD in my country has ranged from 37.01/100,000 to 205.06/100,000, and the reported mortality rate has ranged from 6.46/100,000 to 51.00/100,000.

If the child has a history of direct or indirect contact with an infected person, and develops herpes on the hands, feet, mouth, etc., accompanied by fever, sore throat, runny nose, cough, or vomiting, drooling, etc., it is highly suspected that the child has hand, foot and mouth disease and is recommended to go to the hospital as soon as possible. If the fever lasts for more than 3 days, or the high fever persists, and the antipyretic effect is poor; headache, vomiting, poor spirits, drowsiness, irritability, or even convulsions occur; shallow and rapid breathing, difficulty breathing; purple lips, palpitations, cold sweats, etc., the child should be sent to the hospital immediately.

Traditional Chinese medicine can be used for symptomatic treatment

Children with hand, foot and mouth disease should first keep their mouths and skin clean. Secondly, antiviral treatment can be taken, but there is no specific medicine at present. Studies have shown that interferon spray or atomization has a certain effect when used in the early stage. At the same time, symptomatic treatment can be given. If there is fever, fever can be actively reduced; if there are reactions such as respiratory system, circulatory system, and nervous system, corresponding treatment should be given according to the corresponding manifestations. In addition, the syndrome differentiation and treatment of traditional Chinese medicine can be used, with clearing heat, removing dampness and detoxification as the basic principle, and different Chinese medicines can be given according to the syndrome differentiation and treatment of different diseases and syndromes, and Chinese medicine fumigation, massage, acupuncture, etc. can also be used as appropriate, such as oral Jinlian Qingre Effervescent Tablets, Kangfuxin Liquid, Xiaoer Chiqiao Qingre Granules, Pudilan Anti-inflammatory Oral Liquid, Lanqin Oral Liquid, and Kaihoujian.

Because hand, foot and mouth disease is contagious, children with the disease must be isolated from other children until all symptoms disappear for one week. During this period, children with the disease should avoid going to schools, parks, amusement parks and other crowded places. The ground, sofas, coffee tables that children touch every day, as well as the tableware and milk utensils they use, should be cleaned and disinfected.

The earlier you get vaccinated against hand, foot and mouth disease, the better the effect.

To prevent hand, foot and mouth disease, children should maintain good personal hygiene habits, wash hands before and after meals, and avoid eating raw or cold food or drinking raw water. Parents should regularly clean and disinfect items that children often touch, such as toys and tableware, and children's clothes and quilts should be dried frequently. During the epidemic period of hand, foot and mouth disease, avoid close contact with children with hand, foot and mouth disease and avoid going to crowded places to reduce the chance of infection.

At present, the hand, foot and mouth disease vaccine in my country is an inactivated EV71 vaccine, which has a preventive effect of more than 90% against EV71. For children aged 6 months to 5 years, the earlier the vaccination, the better the effect, but it is necessary to be careful not to vaccinate with other vaccines at the same time, and the vaccination time should be at least 2 weeks apart. The hand, foot and mouth disease vaccine is divided into two doses, and the best effect is achieved with a one-month interval. If the child has a respiratory infection such as fever or cough during the vaccination, the second dose can be postponed for up to 2 weeks until the infection is cured. Vaccination is not recommended for those who are allergic to vaccine components or children with severe allergies. Children with thrombocytopenia or hemorrhagic diseases, as well as those with immune deficiencies or who are using immunosuppressants, uncontrolled epilepsy, and other progressive neurological diseases such as Guillain-Barre syndrome should also carefully consider vaccination.

(The first author Zhai Yiman is a pediatrician at the Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, and the second author Sun Xiangjuan is an associate chief physician of pediatrics at the Affiliated Hospital of Chengdu University of Traditional Chinese Medicine)