Hand, foot and mouth disease and herpetic pharyngitis continue to be prevalent in children

Recently, many parents left messages in the background, saying that kindergartens have been forced to suspend classes recently, and the culprit is a disease called "herpetic pharyngitis". Once a child is infected, the entire class will be suspended. Some children even had a fever due to this disease and had hallucinations...

Looking at all the messages and inquiries, parents are really worried. So what exactly is the origin of this thing called "Herpes Man" (herpetic pharyngitis)?

"Herpes Man" Crime Files

Big reveal

1. The culprit

(Pathogens)

In fact, this "herpes man" is not so unfamiliar. It is a "good brother" to hand, foot and mouth disease! Both are acute infectious diseases caused by enterovirus.

2. Event Season

(High season)

In our province, it does its evil deeds crazily from April to July and from September to November every year.

3. Target

(Susceptible population)

Generally speaking, it is not picky about people (people are generally susceptible to human enterovirus, and people of all ages can be infected and develop the disease). But it especially likes to attack children aged 5 and under (the highest incidence rate is among children aged 3 and under).

4. Transmission routes

It is mainly transmitted through the fecal-oral route, respiratory droplets, contact with nasal secretions of sick children, and contaminated hands and objects.

5. Behavior after infection

Herpetic pharyngitis often presents with a rapid fever, occasionally reaching over 40°C, and even causing convulsions. The fever usually lasts 2 to 4 days. Older children may complain of sore throat, and severe sore throat may affect swallowing. Infants and young children may experience drooling, refusal to eat, and irritability. Sometimes accompanied by headache, abdominal pain, or myalgia.

Herpangina is highly contagious, but most cases are mild and self-limited (1 to 2 weeks) with a good prognosis; very rare cases may be accompanied by serious complications such as encephalitis.

At present, there is no specific medicine to treat herpetic pharyngitis and hand, foot and mouth disease. Antibiotics are ineffective, and doctors generally treat symptoms. For example, for children with a fever over 38.5℃, doctors will recommend the use of acetaminophen or ibuprofen, and warm water sponge baths can also be used to help reduce the temperature.

But please note that these situations may develop into critical cases in a short period of time.

Persistent high fever, body temperature greater than 39°C, and conventional antipyretic effects are ineffective;

Mental depression, drowsiness, headache, nystagmus or upward rolling of the eyeballs, vomiting, easy startle, limb tremors, weak sucking, instability when standing or sitting, etc.;

Breathing becomes faster, slower, or irregular;

Increased heart rate, cold sweats, cold extremities, pale skin, increased blood pressure, etc.

Especially for children under 3 years old, you must not delay. Without timely treatment, they may die. Even if they are rescued, there may be sequelae!

I don't want my child to suffer this.

Prevention is important

1. Wash hands frequently. Wash children’s hands with soap or hand sanitizer before meals, after defecation, and after going out. Caregivers should wash their hands before touching children, changing diapers, and handling feces.

2. Pay attention to hygiene. Infants' diapers should be cleaned, exposed to the sun or disinfected in time. Keep the home environment clean, ventilate the house regularly, and dry clothes and quilts frequently. Bottles, nipples and tableware used by infants and young children should be thoroughly cleaned and disinfected before use. Do not let children drink raw water or eat raw or cold food.

3. Avoid going to crowded places. It is not advisable to take children to public places where there are crowds and poor air circulation; avoid contact with sick children;

4. Do a good job of disinfection. Children receiving home treatment should avoid contact with other children to reduce cross infection. The children's clothes should be dried or disinfected in time, and the children's feces should be disinfected in time.

About "Herpes Man" and "Hand, Foot and Mouth Disease"

You may have these doubts

Q

1. Will there be any sequelae after “Herpes Man” recovers?

Most herpetic pharyngitis will not have any sequelae after recovery.

Only in a few cases will complications such as meningitis occur, leading to sequelae in the nervous system, respiratory system, circulatory system, etc.

Q

2. If I have had this disease before, will I get it again?

It is possible, but as you age, the symptoms will become milder and the chance of serious complications will decrease. (Both herpes pharyngitis and hand, foot and mouth disease are caused by a variety of enteroviruses, and there is some overlap between the two. There is no cross-protection between different pathogens, so repeated infections may occur.)

Q

3. Is there any vaccine available?

Currently, the only inactivated vaccine against enterovirus EV71 is on the market, but it can only prevent hand, foot and mouth disease caused by enterovirus EV71 infection.

Currently, EV71 vaccine is available at all community center vaccination clinics, with a total of two shots.

Q

4. Why did my child still get herpetic pharyngitis after I vaccinated him?

EV71 vaccine can only fight EV71 virus, and is ineffective against other enteroviruses that cause herpangina. (Vaccines against other enterovirus serotypes are still under development.)

Q

5. In this case, is it still necessary to get the EV71 vaccine?

It is necessary.

Although the EV71 vaccine cannot prevent all hand, foot and mouth disease, it will significantly reduce the incidence of severe hand, foot and mouth disease and death. It is recommended that babies aged 6 months or older receive the EV71 vaccine 2 months before the epidemic season. The earlier the better, and it is best to complete the two shots before 12 months of age.

For children over 5 years old, the possibility of infection and severe case development is small, and vaccination is not recommended.

Summary: Hand, foot and mouth disease and herpangina are the same disease, but the manifestations are different. Herpangina usually only causes gray-white blisters in the throat and palate at the beginning of the disease, which will soon break and fade. In typical hand, foot and mouth disease, herpes will not only appear in the mouth, but also on the hands, feet, and near the anus (all or part), and sometimes spread to the legs and arms, and in rare cases, it may spread to the trunk.

However, there are also atypical hand, foot and mouth disease, in which herpes appears only in one of the above parts. The incubation period of hand, foot and mouth disease is usually 3-5 days, but there have been reports of cases as short as 2 days and as long as 7 days. The average incubation period of herpetic pharyngitis is 3-5 days, with a range of 1-10 days. The virus can be detected in the feces for 6 weeks (sometimes several months) after infection with hand, foot and mouth disease. The duration of virus excretion from the oropharynx usually does not exceed 4 weeks. Hand, foot and mouth disease can generally be diagnosed based on season, age, symptoms and rash. Children with mild symptoms only need symptomatic treatment without laboratory tests. If further examination is required for severe cases, cerebrospinal fluid, herpes in the mouth or rash secretions should be taken for nucleic acid testing or virus isolation according to the condition. Serum antibodies are generally not used to diagnose acute infections. It is impossible for a doctor to determine whether it is hand, foot and mouth disease or herpetic pharyngitis just by looking at the blood test report. Because hand, foot and mouth disease is a self-limiting disease and there are no specific drugs to use, only symptomatic treatment and close observation are required. For example, if the fever makes the child uncomfortable, he can take antipyretics, and if he has a sore throat, he can drink cold drinks or cold milk.

The following methods can also help relieve the pain of oral herpes: 1. Sucking popsicles (such as crushed ice) or ice cubes, or you can make them at home. 2. Drinking cold milk or ice water. 3. Eating ice cream. 4. Eating soft foods that do not require much chewing. 5. Rinse your mouth with warm water after meals. 6. If the above methods still do not work and your child is in pain and crying, you can consider using ibuprofen or acetaminophen to relieve the pain.

Source: Nanjing Center for Disease Control and Prevention, Tongba Parenting