Head Foot and Mouth Disease (Flu Singapura)

PATHOLOGY OF HAND FOOT AND MOUTH DESEASE

Hand Foot and Mouth disease (Flu Singapura) is a viral infection characterized by fever and a typical rash most frequently seen on the palms of the hands, soles of the feet, and inside the mouth. The most common cause is Coxsackie virus A-16; less frequently enterovirus 71 is the infectious agent. Initial symptoms of mild fever (38 0C – 39 0C ) and malaise are followed within one or two days by a characteristic rash. Small (2 mm-3 mm) red spots that quickly develop into small blisters (vesicles) appear on the palms, soles, and oral cavity. The gums, tongue, and inner cheek are most commonly involved. The foot lesions may also involve the lower calf region and rarely may appear on the buttocks. Oral lesions are commonly associated with a sore throat and diminished appetite.

Hand Foot and Mouth disease is spread person to person by direct contact with the infecting virus (either Coxsackie virus A-16 or less commonly enterovirus 71). These viruses are most commonly found in the nasal and throat regions but also in the blister fluid or stool of infected individuals. Infected individuals are most contagious during the first week of their illness. It can’t be contracted from pets or animals.

The viruses that cause Hand Foot and Mouth disease may remain in the person’s respiratory or intestinal tract for several weeks to months after all symptoms have resolved. It is possible, therefore, to transmit the infection even though the formally ill individual has completely recovered. Some individuals (most commonly adults) may exhibit no symptoms during their infection but may unwittingly transmit the illness to those (commonly infants and children) who are not immune.

Commonly Hand Foot and Mouth disease is an illness of children less than 10 years of age; adults generally were exposed during childhood and maintain a natural immunity. Information regarding fetal exposure during pregnancy is limited. No solid evidence exists that maternal enterovirus infection is associated with complications such as spontaneous abortion or congenital defects. However, should a baby be born to a mother with active Hand Foot and Mouth disease symptoms, the risk of neonatal infection is high. Typically, such newborns have a mild illness. Rarely, overwhelming infection involving vital organs such as liver, heart, and brain can be lethal.

PREVENTION AND TREATMENT

Prevention to protect a person who risk of being infected by

  • Washing hands often with soap and water, especially after changing diapers and using the toilet.
  • Disinfecting dirty surfaces and soiled items, including toys. First wash the items with soap and water; then disinfect them with a solution of chlorine bleach (made by mixing 1 tablespoon of bleach and 4 cups of water).
  • Avoiding close contact such as kissing, hugging, or sharing eating utensils or cups with people with hand, foot, and mouth disease.

If a person has mouth sores, it might be painful to swallow. However, drinking liquids is important to stay hydrated. If a person cannot swallow enough liquids, these may need to be given through an IV in their vein.

There is no specific treatment for hand, foot and mouth disease. However, some things can be done to relieve symptoms, such as

  • Taking over-the-counter medications to relieve pain and fever (Caution: Aspirin should not be given to children.)
  • Using mouthwashes or sprays that numb mouth pain

Persons who are concerned about their symptoms should contact their health care provider.

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