Hand or mouth diseases of children

What is hand-foot-and-mouth syndrome?



Hand-foot-and-mouth syndrome (HFM) 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. It should not be confused with foot (hoof) and mouth disease that affects cattle, sheep, and swine.

What are the symptoms of hand-foot-and-mouth syndrome?



HFM is most commonly an illness of the spring and fall seasons. Initial symptoms of mild fever (101-102 degrees) and malaise are followed within one or two days by a characteristic rash. Small (2-3 mm) red spots that quickly develop into small vesicles (blisters) 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.

What causes hand-foot-and-mouth syndrome?



HFM is caused by several members of the enterovirus family. The most common cause is Coxsackie virus A-16; less frequently Enterovirus 71 is the infectious agent. The clinical manifestations of routine HFM are the same regardless of the responsible virus. However, patients infected with Enterovirus 71 are more likely to experience rare complications (for example, viral meningitis or cardiac muscle involvement).

What is the incubation period for hand-foot-and-mouth syndrome?



HFM is moderately contagious and spreads from person to person. It cannot be spread by animals. Usually the virus is passed via oral secretions (nasal discharge, saliva, etc.) or via stool. There is a short four- to six-day incubation period between exposure and development of initial symptoms (fever and malaise). A person is most contagious during the first week of illness.

When does it usually occur?



Spring and fall are the most frequent seasons for community epidemics of HFM. While anyone exposed to the viral causes of HFM may develop disease, not everyone infected will develop symptoms.

What is the expression of hand-foot-and-mouth syndrome?



Commonly HFM 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 to HFM 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 HFM 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.

What is the course of the disease?



The illness is characteristically self-limited and is usually over and done within a week, particularly when due to its most common cause, Coxsackie virus A-16. In those outbreaks due to Enterovirus 71, the illness may be more severe with complications such as viral meningitis and encephalitis and paralytic disease. As a rule, HFM is generally a mild and self-limited illness.

Why haven't we heard more about this condition?



Recognition of hand-foot-and-mouth syndrome is relatively recent (as compared to mumps, measles, and chickenpox, for example). HFM was first reported in 1956 in Australia. By the early 1960s, it had emerged as a common childhood illness around the world.

How is HFM diagnosed?



Usually, the diagnosis of HFM is made on a combination of clinical history and characteristic physical findings. Laboratory confirmation is rarely necessary unless severe complications develop.

How is HFM treated?



Therapy for HFM is directed toward symptomatic relief of fever and sore throat. Antibiotics are not indicated for this viral disease.
Hand-Food-and-Mouth Syndrome At A Glance

• Hand-foot-and-mouth syndrome is a viral disease.
  
• Hand-foot-and-mouth syndrome produces a rash on the hands, feet, and in the mouth.
  
• Hand-foot-and-mouth syndrome often occurs in the spring and fall.
  
• Hand-foot-and-mouth syndrome is common in kids, particularly preschoolers.
  
• Hand-foot-and-mouth syndrome usually is mild and over within a week. Treatment is directly toward relief of symptoms (fever and sore throat).
  

Important Safety Information


Vimpat (lacosamide) is a medicine that is used with other medicines to treat partial onset seizures in patients 17 years of age and older with epilepsy. Vimpat is generally well-tolerated, but may not be for everyone. Ask your doctor if Vimpat is right for you. Antiepileptic drugs, including Vimpat, may cause suicidal thoughts or actions in a very small number of people, about 1 in 500. Call your healthcare provider right away if you have new or worsening symptoms of depression, any unusual changes in mood or behavior, or suicidal thoughts, behavior, or thoughts about self harm that you have never had before or may be worse than before. Please see additional patient information in the Medication Guide at the end of the full prescribing information. This information does not take the place of talking with your healthcare provider about your condition or your treatment. Please see additional Patient Safety Information

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