By: SEO Mavens
Controlling infectious diseases is indispensable to preserving public health, social order, and economic development. As the viral infection hand, foot, and mouth disease (HFMD) become common worldwide, especially among newborns and young children in Southeast Asia, we must learn what HFMD is all about to be safe and how we can prevent its spread.
How Can HFMD Spread?
Hand, foot, and mouth disease (HFMD) can spread through various methods, making it highly contagious.
Transmission Methods
Children can contract HFMD through direct contact with infected individuals or touching contaminated objects such as towels, toys, utensils, or bedding. It can also spread through airborne transmission, mouth-to-mouth contact via saliva and throat secretions, and ingestion of contaminated food and water. Although adults are also exposed to the virus, their immune systems generally contain antibodies that protect them against the illness. Approximately 80% of those afflicted are younger than five years old.
Incubation Period
The HFMD virus has an incubation period of typically three to five days. During this phase, the virus can be isolated from the patient’s feces or throat secretions. Many infected individuals exhibit negligible or no symptoms yet are still capable of spreading the illness.
Common Pathogens
More than twenty different enterovirus types cause HFMD. The common pathogens include Coxsackievirus Group A (Type 16, 4, 5, 9, and 10), Coxsackievirus Group B (Types 2 and 5), and Enterovirus 71 (EV71).
What Are the Types of HFMD?
HFMD is associated with different types of Coxsackie viruses, which are RNA viruses. These viruses are categorized into two groups: Group A and Group B.
Group A Coxsackie Viruses
Group A coxsackieviruses are linked to acute hemorrhagic conjunctivitis, HFMD, and skin and mucous membrane infections. Symptoms can include upper respiratory tract infections, skin rashes, and feverish illnesses.
Group B Coxsackie Viruses
Group B coxsackieviruses are responsible for infections causing pleurodynia, myocarditis, pericarditis, hepatitis, and infections of the heart, pleura, pancreas, and liver. Like Group A, they also present symptoms of upper respiratory tract infections, skin rashes, and feverish illnesses.
Risk Factors
While HFMD is generally mild, young children are more susceptible to infection and should be monitored for symptoms. The two most prevalent viruses responsible for HFMD, coxsackievirus A16, and EV71, are especially dangerous. Infected children may suffer severe complications, including heart, brain, and kidney issues, often due to delayed diagnosis and treatment.
HFMD has a latency period of three to seven days. Compared to other enterovirus types, HFMD infections have a far greater chance of producing severe symptoms.
Symptoms
HFMD presents several symptoms.
The symptoms of HFMD include upper respiratory tract infection, skin rashes, and fever. Coxsackie viruses, one of the primary causes of HFMD, are also a leading cause of aseptic meningitis.
Complications
Most infections caused by the Coxsackie virus are modest and self-limiting. Common symptoms include cold-like symptoms, sore throats, and distinctive rashes that resemble mild sunburn. The rashes can sometimes develop into small, painful blisters. These blisters may appear on the palms, soles, inside the mouth, tongue, gums, and cheeks of the patient.
Prevention and Control of HFMD
Preventing HFMD involves good personal hygiene practices and taking necessary precautions to avoid the infection.
Hygiene Practices
Hand washing correctly is one example of good personal hygiene that can significantly lower the risk of illness. Practicing good hygiene is an effective way to reduce the risk of HFMD. Early childhood educators play a helpful role in supporting kids’ healthy hygiene practices.
Particular attention should be given to prevent the infection from spreading through blood, bodily fluids (such as saliva and material coughed up), secretions, excretions (such as wound drainage), urine, and feces. [2]
Standard Precautions:
1. Use of gloves.
2. Cover the mouth and nose during sneezing or coughing.
3. Proper disposal of tissues after use and thorough handwashing.
4. Maintain a distance of three to six feet (1-2 meters) from infected individuals, especially children, people with compromised immune systems, and the elderly.
5. Wear masks in public or congested areas for those with weak immune systems.
6. Refrain from sharing personal goods like clothing, razors, and toothpaste within families.
7. Consider limiting access for individuals with open skin sores to reduce transmission risks.
8. Isolate the sick patient.
Caregiver Practices:
1. Favoring single-dose vials over multi-dose ones when it comes to medicine.
2. Having one person monitor insulin pens, fingerstick gadgets, and medicine containers.
3. Disposing of needles in separate puncture-proof containers.
4. Housekeeping teams should proceed carefully when changing sheets and tidying rooms.
For People with Weak Immune Systems:
1. Using a mask, such as an N95 respirator, may add extra protection in high-risk environments like hospitals.
2. Maintaining the heating, ventilation, and air conditioning (HVAC) system correctly to lower dust overload.
3. Avoid construction sites and dusty areas on windy days.
4. Use a vacuum with a high-efficiency particulate air (HEPA) filter to clean areas regularly when the patient is not present, and avoid carpeting if possible.
5. Refraining from using humidifiers or dehumidifiers in public spaces
Conclusion
In Malaysia, the current Enterovirus 71 vaccines do not offer cross-protection against all Enterovirus species that cause hand, foot, and mouth disease (HFMD). Therefore, identifying effective diagnostic methods and prevention practices to control the illness’s spread and contain outbreaks of HFMD in Malaysia.
Improving communication on surveillance, risk assessment, and epidemic confirmation with key stakeholders is necessary. Effective communication will enable timely notification of clustered outbreaks to a local Center for Disease Control and Prevention (within 24 hours). By implementing early control responses, we will be able to reduce the frequency and duration of outbreaks in childcare settings.
Reference:
1. Zhang, T., Zhang, Z., Yu, Z., Huang, Q., & Gao, D. (2023). Effects of behaviour change on HFMD transmission. Journal of Biological Dynamics, 17(1). https://doi.org/10.1080/17513758.2023.2244968
2. Tahmina, A. (2017). Coxsackie Virus: the Hand, Foot, Mouth Disease (HFMD). Juniper Online Journal of Public Health, 1(4). https://doi.org/10.19080/jojph.2017.01.555566
3. Li, Y., Zhang, J., & Zhang, X. (2014). Modeling and preventive measures of hand, foot, and mouth disease (HFMD) in China. International Journal of Environmental Research and Public Health, 11(3), 3108–3117. https://doi.org/10.3390/ijerph110303108
4. Chan, J Hy; Law, CK; Hamblion, E; Fung, H; Rudge, J; (2017) Best practices to prevent transmission and control outbreaks of hand, foot, and mouth disease in childcare facilities: a systematic review. Hong Kong medical journal = Xianggang yi xue za zhi / Hong Kong Academy of Medicine, 23 (2). pp. 177-190. ISSN 1024-2708 DOI: https://doi.org/10.12809/hkmj166098
5. Mohamed, N. N. A., Faroque, N. H., Rani, N. M. D. M., Umar, N. N. S., Jamaluddin, N. T. Z. M. T., Isahak, N. I., & Mahmud, N. S. M. (2020). Hand Foot and Mouth Disease (HFMD) Educational Workshop for Preschool teachers: An Interventional Study. International Journal of Research in Pharmaceutical Sciences, 11(SPL4), 1551–1558. https://doi.org/10.26452/ijrps.v11ispl4.4337
Disclaimer: The information provided in this article is for general informational purposes only and is not intended as medical advice. Readers should consult a qualified healthcare professional before making any health-related decisions. The contents of this article should not be used as a substitute for professional medical advice, diagnosis, or treatment.
Published by: Martin De Juan
