Hand-foot-and-mouth disease natural history
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Yamuna Kondapally, M.B.B.S[2], Aravind Kuchkuntla, M.B.B.S[3]
Overview
The outbreaks of hand foot mouth disease occur during the period of warm temperatures of spring, summer, and fall, showing a strong seasonal pattern. Hand foot mouth disease affects infants and children, and is quite common.The symptoms appear within 3 days to 1 week after the infection with mild fever, poor appetite, malaise and sore throat, followed by development of painful sores develop in the mouth. It is a self limiting condition but few patients might develop complications such as pulmonary hemorrhage and meningitis.
Natural History, Complications and Prognosis
Natural History
The outbreaks of hand foot mouth disease occur during the period of warm temperatures of spring, summer, and fall, showing a strong seasonal pattern.[1] Hand foot mouth disease affects infants and children, and is quite common. It is highly contagious and is spread through direct contact with the mucus or feces of an infected person. Transmission is by direct contact with nose and throat discharges, saliva, fluid from blisters, or stools of an infected person. It typically occurs in small epidemics in nursery schools or kindergartens, usually during the summer and autumn months.The symptoms appear within 3 days to 1 week after the infection with mild fever, poor appetite, malaise and sore throat, followed by development of painful sores develop in the mouth. The mouth ulcers are usually seen on the tongue, gums, and inside of the cheeks. The skin rash develops over 1 to 2 days as a flat red patch with blisters on the palms and foot. Hand foot mouth disease usually resolves in a week to 10 days, but very rarely complications such as meningitis and acute flaccid paralysis can occur.
Complications
Complications of hand foot and mouth disease include:
- Viral or aseptic meningitis, it presents with fever, headache, stiff neck, or back pain.[2]
- Encephalitis
- A polio-like paralysis
- Fingernail and toenail loss, usually occurs mostly in children within 4 weeks of having hand foot and mouth disease. However, the nail loss has been temporary and nail growth resumed without medical treatment.[3][4]
- Acute flaccid paralysis)
- Cardiopulmonary failure[5]
- Pulmonary edema or pulmonary hemorrhage[6][7]
- Acute pancreatitis[8]
Prognosis
Hand foot mouth disease is a self limiting disease and complete recovery occurs in 5 to 7 days. In very few patients prognosis is poor with the development of pulmonary hemorrhage, hypotension and elevated serum lactate.[9]
References
- ↑ Nguyen HX, Chu C, Nguyen HL, Nguyen HT, Do CM, Rutherford S; et al. (2017). "Temporal and spatial analysis of hand, foot, and mouth disease in relation to climate factors: A study in the Mekong Delta region, Vietnam". Sci Total Environ. 581-582: 766–772. doi:10.1016/j.scitotenv.2017.01.006. PMID 28063653.
- ↑ Lee KY (2016). "Enterovirus 71 infection and neurological complications". Korean J Pediatr. 59 (10): 395–401. doi:10.3345/kjp.2016.59.10.395. PMC 5099286. PMID 27826325.
- ↑ http://www.cdc.gov/ncidod/dvrd/revb/enterovirus/hfhf.htm#10
- ↑ Gan XL, Zhang TD (2017). "Onychomadesis after hand-foot-and-mouth disease". CMAJ. 189 (7): E279. doi:10.1503/cmaj.160388. PMC 5318214. PMID 28246241.
- ↑ Long L, Xu L, Xiao Z, Hu S, Luo R, Wang H; et al. (2016). "Neurological complications and risk factors of cardiopulmonary failure of EV-A71-related hand, foot and mouth disease". Sci Rep. 6: 23444. doi:10.1038/srep23444. PMC 4802311. PMID 27001010.
- ↑ Lee DS, Lee YI, Ahn JB, Kim MJ, Kim JH, Kim NH; et al. (2015). "Massive pulmonary hemorrhage in enterovirus 71-infected hand, foot, and mouth disease". Korean J Pediatr. 58 (3): 112–5. doi:10.3345/kjp.2015.58.3.112. PMC 4388973. PMID 25861335.
- ↑ Zhou L, Li Y, Mai Z, Qiang X, Wang S, Yu T; et al. (2015). "[Clinical feature of severe hand, foot and mouth disease with acute pulmonary edema in pediatric patients]". Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 27 (7): 563–7. doi:10.3760/cma.j.issn.2095-4352.2015.07.005. PMID 26138417.
- ↑ Zhang YF, Deng HL, Fu J, Zhang Y, Wei JQ (2016). "Pancreatitis in hand-foot-and-mouth disease caused by enterovirus 71". World J Gastroenterol. 22 (6): 2149–52. doi:10.3748/wjg.v22.i6.2149. PMC 4726688. PMID 26877620.
- ↑ Song CL, Cheng YB, Chen D, Gu X, Li HB, Yan XQ (2014). "[Risk factors for death in children with severe hand, foot and mouth disease]". Zhongguo Dang Dai Er Ke Za Zhi. 16 (10): 1033–6. PMID 25344186.