I believe everyone has heard of hand, foot and mouth disease, because hand, foot and mouth disease is characterized by blisters on the hands, feet, and mouth. The disease is mild and the course of the disease is short. Spring and autumn are the most prone to illness, and children's resistance is often relatively low, and most children suffer from hand, foot and mouth disease. So what are the symptoms of hand, foot and mouth disease? Let's give you a detailed introduction, let's take a look together.

The cause of hand, foot and mouth disease

The pathogens causing HFMD are mainly coxsackievirus types 2, 4, 5, 7, 9, 10, 16 and enterovirus B types 1, 16 and 16 of Picornaviridae group A. Type 2, type 3, type 16, type 4, type 5, etc.; enterovirus 71; echo virus, etc. Among them, enterovirus 71 and coxsackie virus A16 are more common.

Enteroviruses are suitable for survival and transmission in hot and humid environments, and are not sensitive to ether, dechlorocholate, etc. 75% alcohol and 5% Lysol cannot be inactivated, but are sensitive to ultraviolet rays and drying. Various oxidants (potassium permanganate, bleaching powder, etc.), formaldehyde, iodine, etc. can inactivate the virus. The virus can be rapidly inactivated at 50°C, but the environment of 1 mol concentration of divalent cations can improve the resistance of the virus to heat inactivation. The virus can survive for 1 year at 4°C and long-term storage at -20°C. long-term survival.

Symptoms of hand, foot and mouth disease

Symptoms of hand, foot and mouth disease 1: General symptoms

(1) The onset is acute, the incubation period is 3-5 days, and there are prodromal symptoms such as low-grade fever, general malaise, and abdominal pain. Painful miliary to mung bean-sized blisters spread over the oral mucosa, and maculopapular rashes and herpes appear on the hands and feet. The initial maculopapular rash turns into a herpes, which is round or oval in shape, about 3-7 mm, the size of a rice grain. Small in quality, hard in texture, flushing around, less vesicular fluid, and spot-like or flake-like erosions can be seen under the gray-white membrane. The rash resolves without scarring or hyperpigmentation, and secondary infections often exacerbate skin damage.

(2) In addition to the hands, feet and mouth, it is also close to the buttocks and anus. Occasionally, there are herpes on the trunk and limbs. After a few days, the herpes dries up and subsides. The rash is neither itchy nor painful.

(3) Systemic papules and blisters may appear in individual children, accompanied by aseptic meningitis, encephalitis, and myocarditis. May be accompanied by cough, runny nose, loss of appetite, nausea, vomiting, headache and other symptoms.

(4) Some cases only manifested as rash or herpetic angina. The whole course of the disease is about 5-10 days, and most of them can be cured by themselves. The prognosis is good and there are no sequelae.

Symptoms of hand, foot and mouth disease 2: Severe manifestations

In a small number of cases (especially under 3 years old), encephalitis, encephalomyelitis, meningitis, pulmonary edema, and circulatory failure may occur.

(1) Respiratory system manifestations: shortness of breath, difficulty, changes in respiratory rhythm, cyanosis of lips, white, pink or bloody foamy liquid (sputum) in the mouth, and phlegm or moist rales can be heard in the lungs.

(2) Nervous system manifestations: lack of energy, lethargy, headache, vomiting, irritability, limb tremor, weakness or paralysis; physical examination revealed signs of meningeal irritation, and tendon reflexes were weakened or disappeared; critical cases may manifest as frequent convulsions, coma, and cerebral edema , brain herniation.

(3) Circulatory system manifestations: pale complexion, rapid heart rate, shallow pulse, weakening or even disappearing, cold limbs, cyanosis of fingers (toes), increased or decreased blood pressure.

Treatment of hand, foot and mouth disease

Treatment of hand, foot and mouth disease 1: Treatment of ordinary cases

(1) Strengthen isolation: avoid cross infection, take proper rest, eat lightly, and take good oral and skin care.

(2) Symptomatic treatment: fever, vomiting, diarrhea, etc., and deal with accordingly.

(3) Etiological treatment: the use of ribavirin and so on.

Treatment of hand, foot and mouth disease 2: Treatment of severe cases

(1) Cases with combined nervous system involvement

① Symptomatic treatment: such as cooling, sedation, and convulsion (diazepam, sodium phenobarbital, chloral hydrate, etc.);

②Control intracranial hypertension: limit intake, dehydrate mannitol, dose 0.5-1.0g/kg, Q4h-Q8h, adjust the administration time and dose according to the condition, and add furosemide if necessary;

③Intravenous injection of gamma globulin: 1g/kg*2 times each time or 2g/kg*1 time each time;

④ Use glucocorticoids as appropriate: methylprednisolone 1-2 mg/(kg·d), divided into 1-2 intravenous infusions. Severe cases can be treated with short-term high-dose granules: methylprednisolone 15-30 mg/(kg·d), reduced to a small dose after 3 days;

⑤ Patients with respiratory failure should be mechanically ventilated to strengthen respiratory management.

(2) Cases with respiratory and circulatory system involvement

①Keep the airway open and inhale oxygen;

② Establish venous access to detect respiration, heart rate, blood pressure and blood sample saturation;

③ In case of respiratory failure, timely tracheal intubation, use positive pressure mechanical ventilation, and adjust respiratory parameters at any time according to blood gas analysis;

④ Use vasoactive drugs and gamma globulin if necessary.