How to prevent hand, foot and mouth disease? Can adults get this disease?

Hand, foot and mouth disease (HFMD) is an infectious disease caused by enterovirus, which mostly occurs in infants and can cause hand, foot and mouth herpes, and some patients can cause complications such as myocarditis, pulmonary edema and aseptic meningoencephalitis. There are more than 20 kinds of enteroviruses that cause hand, foot and mouth disease. Coxsackievirus A (16, 4, 5, 9 and 10), Coxsackievirus B (2 and 5) and enterovirus 7 1 are the common pathogens of hand, foot and mouth disease, among which Coxsackievirus A (16) is the most common.

incubation period

The incubation period of the disease is 2 ~ 7 days, and the sources of infection include patients and recessive infected people. During the epidemic, patients are the main source of infection. Patients with acute onset can excrete virus from pharynx; Herpes fluid contains a large number of viruses and overflows when it breaks; After several weeks of illness, patients can still excrete virus from feces.

source of infection

The source of infection of hand, foot and mouth disease is patients and recessive infected people. During the epidemic, patients are the main source of infection. The virus is excreted from the pharynx after 1 ~ 2 weeks, and from the feces after 3 ~ 5 weeks. Herpes fluid contains a large number of viruses, which overflow when it breaks. Drug carriers and light sporadic cases are the main sources of infection in intermittent and epidemic periods.

mode of transmission

The spread of this disease is varied, mainly through close contact with people. The virus can be spread indirectly through hands, towels, handkerchiefs, tooth cups, toys, tableware, milk utensils, bedding and underwear contaminated by saliva, herpes fluid and feces. The virus in patients' throat secretions and saliva can be spread by droplets; If you come into contact with water contaminated by virus, you may also be infected by water; Cross-infection in outpatient department and unqualified disinfection of oral instruments are also one of the reasons for the spread.

susceptible population

People are generally susceptible to the enterovirus that causes hand, foot and mouth disease, and they can gain immunity after infection. Due to the lack of cross-protection of antibodies after infection of different disease types, most adults who can repeatedly infect people obtain corresponding antibodies through recessive infection. Therefore, the patients with hand, foot and mouth disease are mainly preschool children, especially those aged ≤3 years. According to foreign literature, it can be popular among people every 2 ~ 3 years.

Popular pattern

Hand, foot and mouth disease is widely distributed, and there is no strict regionality. It can occur all year round, especially in summer and autumn, and it is rare in winter. The disease usually occurs sporadically after an outbreak. During the epidemic, kindergartens and nurseries are prone to collective infection. The family also has this disease aggregation phenomenon. Cross-infection in hospital outpatient department and lax disinfection of oral instruments can also cause transmission. There have been two major epidemics in Tianjin, and the incidence rate of children in kindergartens is significantly higher than that of scattered children. Family distribution is often a case; Family outbreak, many people or all children and adults in a family are infected. The disease is highly contagious, with complicated transmission routes, strong epidemic intensity and fast transmission speed, which can cause an epidemic in a short time.

clinical features

Acute onset, fever; Oral mucosa appears scattered herpes, the size of rice grain, and the pain is obvious; Herpes the size of a grain of rice appear on the palm or sole of your hand, occasionally involving your hips or knees. There is an inflammatory blush around the herpes, and there is less liquid in the blister. Some children may be accompanied by cough, runny nose, loss of appetite, nausea, vomiting, headache and other symptoms. The disease is a self-limited disease, most of which have a good prognosis and no sequelae. Very few children can cause serious complications such as meningitis, encephalitis, myocarditis, flaccid paralysis and pulmonary edema.

diagnose

Hand, foot and mouth disease is just one of many infectious diseases that can cause oral ulcers. Another common cause of oral ulcers is oral herpes virus infection, which can cause inflammation of the mouth and gums (sometimes called stomatitis).

Doctors can usually distinguish hand, foot and mouth disease from oral ulcers caused by other reasons according to the age of patients, symptoms complained by patients or parents, rashes and ulcers. Swallow swabs or stool samples can be sent to the laboratory for virus testing, but it takes 2-4 weeks for virus testing to produce results, so doctors usually don't recommend this kind of testing.

Main diagnostic basis

Epidemiological data, clinical manifestations, laboratory examination and diagnosis must be based on pathogenic examination.

1, which occurs in summer and autumn;

2. Taking children as the main target often occurs in places where infants gather, showing a popular trend.

3. The main clinical manifestations are first-time fever, slight increase in the total number of white blood cells, followed by maculopapules and herpes-like lesions of oral cavity, hands and feet mucosa and skin.

4, the course of disease is short, and it usually heals within one week.

Precautionary principle

(1) Strengthening monitoring and improving monitoring sensitivity is the key to control the epidemic of this disease. Collect qualified specimens in time and make a clear diagnosis of the cause;

(two) do a good job in reporting the epidemic situation, find patients in time, and actively take preventive measures to prevent the spread of the disease;

(3) Kindergartens should do a good job of morning check-up and timely isolate and treat suspected patients;

(4) Contaminated articles for daily use and tableware should be disinfected, children's feces and excreta should be soaked in 3% bleach solution, clothes should be exposed to the sun, and the room should be ventilated;

(five) when the epidemic occurs, do a good job in environment, food hygiene and personal hygiene;

(6) Wash hands before and after meals to prevent diseases from entering the mouth;

(7) Parents should let their children go to crowded public places as little as possible to reduce the chance of being infected;

(eight) pay attention to the nutrition and rest of infants and young children, avoid the sun, prevent excessive fatigue and reduce the body's resistance;

(9) Hospitals should strengthen pre-diagnosis and set up special outpatient clinics to prevent cross-infection.

International epidemic:

Hand, foot and mouth disease is a global infectious disease, which has been reported in most parts of the world. 1957 The disease was first reported in New Zealand. 1958 isolated coxsackie virus, and 1959 put forward the name "hand, foot and mouth disease". Hand-foot-mouth disease (HFMD) caused by Coxsackie, echovirus and EV 7 1 often occurs in the United States, Australia, Italy, France, Netherlands, Spain, Romania, Brazil, Canada and Germany.

Japan is a country with many hand, foot and mouth diseases, and there have been many large-scale epidemics in history. 1969 ~ 1970 was dominated by Cox A 16, and 1973 and 1978 were caused by EV7 1 and 1978. At the end of 1990s, EV 7 1 began to wreak havoc in East Asia. 1997, an outbreak of hand, foot and mouth disease mainly caused by EV 7 1 occurred in Malaysia. There were 2628 cases from April to August, and only 29 cases died from April to June, with an average age of 1.5 years. 1998, hand, foot and mouth disease and herpetic angina broke out in Taiwan Province province, China. June and June 10, * * monitoring 129 106 cases, 405 cases were severe and 78 cases died, most of them were children under 5 years old.

Outbreaks in China:

The disease was found in Shanghai from China 198 1, and has been reported in ten Yu Sheng cities, including Beijing, Hebei, Tianjin, Fujian, Jilin, Shandong, Hubei and Guangdong. An outbreak of hand, foot and mouth disease caused by Cox A 16 occurred in Tianjin in 1983, and more than 7 000 cases occurred in 5 ~ 10 years. Two years after the epidemic, 1986 broke out in nurseries. 1In 995, Wuhan Virus Research Institute isolated EV 7 1 virus from hand-foot-mouth patients, and in 998, Shenzhen Health and Epidemic Prevention Station isolated two strains of EV 7 1 virus from patients. From May to August, 2000, an epidemic of hand, foot and mouth disease in children occurred in Zhaoyuan City, Shandong Province. The Municipal People's Hospital admitted 1.698 children, including 1.025 males and 673 females, ranging from 5 months to 0/.4 years old. 3 cases died of fulminant myocarditis.

In 2006, hand-foot-mouth disease 13637 cases were reported nationwide (8460 cases were male, accounting for 62.04%; 5 177 women, accounting for 37.96%, and 6 cases (4 men and 2 women) died. Except Xizang Autonomous Region, 3 1 provinces, autonomous regions and municipalities have reported cases. The top ten provinces with reported cases are Shandong (3030 cases), Shanghai (2883 cases), Beijing (22 10 cases), Hebei (1 133 cases), Zhejiang (793 cases), Guangdong (670 cases) and Heilongjiang (670 cases)

As of May 2, 20071day, 5,459 cases of hand, foot and mouth disease were reported in 2007, and 2 cases died. Compared with the same period last year (2488 cases), the number of reported cases increased by 1 19.38+0%.

According to the epidemic data reported in recent years, the annual peak of hand, foot and mouth disease is around July. As the national temperature rose earlier in 2007, experts predicted that the peak incidence of hand, foot and mouth disease might be advanced, and the reported cases of hand, foot and mouth disease would further increase in 2007. It broke out in Fuyang City, Anhui Province in April 2008. From 0: 00 on the 4th to 0: 00 on the 5th, 398 cases of hand, foot and mouth disease were newly reported in Fuyang, among which 253 cases were hospitalized, a decrease of 55 cases compared with the previous day. On the same day, 68 patients were discharged/kloc-0, and there were no deaths. At present, there are still 13 14 cases in hospital, of which 1 1 case is critical, which is less than the previous day.

It is reported that up to now, 2642 cases have been cured in Anhui Province, including 94 cases of severe and critically ill patients.

Chinese medicine treatment:

According to the theory of traditional Chinese medicine, the disease is caused by exogenous damp-heat epidemic virus. When the damp-heat pathogen of the vaccine injures the lung and spleen, it will lead to disharmony between the lung and spleen, or toxic pathogens will accumulate in the spleen, leading to the dysfunction of the spleen in controlling limbs and inducing resuscitation to the mouth, resulting in the above-mentioned clinical characteristics, and may be accompanied by symptoms similar to summer colds such as fever, runny nose and slight cough, or salivation, refusal to eat, irritability and so on.

Traditional Chinese medicine has a good curative effect on this disease, which can not only eliminate and relieve symptoms, but also shorten the course of the disease. In the early and middle stages of the disease, the therapy of clearing away heat and toxic materials, eliminating dampness and cooling blood is generally adopted. Commonly used drugs include honeysuckle, forsythia suspensa, scutellaria baicalensis, gardenia, raw coix seed, burdock, cicada slough, Arnebia euchroma, reed rhizome, bamboo leaves, gypsum, coptis chinensis, Juncus Juncus, Liuyisan and so on. If you see symptoms such as fever, anorexia and irritability in your hands and feet in the later stage of illness, you can add nourishing yin and clearing heat products such as Radix Rehmanniae, Radix Ophiopogonis, Cynanchum atratum and Polygonatum odoratum.

"Hand-foot-mouth disease" is a common infectious disease in children. At present, there is no ideal specific medicine in western medicine. The doctors of Qiqihar Hospital of Traditional Chinese Medicine in Heilongjiang Province used the methods of clearing away heat and toxic materials, cooling blood and removing dampness, regulating spleen transport, nourishing yin and promoting fluid production, and compared and supplemented the long-term effective experience powder, and finally screened out the combination of the three powders. The clinical application of more than 2,000 children has achieved gratifying results, such as rapid relief of symptoms, obviously shortened course of disease and high cure rate.

Hand-foot-mouth disease (HFMD) in children is a newly discovered explosive infectious disease in 1980s. Generally under 5 years old, especially infants, it is easy to spread widely in summer and autumn. The main clinical manifestations of the disease are herpes or ulcers on the mucous membranes of hands, feet and mouth. Pediatrics of Qi City Hospital of Traditional Chinese Medicine is now a national key specialty and a pediatric disease diagnosis and treatment center in Heilongjiang Province. Zhang Tie, He Guihua, Wang Ying and others, directors of this department, think that although hand, foot and mouth disease in children is not recorded in ancient medical books in China, it should be classified as febrile disease according to syndrome differentiation. The pathogenesis is that wind-heat toxin accumulates in lung, heart, spleen, stomach and transpiration qi camp, and the pathogenic factors are between Wei qi camp. Therefore, the general treatment principle should be clearing away heat and toxic materials, strengthening the spleen and nourishing yin.

On the basis of this understanding, Dr. Zhang Tie and others made Lingliangtong Powder and Heping Piling Powder, each of which contains three kinds of powders composed of different drugs. In the acute stage when wind evil invades the lung and heat accumulates in the heart and spleen, the symptoms are herpes or ulcer on the hands, feet and oral mucosa, red color, fever and thirst, dry yellow, red tongue with yellow fur and floating pulse. The main treatment methods are clearing away heat and toxic materials, cooling blood and removing dampness. Lingliangtong Powder is adopted, and its main components are honeysuckle, forsythia, fermented soybean, rhubarb, gypsum, divaricate Saposhnikovia root, Schizonepeta tenuifolia and Scutellaria baicalensis. In the recovery period of spleen and stomach deficiency and yin deficiency and fiery heat, the symptoms are scattered or subsided in herpes of hands, feet and oral mucosa, body heat gradually subsided, dry lips, loss of appetite, red tongue, little body fluid and rapid pulse. The principle of treatment is to regulate the spleen to help transport, nourish yin and promote fluid production. Pingpiling Powder is adopted, and its main components are tangerine peel, magnolia officinalis, Massa Medicata Fermentata, antelope horn, reed rhizome, Ophiopogon japonicus, Atractylodes lancea, Amomum villosum and so on. In the two phases, the three powders are compatible with each other, which has the functions of clearing away heat and toxic materials and promoting diuresis, so that the fever subsides, the spleen can move normally, the deficiency fire is extinguished by itself, and the yin and body fluid are nourished by itself.

Since 1997, the hospital has used the above powder to treat and observe a large number of children with hand-foot-mouth disease, and the average course of treatment has been shortened to 4 days. And the treatment course was 6 days.

Prevention:

The disease is mainly transmitted through food, nose and mouth droplets and contact, so prevention should be given priority to; 1. Pay attention to food hygiene to avoid illness from entering the mouth; 2. Avoid contact with children. If a child care institution finds a patient, it shall take isolation measures; 3. Strengthen physical exercise at ordinary times; 4. Regulate the spleen and stomach and treat dyspepsia as soon as possible.

The difference between hand, foot and mouth disease and foot-and-mouth disease;

Foot-and-mouth disease and hand-foot-mouth disease are two completely different infectious diseases, and the main differences are as follows:

(a) the name of the disease is different from the classification of the disease.

Foot-and-mouth disease is listed as ICD- 10 B08.802 in the International Classification of Diseases (ICD).

Hand, foot and mouth disease is classified into ICD-9 074.3 and ICD- 10 B08.40 1 in the International Classification of Diseases (ICD).

(2) Different pathogens

The pathogen of foot-and-mouth disease is foot-and-mouth disease virus, which belongs to zoonotic pathogens.

Hand, foot and mouth disease is caused by several enterovirus infections. Coxsackie virus (CoxAl6) is a common pathogen prevalent everywhere.

(3) Different sources of infection

Foot-and-mouth disease virus only causes cloven-hoofed animals such as cattle, sheep, pigs, deer and camels. And become the source of infection of foot-and-mouth disease in the population. Only when there is an animal epidemic can people get sick.

The source of infection of hand, foot and mouth disease is patients and recessive infected people, which belongs to human diseases.

Different routes of transmission

Foot-and-mouth disease is infected through skin and mucous membrane by contacting ulcers and scars on the mouth and hoof crown of sick animals. Occasionally infected by eating unheated (pasteurized) milk contaminated with viruses. Therefore, the number of people suffering from foot-and-mouth disease is very small.

Hand, foot and mouth disease is caused by contact with patients. It can be spread through the respiratory tract through the pollution of daily necessities, utensils and toys. Therefore, there can be epidemics of different scales.

(5) The patients are different.

People suffering from foot-and-mouth disease rely on contact with sick animals, and people suffering from foot-and-mouth disease are of a wide age;

Hand-foot-and-mouth disease (HFMD) is mainly an infectious disease of children and adolescents, and children under 3 years old account for the vast majority.

(6) Different symptoms and signs

Foot-and-mouth disease and hand-foot-mouth disease are both located in the mouth, fingers and toes, and they are similar, but their symptoms and signs are different. After the onset of foot-and-mouth disease, the main symptoms are fever and other systemic poisoning symptoms and local herpes damage.

Hand, foot and mouth disease has no fever or low fever, only respiratory tract infection, oral mucosal herpes and papules on fingers, feet, buttocks and knees.

(7) Different diagnostic basis.

Foot-and-mouth disease requires local livestock to have or epidemic foot-and-mouth disease, contact with sick animals, or drink contaminated and unheated sick animal milk.

Hand-foot-and-mouth disease (HFMD) is obviously contagious, showing epidemic transmission and different clinical manifestations. Foot-and-mouth disease and hand-foot-mouth disease can be diagnosed on the clinical basis, and the virus can be isolated for etiological diagnosis if necessary.

Hot question and answer of hand, foot and mouth disease

1. What is hand, foot and mouth disease?

Hand, foot and mouth disease is a common infectious disease of infants caused by enterovirus. The recessive infection rate of the disease is high, and the symptoms of dominant patients are generally mild.

2. What is the source of hand, foot and mouth disease?

Patients, recessive infected persons and asymptomatic carriers are the main sources of infection.

3. How is hand, foot and mouth disease spread?

Mainly through close contact between people. Hand, foot and mouth disease is mainly spread through food contaminated by patients' feces. Direct contact with blisters worn by patients can also spread the virus. The virus in the patient's throat secretions and saliva can be spread by airborne droplets, and the patient's feces are still contagious for several weeks.

4. Which groups of people are susceptible to hand, foot and mouth disease?

People are generally susceptible, and can acquire immunity after infection, and can be infected at all ages, mainly children under 5 years old.

5. What are the clinical manifestations of hand, foot and mouth disease?

Clinical manifestations: Hand-foot-mouth disease is an enterovirus disease, the incubation period is usually 3-7 days, and there is no obvious precursor symptoms: most patients have sudden onset. It mainly invades hands, feet, mouth and buttocks; Clinically, there are four characteristics: no pain, no itching, no scab and no scar. There may be mild upper respiratory symptoms at the beginning. Because of the pain of oral ulcer, the child salivates and refuses to eat. Oral mucosal rashes appeared earlier, initially miliary maculopapules or blisters, with redness around them, mainly on the tongue and cheeks, and often on the labial and dentate sides. Spotted papules or herpes appear on the distal parts such as hands and feet, flat or convex, and the rash is not itchy. The maculopapular rash turns from red to dark in about 5 days, and then disappears. Herpes is a round or oval flat protuberance with turbid liquid in it, and its long diameter is consistent with the direction of dermatoglyphics. For example, soybeans vary in size, which are generally painless and leave no trace after healing. Hand, foot and mouth lesions may not all appear in the same patient. Blisters and rashes usually subside within a week.

6. What complications will hand, foot and mouth disease cause?

Hand, foot and mouth disease is manifested in the skin and mouth, but the virus can invade important organs such as heart, brain and kidney. When the disease is prevalent, the clinical monitoring of patients should be strengthened. If there is high fever and unexplained leukocytosis, we should be alert to the occurrence of fulminant myocarditis. When accompanied by aseptic meningitis, its symptoms are fever, headache, stiff neck, vomiting, irritability, restless sleep and so on. Occasionally, nonspecific red papules and even punctate bleeding spots can be found in the body. People with central nervous system symptoms are more common in children under 2 years old.

What are the epidemic characteristics of hand, foot and mouth disease?

This disease is often prone to collective infection in kindergartens. Cross-infection in hospitals can also cause transmission. The disease is highly contagious, with complicated transmission routes, strong epidemic intensity and fast transmission speed, which can cause an epidemic in a short time. Hand, foot and mouth disease is widely distributed in Europe, America, Asia and other places. Hand, foot and mouth disease can occur all year round, especially in summer and autumn, and it is rare in winter.

8. How to diagnose hand, foot and mouth disease?

The main diagnostic basis of this disease is ① it is easy to occur in summer and autumn. ② Taking children as the main target, it often happens in places where infants gather, showing a popular trend. ③ The main clinical manifestations were the first fever, slight increase in the total number of white blood cells, followed by maculopapules and herpes-like lesions of oral cavity, hands and feet mucosa and skin. ④ The course of disease is short, and it usually heals within one week. When it occurs, it should be differentiated from foot-and-mouth disease, herpetic pharyngeal buccal inflammation and rubella.

9. How to treat hand, foot and mouth disease?

The principle of treatment is mainly symptomatic treatment. During the illness, it is necessary to strengthen the care of children and do a good job in oral hygiene. Liquid and semi-liquid foods are suitable. Because hand, foot and mouth disease can be complicated with myocarditis, encephalitis and meningitis. It is necessary to go to medical institutions and disease control institutions for treatment and re-examination in time, and patients can generally recover completely.

10. How to prevent hand, foot and mouth disease?

So far, there is no special prevention method for this disease. The main measure of epidemic control is to deal with the feces and other excreta of patients, and generally it is not necessary to take medical measures for contacts. Kindergartens and other units should do a good job in morning examination, find suspected patients in time and isolate them. Contaminated daily necessities, tableware, toys, etc. Should be disinfected, clothes should be exposed to the sun, and the room should be ventilated. When hand, foot and mouth disease is prevalent, we should do a good job in environmental hygiene, food hygiene and personal hygiene, and wash our hands before and after meals to prevent the disease from entering the mouth.

What is the difference between hand-foot-mouth disease and foot-and-mouth disease?

Foot-and-mouth disease and hand-foot-mouth disease are two completely different infectious diseases. The pathogen of foot-and-mouth disease is foot-and-mouth disease virus, which is a pathogen of human and animals. Hand, foot and mouth disease is caused by a variety of enterovirus infections, and the common pathogen that is prevalent everywhere is Coxal6.

Foot-and-mouth disease virus only causes cloven-hoofed animals such as cattle, sheep, pigs, deer and camels. And become the source of infection of foot-and-mouth disease in the population. Only when an animal epidemic occurs first can people get sick, and the source of infection of hand, foot and mouth disease is patients and people with viruses in their intestines, which belongs to human diseases.

Foot-and-mouth disease is infected through skin and mucous membrane by contacting ulcers and scars on the mouth and hoof crown of sick animals. Occasionally infected by eating unheated (pasteurized) milk contaminated with viruses. Therefore, the number of people suffering from foot-and-mouth disease is very small. Hand, foot and mouth disease is caused by contact with patients. It can be spread through the respiratory tract through the pollution of daily necessities, utensils and toys. Therefore, there can be epidemics of different scales.

People suffering from foot-and-mouth disease rely on contact with sick animals, and people suffering from foot-and-mouth disease are of a wide age; Hand, foot and mouth disease is mainly an infectious disease of children and adolescents, and children under 3 years old account for the vast majority.

Foot-and-mouth disease and hand-foot-mouth disease are both located in the mouth, fingers and toes, and they are similar, but their symptoms and signs are different. Foot-and-mouth disease is characterized by fever and other systemic poisoning symptoms and local herpes damage, while hand, foot and mouth disease mostly has no fever or low fever, only respiratory tract infection, oral mucosal herpes and papules on fingers, feet, buttocks and knees.

Foot-and-mouth disease requires local livestock to have or epidemic foot-and-mouth disease, contact with sick animals, or drink contaminated and unheated sick animal milk. However, hand-foot-mouth disease (HFMD) is obviously contagious and epidemic, and its clinical manifestations are different. Foot-and-mouth disease and hand-foot-mouth disease can be diagnosed on the clinical basis, and the virus can be isolated for etiological diagnosis if necessary.

Can effectively prevent hand, foot and mouth disease.

Hand, foot and mouth disease is generally easy to infect babies. Most cases have mild symptoms, mainly manifested as fever, rash or herpes on hands, feet and mouth, and most patients can heal themselves. Disease control experts advise everyone to develop good hygiene habits, wash their hands before and after meals, do not drink raw water, do not eat cold food, dry clothes and quilts frequently, and have more ventilation. Kindergartens and parents who find suspicious children should go to medical institutions for treatment in time, report to health and education departments in time, and take control measures in time. Mild children do not need to be hospitalized, but can be treated and rested at home to avoid cross-infection. As long as these aspects are well done, hand, foot and mouth disease can be effectively prevented and controlled.