Hand, foot, and mouth disease - wikipedia Hand, foot, and mouth disease This article is about viral disease. For the chemotherapy - induced condition, see Chemotherapy - induced acral erythema. For the animal disease, see Foot - and - mouth disease. Hand, foot, and mouth disease Synonyms Enteroviral vesicular stomatitis with exanthem Typical lesions around the mouth of an 11 - month - old boy Specialty Infectious disease Symptoms Fever, flat discolored spots or bumps that may blister Complications Temporary loss of nails, viral meningitis Usual onset 3 -- 6 days post exposure Duration 1 week Causes Coxsackievirus A16, Enterovirus 71 Diagnostic method Based on symptoms, viral culture Prevention Handwashing Treatment Supportive care Medication Pain medication such as ibuprofen Frequency As outbreaks Hand, foot, and mouth disease ( HFMD ) is a common infection caused by a group of viruses. It typically begins with a fever and feeling generally unwell. This is followed a day or two later by flat discolored spots or bumps that may blister, on the hands, feet, and mouth, and occasionally buttocks and groin. Signs and symptoms normally appear 3 -- 6 days after exposure to the virus. The rash generally resolves on its own in about a week. Fingernail and toenail loss may occur a few weeks later, but they will regrow with time. The viruses that cause HFMD are spread through close personal contact, through the air from coughing, and the feces of an infected person. Contaminated objects can also spread the disease. Coxsackievirus A16 is the most common cause and Enterovirus 71 is the second-most common cause. Other strains of coxsackievirus and enterovirus can also be responsible. Some people may carry and pass on the virus despite having no symptoms of disease. Other animals are not involved. Diagnosis can often be made based on symptoms. Occasionally a throat or stool sample may be tested for the virus. Handwashing may prevent spread and those infected should not go to work, daycare, or school. No antiviral medication or vaccine is available, but development efforts are underway. Most cases require no specific treatment. Simple pain medication such as ibuprofen or numbing mouth gel may be used. Occasionally intravenous fluids are given to children who are unable to drink enough. Rarely viral meningitis or encephalitis may complicate the disease. HFMD occurs in all areas of the world. It often occurs in small outbreaks in nursery schools or kindergartens. Large outbreaks have been occurring in Asia since 1997. It usually occurs during the spring, summer, and fall months. Typically it occurs in children less than five years old, but can occasionally occur in adults. HFMD should not be confused with foot - and - mouth disease ( also known as hoof - and - mouth disease ) which mostly affects livestock. Contents 1 Signs and symptoms 2 Cause 2.1 Transmission 3 Diagnosis 4 Prevention 4.1 Vaccine 5 Treatment 6 Complications 7 Epidemiology 7.1 Outbreaks 8 History 9 Research 10 References 11 External links Signs and symptoms Common constitutional signs and symptoms of the HFMD include fever, nausea, vomiting, feeling tired, generalized discomfort, loss of appetite, and irritability in infants and toddlers. Skin lesions frequently develop in the form of a rash of flat discolored spots and bumps which may be followed by vesicular sores with blisters on palms of the hands, soles of the feet, buttocks, and sometimes on the lips. The rash is rarely itchy for children, but can be extremely itchy for adults. Painful facial ulcers, blisters, or lesions may also develop in or around the nose or mouth. HFMD usually resolves on its own after 7 -- 10 days. Most cases of the disease are relatively harmless, but complications including encephalitis, meningitis, and paralysis that mimics the neurological symptoms of polio can occur. Rash on palms of the hands. Rash on hand and feet of a 36 - year - old man Rash on the soles of a child 's feet Cause The viruses that cause the disease are of the Picornaviridae family. Coxsackievirus A16 is the most common cause of HFMD. Enterovirus 71 ( EV - 71 ) is the second-most common cause. Many other strains of coxsackievirus and enterovirus can also be responsible. Transmission HFMD is highly contagious and is transmitted by nasopharyngeal secretions such as saliva or nasal mucus, by direct contact, or by fecal - oral transmission. Child care settings are the most common places for HMFD to be contracted because of the bathroom training, diaper changes, and that children often put their hands into their mouths. Children who do not attend a preschool or kindergarten were found to be more susceptible to the disease. HFMD is contracted through nose and throat secretions such as saliva, sputum, nasal mucus and as well as fluid in blisters, and stool. Diagnosis A diagnosis usually can be made by the presenting signs and symptoms alone. If the diagnosis is unclear, a throat swab or stool specimen may be taken to identify the virus by culture. The common incubation period ( the time between infection and onset of symptoms ) ranges from three to six days. Early detection of HFMD is important in preventing an outbreak in the pediatric population. Prevention Preventive measures include avoiding direct contact with infected individuals ( including keeping infected children home from school ), proper cleaning of shared utensils, disinfecting contaminated surfaces, and proper hand hygiene. These measures have been shown to be effective in decreasing the transmission of the viruses responsible for HFMD. Protective habits include hand washing and disinfecting surfaces in play areas. Breast - feeding has also shown to decrease rates of severe HFMD, though does not reduce the risk for the infection of the disease. Vaccine A vaccine known as the EV71 vaccine is available to prevent HFMD in China as of December 2015. No vaccine is currently available in the United States. Treatment Medications are usually not needed as hand, foot, and mouth disease is a viral disease that typically resolves on its own. Currently, there is no specific curative treatment for hand, foot and mouth disease. Disease management typically focuses on achieving symptomatic relief. Pain from the sores may be eased with the use of analgesic medications. Infection in older children, adolescents, and adults is typically mild and lasts approximately 1 week, but may occasionally run a longer course. Fever reducers and lukewarm baths can help decrease body temperature. A minority of individuals with hand, foot and mouth disease may require hospital admission due to complications such as inflammation of the brain, inflammation of the meninges, or acute flaccid paralysis. Non-neurologic complications such as inflammation of the heart, fluid in the lungs, or bleeding into the lungs may also occur. Complications Complications from the viral infections that cause HFMD are rare, but require immediate medical treatment if present. HFMD infections caused by Enterovirus 71 tend to be more severe and are more likely to have neurologic or cardiac complications including death than infections caused by Coxsackievirus A16. Viral or aseptic meningitis can occur with HFMD in rare cases and is characterized by fever, headache, stiff neck, or back pain. The condition is usually mild and clears without treatment ; however, hospitalization for a short time may be needed. Other serious complications of HFMD include encephalitis ( swelling of the brain ), or flaccid paralysis in rare circumstances. Fingernail and toenail loss have been reported in children 4 -- 8 weeks after having HFMD. The relationship between HFMD and the reported nail loss is unclear ; however, it is temporary and nail growth resumes without treatment. Minor complications due to symptoms can occur such as dehydration, due to mouth sores causing discomfort with intake of foods and fluid. Epidemiology Hand, foot and mouth disease most commonly occurs in children under the age of 10. It tends to occur in outbreaks during the spring, summer, and autumn seasons. This is believed to be due to heat and humidity improving spread. HFMD is more common in rural areas than urban areas ; however, socioeconomic status and hygiene levels need to considered. Poor hygiene is a risk factor for HFMD. Outbreaks have occurred in China, Japan, Hong Kong, the Republic of Korea, Malaysia, Singapore, Thailand, Taiwan, and Vietnam. HFMD most commonly affects young children under the age of 10 and more often under the age of 5, but can also affect adults with varying symptoms. Since 1997 there have been 71 large enterovirus outbreaks reported, mostly in East and South East Asia, primarily affecting children. From the years 2008 to 2014, more than 1 million HFMD cases have been reported in China each year. Outbreaks In 1998, there was an outbreak in Taiwan, affecting mainly children. There were 405 severe complications, and 78 children died. The total number of cases in that epidemic is estimated to have been 1.5 million. In 2008 an outbreak in China, beginning in March in Fuyang, Anhui, led to 25,000 infections, and 42 deaths, by May 13. Similar outbreaks were reported in Singapore ( more than 2,600 cases as of April 20, 2008 ), Vietnam ( 2,300 cases, 11 deaths ), Mongolia ( 1,600 cases ), and Brunei ( 1053 cases from June -- August 2008 ) In 2009 17 children died in an outbreak during March and April 2009 in China 's eastern Shandong Province, and 18 children died in the neighboring Henan Province. Out of 115,000 reported cases in China from January to April, 773 were severe and 50 were fatal. In 2010 in China, an outbreak occurred in southern China 's Guangxi Autonomous Region as well as Guangdong, Henan, Hebei and Shandong provinces. Until March 70,756 children were infected and 40 died from the disease. By June, the peak season for the disease, 537 had died. The World Health Organization reporting between January to October 2011 ( 1,340,259 ) states the number of cases in China had dropped by approx 300,000 from 2010 ( 1,654,866 ) cases, with new cases peaking in June. There were 437 deaths, down from 2010 ( 537 deaths ). In December 2011, the California Department of Public Health identified a strong form of the virus, coxsackievirus A6 ( CVA6 ), where nail loss in children is common. In 2012 in Alabama, United States there was an outbreak of an unusual type of the disease. It occurred in a season when it is not usually seen and affected teenagers and older adults. There were some hospitalizations due to the disease but no reported deaths. In 2012 in Cambodia, 52 of 59 reviewed cases of children reportedly dead ( as of July 9, 2012 ) due to a mysterious disease were diagnosed to be caused by a virulent form of HFMD. Although a significant degree of uncertainty exists with reference to the diagnosis, the WHO report states, `` Based on the latest laboratory results, a significant proportion of the samples tested positive for enterovirus 71 ( EV - 71 ), which causes hand foot and mouth disease ( HFMD ). The EV - 71 virus has been known to generally cause severe complications amongst some patients. '' HFMD infected 1,520,274 people with up to 431 deaths reported at the end of July in 2012 in China. History HFMD cases were first described clinically in Canada and New Zealand in 1957. The disease was termed `` Hand Foot and Mouth Disease '', by Thomas Henry Flewett, after a similar outbreak in 1960. Research Novel antiviral agents to prevent and treat infection with the viruses responsible for HFMD are currently under development. Preliminary studies have shown inhibitors of the EV - 71 viral capsid to have potent antiviral activity. References ^ Jump up to : Kaminska, K ; Martinetti, G ; Lucchini, R ; Kaya, G ; Mainetti, C ( 2013 ). `` Coxsackievirus A6 and Hand, Foot, and Mouth Disease : Three Case Reports of Familial Child - to - Immunocompetent Adult Transmission and a Literature Review ''. Case Reports in Dermatology. 5 ( 2 ) : 203 -- 209. doi : 10.1159 / 000354533. PMC 3764954. 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External links Classification ICD - 10 : B08. 4 ICD - 9 - CM : 074.3 MeSH : D006232 DiseasesDB : 5622 External resources MedlinePlus : 000965 eMedicine : derm / 175 Patient UK : Hand, foot, and mouth disease Media related to Hand, foot and mouth disease at Wikimedia Commons News related to Highly contagious Hand, foot and mouth disease killing China 's children at Wikinews Infectious skin disease : Viral cutaneous conditions, including viral exanthema ( B00 -- B09, 050 -- 059 ) DNA virus Herpesviridae Alpha HSV Herpes simplex Herpetic whitlow Herpes gladiatorum Herpes simplex keratitis Herpetic sycosis Neonatal herpes simplex Herpes genitalis Herpes labialis Eczema herpeticum Herpetiform esophagitis Herpes B virus B virus infection VZV Chickenpox Herpes zoster Herpes zoster oticus Ophthalmic zoster Disseminated herpes zoster Zoster - associated pain Modified varicella - like syndrome Beta Human herpesvirus 6 / Roseolovirus Exanthema subitum Roseola vaccinia Cytomegalic inclusion disease Gamma KSHV Kaposi 's sarcoma Poxviridae Ortho Variola Smallpox Alastrim MoxV Monkeypox CPXV Cowpox VV Vaccinia Generalized vaccinia Eczema vaccinatum Progressive vaccinia Buffalopox Para Farmyard pox : Milker 's nodule Bovine papular stomatitis Pseudocowpox Orf Sealpox Other Yatapoxvirus : Tanapox Yaba monkey tumor virus MCV Molluscum contagiosum Papillomaviridae HPV Wart / plantar wart Heck 's disease Genital wart giant Laryngeal papillomatosis Butcher 's wart Bowenoid papulosis Epidermodysplasia verruciformis Verruca plana Pigmented wart Verrucae palmares et plantares BPV Equine sarcoid Parvoviridae Parvovirus B19 Erythema infectiosum Reticulocytopenia Papular purpuric gloves and socks syndrome Polyomaviridae Merkel cell polyomavirus Merkel cell carcinoma RNA virus Paramyxoviridae MeV Measles Togaviridae Rubella virus Rubella Congenital rubella syndrome ( `` German measles '' ) Alphavirus infection Chikungunya fever Picornaviridae CAV Hand, foot and mouth disease Herpangina FMDV Foot - and - mouth disease Boston exanthem disease Ungrouped Asymmetric periflexural exanthem of childhood Post-vaccination follicular eruption Lipschütz ulcer Eruptive pseudoangiomatosis Viral - associated trichodysplasia Gianotti -- Crosti syndrome Oral and maxillofacial pathology ( K00 -- K06, K11 -- K14, 520 -- 525, 527 -- 529 ) Lips Cheilitis Actinic Angular Plasma cell Cleft lip Congenital lip pit Eclabium Herpes labialis Macrocheilia Microcheilia Nasolabial cyst Sun poisoning Trumpeter 's wart Tongue Ankyloglossia Black hairy tongue Caviar tongue Crenated tongue Cunnilingus tongue Fissured tongue Foliate papillitis Glossitis Geographic tongue Median rhomboid glossitis Transient lingual papillitis Glossoptosis Hypoglossia Lingual thyroid Macroglossia Microglossia Rhabdomyoma Palate Bednar 's aphthae Cleft palate High - arched palate Palatal cysts of the newborn Inflammatory papillary hyperplasia Stomatitis nicotina Torus palatinus Oral mucosa -- Lining of mouth Amalgam tattoo Angina bullosa haemorrhagica Behçet 's disease Bohn 's nodules Burning mouth syndrome Candidiasis Condyloma acuminatum Darier 's disease Epulis fissuratum Erythema multiforme Erythroplakia Fibroma Giant - cell Focal epithelial hyperplasia Fordyce spots Hairy leukoplakia Hand, foot and mouth disease Hereditary benign intraepithelial dyskeratosis Herpangina Herpes zoster Intraoral dental sinus Leukoedema Leukoplakia Lichen planus Linea alba Lupus erythematosus Melanocytic nevus Melanocytic oral lesion Molluscum contagiosum Morsicatio buccarum Oral cancer Benign : Squamous cell papilloma Keratoacanthoma Malignant : Adenosquamous carcinoma Basaloid squamous carcinoma Mucosal melanoma Spindle cell carcinoma Squamous cell carcinoma Verrucous carcinoma Oral florid papillomatosis Oral melanosis Smoker 's melanosis Pemphigoid Benign mucous membrane Pemphigus Plasmoacanthoma Stomatitis Aphthous Denture - related Herpetic Smokeless tobacco keratosis Submucous fibrosis Ulceration Riga -- Fede disease Verruca vulgaris Verruciform xanthoma White sponge nevus Teeth ( pulp, dentin, enamel ) Amelogenesis imperfecta Ankylosis Anodontia Caries Early childhood caries Concrescence Failure of eruption of teeth Dens evaginatus Talon cusp Dentin dysplasia Dentin hypersensitivity Dentinogenesis imperfecta Dilaceration Discoloration Ectopic enamel Enamel hypocalcification Enamel hypoplasia Turner 's hypoplasia Enamel pearl Fluorosis Fusion Gemination Hyperdontia Hypodontia Maxillary lateral incisor agenesis Impaction Wisdom tooth impaction Macrodontia Meth mouth Microdontia Odontogenic tumors Keratocystic odontogenic tumour Odontoma Dens in dente Open contact Premature eruption Neonatal teeth Pulp calcification Pulp stone Pulp canal obliteration Pulp necrosis Pulp polyp Pulpitis Regional odontodysplasia Resorption Shovel - shaped incisors Supernumerary root Taurodontism Trauma Avulsion Cracked tooth syndrome Vertical root fracture Occlusal Tooth loss Edentulism Tooth wear Abrasion Abfraction Acid erosion Attrition Periodontium ( gingiva, periodontal ligament, cementum, alveolus ) -- Gums and tooth - supporting structures Cementicle Cementoblastoma Gigantiform Cementoma Eruption cyst Epulis Pyogenic granuloma Congenital epulis Gingival enlargement Gingival cyst of the adult Gingival cyst of the newborn Gingivitis Desquamative Granulomatous Plasma cell Hereditary gingival fibromatosis Hypercementosis Hypocementosis Linear gingival erythema Necrotizing periodontal diseases Acute necrotizing ulcerative gingivitis Pericoronitis Peri-implantitis Periodontal abscess Periodontal trauma Periodontitis Aggressive As a manifestation of systemic disease Chronic Perio - endo lesion Teething Periapical, mandibular and maxillary hard tissues -- Bones of jaws Agnathia Alveolar osteitis Buccal exostosis Cherubism Idiopathic osteosclerosis Mandibular fracture Microgenia Micrognathia Intraosseous cysts Odontogenic : periapical Dentigerous Buccal bifurcation Lateral periodontal Globulomaxillary Calcifying odontogenic Glandular odontogenic Non-odontogenic : Nasopalatine duct Median mandibular Median palatal Traumatic bone Osteoma Osteomyelitis Osteonecrosis Bisphosphonate - associated Neuralgia - inducing cavitational osteonecrosis Osteoradionecrosis Osteoporotic bone marrow defect Paget 's disease of bone Periapical abscess Phoenix abscess Periapical periodontitis Stafne defect Torus mandibularis Temporomandibular joints, muscles of mastication and malocclusions -- Jaw joints, chewing muscles and bite abnormalities Bruxism Condylar resorption Mandibular dislocation Malocclusion Crossbite Open bite Overbite Overeruption Overjet Prognathia Retrognathia Scissor bite Maxillary hypoplasia Temporomandibular joint dysfunction Salivary glands Benign lymphoepithelial lesion Ectopic salivary gland tissue Frey 's syndrome HIV salivary gland disease Necrotizing sialometaplasia Mucocele Ranula Pneumoparotitis Salivary duct stricture Salivary gland aplasia Salivary gland atresia Salivary gland diverticulum Salivary gland fistula Salivary gland hyperplasia Salivary gland hypoplasia Salivary gland neoplasms Benign : Basal cell adenoma Canalicular adenoma Ductal papilloma Monomorphic adenoma Myoepithelioma Oncocytoma Papillary cystadenoma lymphomatosum Pleomorphic adenoma Sebaceous adenoma Malignant : Acinic cell carcinoma Adenocarcinoma Adenoid cystic carcinoma Carcinoma ex pleomorphic adenoma Lymphoma Mucoepidermoid carcinoma Sclerosing polycystic adenosis Sialadenitis Parotitis Chronic sclerosing sialadenitis Sialectasis Sialocele Sialodochitis Sialosis Sialolithiasis Sjögren 's syndrome Orofacial soft tissues -- Soft tissues around the mouth Actinomycosis Angioedema Basal cell carcinoma Cutaneous sinus of dental origin Cystic hygroma Gnathophyma Ludwig 's angina Macrostomia Melkersson -- Rosenthal syndrome Microstomia Noma Oral Crohn 's disease Orofacial granulomatosis Perioral dermatitis Pyostomatitis vegetans Other Eagle syndrome Hemifacial hypertrophy Facial hemiatrophy Oral manifestations of systemic disease NDL : 00804612 Retrieved from `` https://en.wikipedia.org/w/index.php?title=Hand,_foot,_and_mouth_disease&oldid=865134490 '' Categories : Enterovirus - 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Question: where is hand foot and mouth disease found in the world
Answer: all areas of the world