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: Hand foot mouth disease and other summer
time infections
DEAR DR.PAUL: Do you have any information on hand, foot
and mouth disease - what causes it, what it looks like? How do
you know if you have it? And how do you get rid of it? Thank you
for your help.
PEDIATRICIAN DR.PAUL Answers: Your question is timely,
as hand, foot and mouth disease occurs primarily during the
summer and fall months.
Enteroviruses are a group of viruses that cause a large variety
of rashes and infections. As a matter of fact, during the summer
and fall months these viruses are the most common cause of viral
rashes in children. It is also interesting that the younger
a child, the more likely she will develop a rash as a result
of infection from these viruses.
Older individuals may get the infection, but their symptoms
are less severe and non-specific - just a bit of fever or a
bit of diarrhea.
Among the group of enteroviruses are various specific viruses
including the Coxsackievirus and Echovirus. Each group has different
sub-types which are classified based on a number.
For example, the Coxsackievirus A16 strain is the major cause
of hand, foot and mouth disease. Typically, there are small
lesions or spots in the mouth, mostly on the tongue, and inside
the front part of the inside of the mouth known as the buccal
mucosa. Additionally, a rash develops on the hands as well as
the feet and is described as vesicular, looking like it has
a bit of fluid in its centre.
There can be fever and other symptoms too, including abdominal
pain, vomiting and/or diarrhea. The diagnosis is usually easy
to make, due to the very characteristic location of the rash
and the summer/fall seasonal preference of the infection. The
infection can last for up to one week and usually goes away
on its own without any specific treatment. The viruses spread
from one person to another by contact, for example with the
hands of an infected person. So prevention is best practised
by washing hands thoroughly when in contact with a person infected
with this or any other enteroviral infection. Once a person
has come into contact with the virus, it takes about four to
six days for the infection to show itself (this is called the
incubation period).
Other Enteroviruses can cause an infection with or without a
rash. For example, Echovirus type 9 causes a total body rash
and fever.
Other Enteroviruses can cause a variety of symptoms including:
isolated fever, abdominal pain, vomiting and diarrhea. Often
there are outbreaks of these types of infections in summer sleep-away
camps or day camps. Again, these infections go away on their
own without any specific treatment. It is important to make
sure that a child who is vomiting and/or has diarrhea does not
become dehydrated by ensuring that he keeps drinking the appropriate
fluids.
Aseptic or viral meningitis can also be caused by certain Enteroviruses.
This type of meningitis again occurs mostly during the summer
and resolves on its own. Fortunately, contrary to bacterial
meningitis, viral meningitis usually have no complications or
consequences.
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designed to be an educational aid only. It is not intended to
replace the advice and care of your child's physician, nor is
it intended to be used for medical diagnosis or treatment. If
you suspect that your child has a medical condition, always
consult a physician.
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