Hand foot and mouth disease (HFMD) is a common acute viral infection which primarily affects infants and young children, often in outbreaks or epidemics, and occurs in many parts of the world.
It is characterized by rapid onset of fever and sore throat, and small superficial ulcers develop from vesicles on the gums, tongue, buccal mucosa and palate.
A day or two later, punctate and usually fleeting skin lesions appear on the palms of the hands, soles of the feet and occasionally on the buttocks, axillae or other areas.
The skin lesions may be very few in number. The fever and rash may subside rapidly, but mouth lesions may last more than a week, and virus may continue to be shed for several weeks.
The major causative agents of HFMD are Coxsackie A16 (CA16) and Enterovirus type 71 (EV71) of the genus Enterovirus, in the family Picornaviridae.
Other enteroviruses known to cause HFMD are Coxsackie A5 and A10 and some texts mention also Coxsackie B2 and B5.
Unlike CA16 which is not associated with complications involving the central nervous system, EV71 can also rarely cause meningitis, encephalitis or a poliomyelitis-like flaccid paralysis and has been implicated in outbreaks in Australia in 1972, Japan in 1973 and 1978 Bulgaria in 1975, Hungary in 1978 and more recently in Peninsular Malaysia and Sarawak in 1997, Taiwan in 1998 and Perth, Australia in 1999.
In some of these outbreaks, a large number of fatalities or cases with neurological manifestations were recorded, while in others complications were unusual.
In mid 2000, a large outbreak of EV71 occurred in Sarawak as well as in Taiwan but the case fatality rate was much lower than in the 1997 and 1998 outbreaks respectively.
However, a number of highly publicized deaths associated with EV71 infection occurred in Singapore in late 2000, leading to worries about the frequency with which EV71 outbreaks are now occurring in the region.
Source: Prof Mary Jane Cardosa / UNIMAS
email: jcardosa@ihcm.unimas.my
It is characterized by rapid onset of fever and sore throat, and small superficial ulcers develop from vesicles on the gums, tongue, buccal mucosa and palate.
A day or two later, punctate and usually fleeting skin lesions appear on the palms of the hands, soles of the feet and occasionally on the buttocks, axillae or other areas.
The skin lesions may be very few in number. The fever and rash may subside rapidly, but mouth lesions may last more than a week, and virus may continue to be shed for several weeks.
The major causative agents of HFMD are Coxsackie A16 (CA16) and Enterovirus type 71 (EV71) of the genus Enterovirus, in the family Picornaviridae.
Other enteroviruses known to cause HFMD are Coxsackie A5 and A10 and some texts mention also Coxsackie B2 and B5.
Unlike CA16 which is not associated with complications involving the central nervous system, EV71 can also rarely cause meningitis, encephalitis or a poliomyelitis-like flaccid paralysis and has been implicated in outbreaks in Australia in 1972, Japan in 1973 and 1978 Bulgaria in 1975, Hungary in 1978 and more recently in Peninsular Malaysia and Sarawak in 1997, Taiwan in 1998 and Perth, Australia in 1999.
In some of these outbreaks, a large number of fatalities or cases with neurological manifestations were recorded, while in others complications were unusual.
In mid 2000, a large outbreak of EV71 occurred in Sarawak as well as in Taiwan but the case fatality rate was much lower than in the 1997 and 1998 outbreaks respectively.
However, a number of highly publicized deaths associated with EV71 infection occurred in Singapore in late 2000, leading to worries about the frequency with which EV71 outbreaks are now occurring in the region.
Source: Prof Mary Jane Cardosa / UNIMAS
email: jcardosa@ihcm.unimas.my
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