A daycare virus paints hands, feet, and mouths with blisters
Hand, foot, and mouth disease usually starts with fever and malaise, then flat spots or bumps that may blister on hands, feet, and mouth. It is mostly a mild childhood illness that clears in about a week, yet one outbreak in Taiwan in 1998 reached an estimated 1.5 million people.
Enteroviruses from the Picornaviridae family cause HFMD. Coxsackievirus A16 is the most common culprit and enterovirus 71 ranks second, with strains such as CV-A6 and CV-A10 also responsible. The virus travels through saliva, mucus, blister fluid, stool, and contaminated objects, and people can stay infectious for days to weeks after feeling better; some carry it with no symptoms at all. Childcare settings concentrate risk through toilet training and nappy changes. Symptoms usually appear three to six days after exposure, and doctors can generally diagnose it by sight, testing a throat swab or stool only when unsure.
Most patients recover on their own in seven to ten days. Treatment is about comfort: ibuprofen can ease fever and mouth sores, though aspirin is avoided in children, and dehydrated children occasionally need fluids by drip. The rash rarely itches in children but can be intensely itchy in adults. Some children shed fingernails or toenails four to eight weeks later; the loss is temporary.
Serious complications are rare but real. Enterovirus 71 infections are more likely than A16 to cause brain inflammation, meningitis, polio-like paralysis, heart problems, or death. China licensed an EV71 vaccine by December 2015; the United States has none.
Large outbreaks have hit Asia since 1997, when Sarawak in Malaysia recorded about 600 cases and more than 30 child deaths. Taiwan’s 1998 epidemic caused 78 child deaths, and China reported 537 deaths in 2010. A 2022 Kerala outbreak was dubbed tomato flu by the media, but no special variant was found. The illness was first described in Canada and New Zealand in 1957 and named in 1960; it is unrelated to livestock foot-and-mouth disease.
Source: Hand, foot, and mouth disease
