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.
distinguish
The main diagnostic basis of this disease
① It occurs 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. According to the above clinical features, it is not difficult to diagnose in a large-scale epidemic. But when it happens, it must be differentiated from foot-and-mouth disease, herpetic pharyngitis and rubella:
(1) foot-and-mouth disease is caused by foot-and-mouth disease virus. There are currently 7 serotypes and 65 subtypes. It mainly infringes on domestic animals such as pigs, cattle and horses. Although it will cause disease to people, it is not sensitive. It generally occurs in animal husbandry areas, and adult herders are common all year round. Oral mucosal rash is easy to fuse into a larger ulcer, and there is a rash between the back of the hand and fingers and toes, which is itchy and painful.
(2) Herpetic stomatitis can occur in all seasons, mainly scattered. Generally, there is no rash, and occasionally herpes can appear in the lower abdomen.
(3) Herpetic pharyngeal and buccal inflammation, which can be caused by Coxsackie virus and the lesion is at the back of the mouth; Such as tonsil, soft palate and uvula, rarely involving buccal mucosa, tongue and gums. Atypical and sporadic HFMD are difficult to distinguish from rash fever, so etiology and serum examination are needed.
prevent
The disease is mainly transmitted through food, nose and mouth droplets and contact, and prevention mainly depends on God.
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.
(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.