4 stages of development of hand, foot and mouth disease

The article was professionally consulted with Specialist II Cao Thi Thanh - Pediatrician - Pediatrics - Neonatology - Vinmec Hai Phong International General Hospital.

Hand, foot and mouth disease is caused by enteric viruses, most commonly Coxsackievirus and Enterovirus 71. The disease is transmitted by the gastrointestinal tract, but viruses present in respiratory secretions can also be the route of transmission. Clinically, hand, foot and mouth disease is divided into 4 stages of development.

The incubation period for hand, foot and mouth disease usually lasts from 3 to 7 days after the child is infected with the virus from the saliva, blisters on the skin and feces of an infected person. Hand, foot and mouth disease can occur at any age but is most common in children, especially during outbreaks. Children are very susceptible to contact with blister secretions, gastrointestinal secretions, nose and mouth secretions when coughing and sneezing from friends with similar diseases in kindergartens or public playgrounds.
Around the issue of whether hand, foot and mouth disease is contagious, specialists say that hand, foot and mouth disease can also be spread indirectly through hands that come into contact with virus-infected surfaces, from caregivers. Maintain proper hygiene, from poor quality environment, contaminated toys, undercooked food boiled thoroughly...

The initial stage of illness will last from 1-2 days with hand, foot and mouth symptoms similar to flu, specifically:
Mild or high fever Feeling tired Sore throat Anorexia, possibly with vomiting Diarrhea Several times a day In fact, many parents do not know how many days a child has hand, foot and mouth disease, this is extremely dangerous, leading to subjective and not timely treatment if complications occur.
At the onset of hand, foot and mouth disease, a child may have a low-grade fever, moderate in onset as well as full-blown. However, if the fever is consistently above 39 degrees Celsius and lasts for 3 days or more, especially in children younger than 3 years old, it could be a sign of an increased risk of complications from encephalitis.

The full-blown phase can last 3 - 10 days, the child will face typical symptoms in the hands - feet - mouth, including:
Mouth ulcers Mucosal lesions in the form of blisters in the mouth, gums and tongue. The blistering sores are small in diameter from 2 to 3 mm and progress quickly. After rupture, the child has mouth pain, stops eating or sucking, as well as increased salivation.
Urticaria-like rash At first, it was just common erythema, very small in size (only about 1-2 mm) so it is easy to miss if not paying close attention, even for doctors and parents. Then gradually become a water ball with a diameter of 2 - 10mm oval.
The blister-like rash mainly appears on the palms, soles, infants may develop blisters on the buttocks (swaddled) and knees on an erythematous background. The blisters can be protruding or hidden under the skin, usually painless when pressed, and clear fluid. If the shift turns cloudy then this is a sign of superinfection, but this is also rare. The blistering rash will last for less than 7 days, then there is a risk of leaving a deep scar or disappearing completely if it is treated properly.

Other signs The child may have a low-grade fever and vomiting. However, if the child has a high fever and vomits a lot, the risk of complications is quite high. In which, neurological, cardiovascular, or respiratory complications often appear as early as the 2nd to 5th day of illness.

After the full-blown period, if the child fully recovers without any complications, the child will enter the remission phase. This final period is usually from 3 to 5 days after the onset of illness or 7 days from the onset of illness.
In fact, not all patients with hand, foot and mouth disease experience the same course of action. The four typical stages of disease development as above are acute. There are also two other clinical forms:
Fulminant form: The disease progresses very quickly and severe complications such as circulatory - respiratory failure, coma lead to death within 24 - 48 hours; Atypical form: Unspecified rash or oral ulceration alone, or a neurological/cardiovascular/respiratory symptom without both rash and oral ulceration.

Complications of hand, foot and mouth disease are very dangerous and even lead to death. Therefore, in addition to proactively preventing disease by keeping it clean, parents also need to know the early signs of complications to promptly detect and bring their children to the hospital for examination. The specific emergency symptoms are:
Persistent high fever that is difficult to bring down with vomiting Neurological complications with startling, tremor, startling, somnolence, coma, or convulsions Signs of breathing such as difficulty breathing, rapid breathing, or irregular breathing Circulatory failure as shown by rapid heart rate, cold hands and feet, pale or cyanotic skin Also, if parents are too concerned about the child's general condition, do not Knowing if hand, foot and mouth disease is contagious, or how many days the fever will go away, ... or if the house is far from a medical facility, it should not be subjectively monitored at home.
Vinmec International General Hospital is the address for examination, treatment and prevention of diseases. When performing the examination process at Vinmec, customers will be welcomed and used modern facilities and equipment along with perfect medical services under the guidance and advice of experts. Good doctors, well-trained both at home and abroad.