Signs of mild hand, foot and mouth disease in the early stages of infection

Hand, foot and mouth disease in children is caused by many viruses and can spread into large epidemics. Most of the cases will have mild hand, foot and mouth signs, however, in some cases, it will develop seriously and lead to many dangerous complications (encephalitis - meningoencephalitis, myocarditis, acute pulmonary edema and possibly lead to encephalitis). to death) if not detected and treated early. Therefore, early recognition of hand, foot and mouth manifestations is very important to have appropriate treatment and care for children.

Hand, foot and mouth disease in children is mainly caused by enteric viruses, the most common agents are Coxsackie A16 and Enterovirus type 71 (EV71). According to experts, hand, foot and mouth disease caused by Coxsackie A16 virus usually has little risk of neurological complications and can resolve on its own within a few days. On the contrary, if children are infected with EV71 virus, the likelihood of getting hand, foot and mouth disease with dangerous complications will be higher.
In addition to the two young viruses, children with hand, foot and mouth disease can also be infected with some strains of Coxsackie virus group A such as A4 to A7, A9, A10 or group B Coxsackie virus (B1 to B3 and B5). Due to the cause of viral infection, hand, foot and mouth disease can occur all year round, however, the time of widespread outbreak is when the weather is favorable for the virus to develop (March to May and September to May). 12 annually).
In most cases, children will have mild hand, foot and mouth signs, but some children will have many dangerous complications of hand, foot and mouth disease, especially the course of the disease is usually very fast within a few hours. The cases of children with hand, foot and mouth complications, if not detected and treated promptly, will lead to serious conditions such as shock, encephalitis - meningoencephalitis, myocarditis, acute pulmonary edema and may lead to dead.

Hand, foot and mouth manifestations may include fever (which can be mild or high), skin lesions (a blister-like rash on the palms, soles, buttocks, knees...) and mouth sores. However, many children with hand, foot and mouth disease have very discreet manifestations and parents have to be very observant to detect abnormalities in their children.
Hand, foot and mouth disease in children has different manifestations, specific to each stage of infection, specifically as follows:
Incubation period: Lasts 3-6 days from the time the child is exposed to the virus and usually does not have unusual manifestations; Onset stage: Children begin to show signs of viral infection such as fatigue, low fever (37.5-38 degrees Celsius) or high fever (38-39 degrees Celsius), sore throat, sore sores in the mouth, bleeding excessive saliva, anorexia, diarrhea several times a day; The full-blown stage: Usually starting 1-2 days after the onset of the disease, the child begins to show typical hand, foot and mouth symptoms such as: A blister-like rash in places such as palms/legs, knees, butt. The blisters in hand-foot-and-mouth disease are oval in shape, 2-10mm in diameter, gray, may be raised or hidden under the skin, palpable, do not cause pain or itching; Mouth ulcers: Appearing in the mucous membranes of cheeks, gums and tongue, blisters with a diameter of 2-3mm, easily broken, forming sores when broken, causing burning pain and causing children to cry and refuse to eat; Systemic signs suggest complications such as disturbances of consciousness, delirium, convulsions, vomiting, tremors of limbs, tachycardia, dyspnea, cyanosis...; Remission phase: Usually takes place from 8-10 days, children with mild hand, foot and mouth signs and no complications will recover completely. Watch now: Early diagnosis of hand, foot and mouth disease

According to experts, children with hand, foot and mouth disease, if they have at least 1 of the following 3 very early symptoms, will warn of the risk of severe disease and require parents to pay attention to monitor:
The child is persistently fussy : Children with hand, foot and mouth are often uncomfortable and may cry, but if this sign occurs a lot and even the child cries all night without sleep, every 15-20 minutes he wakes up crying about 15-20 minutes. minutes and then fall asleep again, which can warn of a serious progression. Parents often assume that fussy babies are caused by mouth ulcers, but in fact this can be a sign of neurotoxicity at a very early stage; High fever that does not go down: Children with hand, foot and mouth fever over 38.5 degrees Celsius lasting more than 48 hours and not responding to antipyretic drugs Paracetamol suggests that the child's body has a very strong inflammatory response and increases the risk of causing neurotoxicity. terrible; Startle: This is a symptom of neurotoxicity. Therefore, parents need to pay attention to this symptom, if it appears even when the child is playing or the frequency of startling increases over time, take the child to the hospital as soon as possible. See now: How long are children isolated from hand, foot and mouth disease?

To determine whether a child has hand, foot and mouth disease, the doctor will examine you to detect typical symptoms and give some necessary diagnostic tests such as blood tests, cerebrospinal fluid tests. marrow if there are neurological complications. In addition, chest x-ray can detect acute pulmonary edema lesions in children with hand, foot and mouth disease complicated by myocardial dysfunction.
In order to accurately determine the causative agent, children will be taken samples of hand, foot and mouth diagnostic specimens from blisters, oropharyngeal fluid, feces... to do PCR (Polymerase Chain Reaction) test with high accuracy. and time for quick results.

The majority of children with hand, foot and mouth disease have mild symptoms and are monitored and treated at home by a doctor according to the following principles:
Isolating sick children according to principles, not allowing contact with healthy children To limit the spread of infection: Children with hand, foot and mouth disease should be absent from school for at least 10 days from the date of onset of illness to prevent infecting other children in the same class. If there are many children living together in the house, they must be completely isolated, encourage sick children not to play with healthy children, parents need to closely supervise the daily activities of sick children; Sick children and caregivers need to wear medical masks; Parents who come into contact with children with hand, foot and mouth disease must wash their hands with soap and clean water; Wash your baby regularly with soap and clean water every day. Teach children to wash their hands with soap under running water to prevent re-infection through the hand - mouth; Clothes, diapers and personal items of sick children should be cleaned and disinfected with boiling water before washing with soap; Use home remedies for hand, foot and mouth disease as directed by your doctor. Some ways to care for children with hand, foot and mouth disease at home parents need to know:
Oral hygiene: Hand, foot and mouth symptoms are typically blisters or mouth ulcers. This is the most ominous problem, causing pain and making children unable to eat and drink, and at the same time not giving parents oral hygiene, leading to the risk of superinfection or fungal infection. Parents often use milk towels, cotton swabs soaked in salt water to wash their children's teeth, leading to an increased risk of touching, breaking the blisters or making the sores worse. The best oral hygiene for children with hand, foot and mouth disease is to gargle with physiological saline after eating, before going to bed and when waking up. Nutrition: Children with hand-foot-and-mouth disease are often anorexic, easy to stop eating because sores in the oral mucosa cause pain, so give them soft, cool foods to create a pleasant feeling when eating. Babies who are still nursing need to continue to breastfeed, give them rest, and avoid stimulation. Skin hygiene to avoid superinfection: bathe the child with mild antiseptic water and apply Betadin solution to skin lesions after bathing. Children with fever can take fever-reducing medicine with Paracetamol at a dose of 10-15mg/kg/time, every 4-6 hours, only used when the child has a fever of 38.5 degrees Celsius or more, combined with cooling the two underarms and underarms. inguinal. In short, when a child develops symptoms such as fever (low fever or high fever), skin lesions (a blister-like rash on palms, soles, buttocks, knees) and mouth ulcers, Parents need to think a lot about the possibility of children having hand, foot and mouth disease for appropriate and timely medical interventions.
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