Hand, Foot and Mouth Disease: Preventable With a Vaccine

• The EV71 hand, foot, and mouth disease vaccine can offer protection against the EV71 strain of the virus, which is the main cause of life-threatening infections. The vaccine is suitable for children aged 6 months to 5 years. 2 doses are administered 1 month apart.  
• Hand, foot and mouth disease is mostly caused by the coxsackievirus and enterovirus 71 (EV71) strains of the enterovirus group. This virus is common among young children, although there is a potential for dangerous complications if a child under 5 years of age contracts the infection. 
• The symptoms of hand, foot, and mouth disease can be potentially life-threatening, with the most dangerous complications being those that affect the central nervous system, including seizures, drowsiness, vomiting, meningitis, encephalitis, paralysis, acute muscle weakness, myocarditis and acute pneumonia.

The EV71 hand, foot and mouth vaccine offers protection against the enterovirus 71 or EV71 strain of the disease, which is the strain most associated with severe symptoms (this vaccine offers specific protection against the EV71 strain of the virus but does not offer protection against other strains).

Hand, foot and mouth disease is a communicable disease caused by the enterovirus group of viruses, the most common types of which are the coxsackievirus and the enterovirus 71 (EV71) strains. The disease is most common among younger children, and it can involve extremely severe symptoms in children under 5 who contract the infection.

Hand, foot and mouth disease can present a range of symptoms, including fever,  rash involving pustules filled with a clear fluid or reddish bumps, and blister-like lesions inside the mouth, and on the fingers and palms of the hands, with some cases developing these lesions on the abdomen, arms, or legs. The lesions that develop in the mouth are small and round, generally affecting the tongue, gums, roof of the mouth, and inside of the cheeks. Moreover, the symptoms of this disease can result in nervous system complications that can be potentially life-threatening.

Most cases of hand, foot and mouth disease are minor, involving just a fever and rashes, with the fever disappearing within 2–3 days and the rashes vanishing within 7–10 days. However, patients who contract the EV71 strain of this virus can develop dangerous and potentially life-threatening complications, as follows:

• Nervous system complications, including seizures, drowsiness, vomiting, meningitis, encephalitis, paralysis, acute muscle weakness, myocarditis, and acute pneumonia.
• Cases who survive such symptoms could be left with permanent nervous system complications.

In Thailand, hand, foot, and mouth disease is prevalent throughout the year, although its spread is most rapid and dangerous during June to September – the monsoon season – with outbreaks also possible from September to December. Therefore, whenever there is news of an outbreak, people should take greater care or employ strategies to protect themselves from infection.

Hand, foot, and mouth disease can be transmitted in various ways, including via contact with saliva, phlegm, pustule secretions, or the fecal matter of infected patients who are not displaying symptoms. The virus can also be contracted through contact with symptomatic infected patients, such as during play, via toys, when changing nappies, when bathing children, during feeding times, or through the sharing of contaminated objects.

The virus can still be present in the fecal matter of patients for up to 6–8 weeks following their initial infection, which can result in its spread despite a lack of outward symptoms. As such, care must be taken for an extended period following an infection as the virus can survive in the environment for long periods, while it is also resistant to antibacterial products and alcohol-based cleaning fluids.

Treatment for hand, foot, and mouth disease currently focuses on alleviating symptoms.

Infected patients should be kept separate from others and contact must be limited to prevent the spread of the virus. Children infected with the virus should be kept at home and away from other children. Should an infection be detected in a school, the school should be closed for a period to allow deep cleaning to take place. If an outbreak does occur, parents are advised to keep their children away from busy locations, including playgrounds and shopping centers.

Additionally, parents and children alike should practice good personal hygiene measures, including washing their hands regularly and cleaning shared objects and surfaces thoroughly and frequently.

The hand, foot, and mouth disease vaccine can offer protection against the virus or reduce its severity when contracted. The EV71 vaccine is the most common as this strain is the main cause of life-threatening infections. This vaccine is suitable for children aged 6 months to 5 years, with 2 doses required, administered 1 month apart.