disease
Symptoms similar to a cold will appear at the beginning of the disease, and the fever may last for 4 to 5 days; Painless rashes or blisters will appear on the palms, soles and sometimes buttocks; There will be painful ulcers in the mouth, leading to dysphagia and loss of appetite. These blisters and rashes usually subside within 7 to 10 days. Complications of hand, foot and mouth disease are not common. In rare cases, the disease can lead to viral meningitis.
Transmission routing
Hand, foot and mouth disease is mainly spread through food contaminated by patients' feces. Direct contact with blisters punctured by patients can also spread the virus. Patients are most likely to infect others when they are sick 1 week, and the patient's feces are still contagious for several weeks.
hand-foot-and-mouth disease
Disease Overview: Hand-foot-mouth disease (HFMD) is an infectious disease caused by enterovirus, which mostly occurs in infants and can cause hand-foot-mouth herpes, and some patients can cause complications such as myocarditis, pulmonary edema and aseptic meningoencephalitis. There are more than 20 kinds of enteroviruses that cause hand, foot and mouth disease. Coxsackievirus A (16, 4, 5, 9 and 10), Coxsackievirus B (2 and 5) and enterovirus 7 1 are the common pathogens of hand, foot and mouth disease, among which Coxsackievirus A (16) is the most common.
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.
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.
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, people can be infected repeatedly. Most adults acquire 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.
Hand, foot and mouth disease is widely distributed, and there is no obvious regional; It can occur in all seasons, with high incidence in summer and autumn. The disease usually occurs sporadically after an outbreak; During the epidemic, kindergartens and nurseries are prone to collective infection, and families can also gather. The disease is highly contagious and has complicated transmission routes, which can cause a large-scale 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.
International epidemic situation: Hand, foot and mouth disease is a global infectious disease, which has been reported in most parts of the world. 1957 The disease was first reported in New Zealand. 1958 isolated coxsackie virus, and 1959 put forward the name "hand, foot and mouth disease". Hand-foot-mouth disease (HFMD) caused by Coxsackie, echovirus and EV 7 1 often occurs in the United States, Australia, Italy, France, Netherlands, Spain, Romania, Brazil, Canada and Germany.
Japan is a country with many hand, foot and mouth diseases, and there have been many large-scale epidemics in history. 1969 ~ 1970 was dominated by Cox A 16, and 1973 and 1978 were caused by EV7 1 and 1978. At the end of 1990s, EV 7 1 began to wreak havoc in East Asia. 1997, an outbreak of hand, foot and mouth disease mainly caused by EV 7 1 occurred in Malaysia. There were 2628 cases in April-August, and 29 cases died in April-June alone. The average age of the deceased was 1.5 years old. 1998, hand, foot and mouth disease and herpetic angina broke out in Taiwan Province province, China. June and June 10, * * monitoring 129 106 cases, 405 cases were severe and 78 cases died, most of them were children under 5 years old.
China epidemic situation: The disease was discovered in Shanghai on 198 1, and has been reported in ten Yu Sheng cities including Beijing, Hebei, Tianjin, Fujian, Jilin, Shandong, Hubei and Guangdong. An outbreak of hand, foot and mouth disease caused by Cox A 16 occurred in Tianjin in 1983, and more than 7 000 cases occurred in 5 ~ 10 years. Two years after the epidemic, 1986 broke out again in nurseries. 1In 995, Wuhan Virus Research Institute isolated EV 7 1 virus from hand-foot-mouth patients, and in 998, Shenzhen Health and Epidemic Prevention Station isolated two strains of EV 7 1 virus from patients. From May to August, 2000, an epidemic of hand, foot and mouth disease in children occurred in Zhaoyuan City, Shandong Province. The Municipal People's Hospital admitted 1.698 children, including 1.025 males and 673 females, ranging from 5 months to 0/.4 years old. 3 cases died of fulminant myocarditis.
In 2006, hand-foot-mouth disease 13637 cases were reported nationwide (8460 cases were male, accounting for 62.04%; 5 177 women, accounting for 37.96%, and 6 cases (4 men and 2 women) died. Except Xizang Autonomous Region, 3 1 provinces, autonomous regions and municipalities have reported cases. The top ten provinces with reported cases are Shandong (3030 cases), Shanghai (2883 cases), Beijing (22 10 cases), Hebei (1 133 cases), Zhejiang (793 cases), Guangdong (670 cases) and Heilongjiang (670 cases).
As of May 2, 20071day, 5,459 cases of hand, foot and mouth disease were reported in 2007, and 2 cases died. Compared with the same period last year (2488 cases), the number of reported cases increased by 1 19.38+0%.
Supplement: Because hand, foot and mouth disease has not been included in the management of legal infectious diseases in China, most of the epidemic data come from monitoring or epidemic investigation data, so it is difficult to make an accurate and comprehensive judgment on the epidemic situation.
According to the epidemic data reported in recent years, the annual peak of hand, foot and mouth disease is around July. As the national temperature rose earlier in 2007, experts predicted that the peak incidence of hand, foot and mouth disease might be advanced, and the reported cases of hand, foot and mouth disease would further increase in 2007.
TCM treatment: TCM theory holds that the disease is caused by exogenous damp-heat epidemic virus. When the damp-heat pathogen of the vaccine injures the lung and spleen, it will lead to disharmony between the lung and spleen, or toxic pathogens will accumulate in the spleen, leading to the dysfunction of the spleen in controlling limbs and inducing resuscitation to the mouth, resulting in the above-mentioned clinical characteristics, and may be accompanied by symptoms similar to summer colds such as fever, runny nose and slight cough, or salivation, refusal to eat, irritability and so on.
Traditional Chinese medicine has a good effect on this disease, which can not only eliminate and relieve symptoms, but also shorten the course of the disease. In the early and middle stages of the disease, the therapy of clearing away heat and toxic materials, eliminating dampness and cooling blood is generally adopted. Commonly used drugs include honeysuckle, forsythia suspensa, scutellaria baicalensis, gardenia, raw coix seed, burdock, cicada slough, Arnebia euchroma, reed rhizome, bamboo leaves, gypsum, coptis chinensis, Juncus Juncus, Liuyisan and so on. If you see symptoms such as fever, anorexia and irritability in your hands and feet in the later stage of illness, you can add nourishing yin and clearing heat products such as Radix Rehmanniae, Radix Ophiopogonis, Cynanchum atratum and Polygonatum odoratum.
Prevention: the disease is mainly transmitted through food, droplets in the mouth and nose and contact, so 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.
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Treatment of Hand, Foot and Mouth Disease in Children with Various Powders (Pediatrics, Qishi Hospital of Traditional Chinese Medicine)
"Hand-foot-mouth disease" is a common infectious disease in children. At present, there is no ideal specific medicine in western medicine. The doctors of Qiqihar Hospital of Traditional Chinese Medicine in Heilongjiang Province used the methods of clearing away heat and toxic materials, cooling blood and removing dampness, regulating spleen transport, nourishing yin and promoting fluid production, and compared and supplemented the long-term effective experience powder, and finally screened out the combination of the three powders. The clinical application of more than 2,000 children has achieved gratifying results, such as rapid relief of symptoms, obviously shortened course of disease and high cure rate.
Hand-foot-mouth disease (HFMD) in children is a newly discovered explosive infectious disease in 1980s. Generally under 5 years old, especially infants, it is easy to spread widely in summer and autumn. The main clinical manifestations of the disease are herpes or ulcers on the mucous membranes of hands, feet and mouth. Pediatrics of Qi City Hospital of Traditional Chinese Medicine is now a national key specialty and a pediatric disease diagnosis and treatment center in Heilongjiang Province. Zhang Tie, He Guihua, Wang Ying and others, directors of this department, think that although hand, foot and mouth disease in children is not recorded in ancient medical books in China, it should be classified as febrile disease according to syndrome differentiation. The pathogenesis is that wind-heat toxin accumulates in lung, heart, spleen, stomach and transpiration qi camp, and the pathogenic factors are between Wei qi camp. Therefore, the general treatment principle should be clearing away heat and toxic materials, strengthening the spleen and nourishing yin.
On the basis of this understanding, Dr. Zhang Tie and others made Lingliangtong Powder and Heping Piling Powder, each of which contains three kinds of powders composed of different drugs. In the acute stage when wind evil invades the lung and heat accumulates in the heart and spleen, the symptoms are herpes or ulcer on the hands, feet and oral mucosa, red color, fever and thirst, dry yellow, red tongue with yellow fur and floating pulse. The main treatment methods are clearing away heat and toxic materials, cooling blood and removing dampness. Lingliangtong Powder is adopted, and its main components are honeysuckle, forsythia, fermented soybean, rhubarb, gypsum, divaricate Saposhnikovia root, Schizonepeta tenuifolia and Scutellaria baicalensis. In the recovery period of spleen and stomach deficiency and yin deficiency and fiery heat, the symptoms are scattered or subsided in herpes of hands, feet and oral mucosa, body heat gradually subsided, dry lips, loss of appetite, red tongue, little body fluid and rapid pulse. The principle of treatment is to regulate the spleen to help transport, nourish yin and promote fluid production. Pingpiling Powder is adopted, and its main components are tangerine peel, magnolia officinalis, Massa Medicata Fermentata, antelope horn, reed rhizome, Ophiopogon japonicus, Atractylodes lancea, Amomum villosum and so on. In the two phases, the three powders are compatible with each other, which has the functions of clearing away heat and toxic materials and promoting diuresis, so that the fever subsides, the spleen can move normally, the deficiency fire is extinguished by itself, and the yin and body fluid are nourished by itself.
Since 1997, the hospital has used the above powder to treat and observe a large number of children with hand-foot-mouth disease, and the average course of treatment has been shortened to 4 days. And the treatment course was 6 days.