More dangerously, even when the disease has severe complications leading to death, both doctors and family members may not be aware that it is due to the severe progression of hand, foot, and mouth disease that requires timely intervention.
Misdiagnosis and Severe Complications
Hand, foot, and mouth disease is not a new illness; it has been mentioned in medical literature for a long time. However, most doctors and the public are not familiar with this disease because, in the past, it was primarily caused by the coxsackie virus, which is relatively benign.
Recently, a new and very dangerous agent has been discovered worldwide that also causes this disease: enterovirus 71. This agent is dangerous because it can lead to complications in the brain and heart, resulting in high and rapid mortality. Due to a lack of awareness of this disease, it is sometimes misdiagnosed by doctors as chickenpox, skin infections, or allergies…
Image of blisters on the knee area of a child with hand, foot, and mouth disease (Photo: TTO)
This disease commonly occurs in children under five years old and is highly contagious. It typically spreads quickly through the gastrointestinal tract among children living in the same household and attending daycare. According to many years of data from Children’s Hospital 1 in Ho Chi Minh City, the disease occurs in two seasons each year, from February to April and then from September to December.
The symptoms of the disease are quite recognizable if one pays attention, primarily the presence of blisters. The blisters range in size from 2 to 10 mm, are gray in color, oval-shaped, and usually appear on the buttocks, knees, palms, and soles of the feet, often without causing pain when pressed. Blisters can also appear in the mouth, and when they burst, they cause ulcers in the oral cavity.
Last year, Children’s Hospital 1 in Ho Chi Minh City admitted 1,000 children with “hand, foot, and mouth disease”, of which 400 cases had complications requiring hospitalization. In the first two months of this year, an additional 187 cases were admitted due to complications from this disease. |
When blisters appear, children may have a mild fever, be irritable due to mouth pain, and lose their appetite. The blisters will usually flatten and may self-resolve within 5-7 days. Some children may also experience vomiting and diarrhea when the blisters appear or after they have flattened.
In most cases, the illness will resolve on its own, but if caused by enterovirus 71, some children may develop very dangerous complications such as encephalitis, myocarditis, or meningitis. What is more dangerous is that these complications are very difficult to detect early if the doctor lacks experience and the family does not pay attention.
Children with neurological complications often do not present with deep coma but may show subtle symptoms such as difficulty sleeping, continuous irritability, startled reactions during wakefulness or when beginning to doze off, and they may exhibit signs of panic, incoherent speech, tremors, or seizures.
Other symptoms that may indicate complications include very high fever, excessive vomiting, skin rashes, rapid pulse without high fever, weakness in limbs, and facial drooping. If a child has complications and does not receive appropriate and timely treatment, they may die within a few hours.
Early Detection and Close Monitoring
To detect complications early, it is crucial that when a child shows symptoms of hand, foot, and mouth disease (blisters on hands, feet, and mouth), family members closely monitor the child for at least eight days to identify any signs of suspected complications and take the child to the hospital.
Moreover, if any of the aforementioned unusual symptoms are observed, check for blisters on the palms, soles, knees, or buttocks. If present, quickly take the child to the hospital. For cases without complications, treatment can be managed at home with pain relief medications, providing soft, easily digestible foods, and attempting to have the child eat in smaller, more frequent meals.
Currently, there is no vaccine available for enterovirus 71, so the best preventive measure is to ensure hygiene in food and drink. It is advisable to keep children home from school or avoid contact with sick children when living in the same household, as the disease spreads easily from one child to another through close contact.
Dr. TRUONG HUU KHANH (Head of the Infectious Diseases Department at Children’s Hospital 1)
