Foot and mouth disease (Hand, foot and mouth disease, HFMD) is caused by enteroviruses, many infectious diseases occur in infants and young children, can cause the hand, foot, oral herpes, such as parts of individual patients may cause myocarditis, pulmonary edema, aseptic meningitis and other complications. Foot and mouth disease caused by enteroviruses are 20 (type), A group of Coxsackie virus 16, 4, 5, 9, 10, B group 2, 5, and enterovirus 71-foot-mouth disease are more common pathogens, with Coxsackievirus A16 (Cox A16) and enterovirus 71 (EV-71).
The disease has an incubation period of 2 to 7 days of infection including patients and covert infections. During a pandemic, the patient is a major source of infection. Patients in the acute phase of illness may be excreted from the pharynx; herpes virus solution combined with a large number of virus, the virus overflow when; disease after a few weeks, patients still excreted in feces can ever since.
Disease transmission and diverse to spread through close contact with people. Viruses can pass saliva, herpes fluid, excreta and other pollution, hand towels, handkerchiefs, tooth Cup, toys, food, milk products, as well as bed linen and underwear cause indirect contact; patients throat secretions and saliva of viruses via droplets; if the contact is virus contamination of water sources, but also by water infection; outpatient cross-infection and oral instrument disinfection failed is one of the causes of the spread.
The crowd on the foot and mouth disease caused by enteroviruses generally susceptible to infection can get immunity. Due to the different type of pathogen infections after the antibody lack cross-protection force, so the crowd can be repeated infections. Most adults have been infected by hidden, thus obtaining the appropriate antibody, foot and mouth disease in patients mainly for preschool children, especially ≤ 3-year-old age group had the highest incidence. According to foreign literature reported that every 2 ~ 3 years you can pop in the crowd.
Foot and mouth disease widely distributed, no obvious regional; the four seasons can be illness to a high incidence in summer and autumn. The disease usually appears after an outbreak occur sporadically in; during a pandemic, kindergarten and nursery prone to infection, family or group can occur aggregation phenomena of onset. Disease transmission, transmission complex, in a short period of time could cause a pandemic.
Epidemic situation and trend forecast
(A) international outbreak situation.
Foot and mouth disease is a global epidemic, most parts of the world are popular. In 1957, New Zealand first report disease, 1958, separating out the Coxsackie virus, 1959, the “name”, foot and mouth disease. United States, Australia, Italy, France, Netherlands, Spain, Romania, Brazil, Canada, Germany and other countries often arise from different types of Coxsackie, ECHO virus and EV 71 of foot and mouth disease.
Japan is a foot and mouth disease, there are many times in the history of the pandemic, 1969-1970 pop to Cox A16 infection, 1973 and the 1978 2 times caused by the epidemic, 1997 EV71 ~ 2000, foot and mouth disease in Japan active again, EV 71, Cox A16 virus are separate. In the late 1990s, EV 71 start wreaking havoc in East Asia. 1997 Malaysia has caused primarily by EV 71 of foot and mouth disease epidemic, 4 to 8-month total of 2628 cases onset, only 4 ~ June 29 patients mean age of death, the deceased 1.5 years. Taiwan Province of China 1998 occurred due to EV 71, foot and mouth disease and herpetic outbreaks, epidemics, in June and October two wave pop, the total monitoring to 129106 cases, severe patients 405 cases, death 78 cases, deaths, mostly for children under 5 years old, complications include encephalitis, aseptic meningitis, pulmonary edema, or pulmonary hemorrhage, acute soft paralysis and myocarditis, etc.
Since 1981, the disease is found in Shanghai, Beijing, Hebei, Tianjin and Fujianese, Jilin, Shandong, Hubei, Guangdong, more than 10 provinces (municipalities) are reported. 1983 Tianjin occur caused by Cox A16, foot and mouth disease outbreak, 5 ~ October took place more than 7 000 cases; after 2 years after sporadic pop, 1986 came to nurseries and kindergartens-the outbreak. Wuhan Institute of Virology in 1995 from foot and mouth in patients with isolated EV 71 virus, in 1998, Shenzhen and Antiepidemic station from 2 strains isolated from patients with EV-71. 2000 August 5 ~ Zhaoyuan city, Shandong province, foot and mouth disease outbreak in children, city people’s Hospital reception in 1698 cases, of which men and women 1025 cases, 673 patients, aged a minimum of 5 months and a maximum of 14 years; 3 patients with fulminant myocarditis death.
The report of the national total of foot and mouth disease 13637 patients (male 8460 cases, 62.04%; female: 5177, 37.96%) deaths in 6 patients (male 4 cases, the female 2 cases). In addition to the Tibet Autonomous Region, the 31 provinces, autonomous regions and municipalities are case report. Reported incidence home top ten provinces, Shandong (3030), Shanghai (2883 cases), Beijing (2210), Hebei (1133), Zhejiang (793), Canton (670), Heilongjiang (576), Sichuan (335), Jiangsu (287) and Fujian (240 cases).
As of May 21-report of the national total of 5459 cases of foot and mouth disease in 2 cases, death. With the same period last year (2488 cases) compared to the number of reported cases rose 119.41%.
Due to foot and mouth disease has not been included in the management of infectious diseases in China, currently available in the data source to the monitor or the number of the outbreak investigation, on the outbreak of the epidemic situation make accurate comprehensive judgment.
Report from the recent outbreak information, foot and mouth disease onset time of year is located about 7 month high. As 2007 National temperature rose earlier, experts forecast that can lead to foot and mouth disease incidence peak ahead of the 2007 national report on foot and mouth disease will further increase the number of cases.
Strengthening of medical institutions of infectious diseases Division of the work and do a good job of differentiating, diagnosis and treatment of infectious diseases.
1. According to the case of clinical features, combined with the epidemiological history on foot and mouth disease cases clinical diagnosis.
Clinical characteristics: acute onset, fever; oral mucosa appears in the Valley of herpes, as large, obvious pain; Palm or a portion of a grain size of herpes, hip or knee I may suffer. Herpes with inflammatory, blister fluid flush. Some children may be associated with cough, tears, loss of appetite, nausea, vomiting, headaches and other symptoms. The disease is self-limiting disease, most of the prognosis is good, does not leave sequelae. Very few children can cause meningitis, encephalitis, myocarditis, flaccid paralysis, pulmonary edema, and other serious complications.
Understanding the epidemiology of exposure history helps case diagnosis, including: local pre-school institutions or schools of similar outbreaks or cases with similar contact history, etc. Onset object to pre-school children.
2. mild cases with outpatient treatment for patients. In severe cases (a neural symptoms or cardiovascular symptoms, etc.) should be hospitalized, focusing on medical treatment.
3. strengthen infection control in hospitals and to avoid cross-infection hospital. Hospitals to implement preliminary consultation system, creation of heating and herpes cases specialized consulting room; focus on strengthening hospital delivery room, paediatric wards of disinfection, prevention of nosocomial infection in neonates and infants and cause serious consequences.
Carry out surveillance and epidemiology, prevalence.
1. strengthening of nurseries and kindergartens, schools, and other key areas and population monitoring and management of outbreaks; in-depth medical agencies timely understanding of the epidemic, and encourages the active report outbreak of medical institutions.
2. takes note of the differences between the foot and mouth disease and viral encephalitis, viral encephalitis, and other related diseases monitoring and surveys, to ensure the accuracy of the epidemiological investigations.
3. foot and mouth disease-endemic areas to nurseries and primary schools strengthen morning check work, timely detection of cases. Found to be suffering from herpes patients should immediately mobilize parents to family isolation treatment until the illness before back to school.
4. nurseries should be daily on toys, appliances for cleaning and disinfecting, reduce indirect contact.
5. strengthening food and sanitation supervision work, reduce the foot and mouth disease spread through food and public places.
6. on the new episode of human specimens should be timely, etiologic diagnosis.
Advocacy education and health promotion.
In nurseries, schools, hospitals and other places, then wash after wash, promotion room ventilation and other related content of health education; printing related materials, to the masses for health literacy, advocacy to establish good personal hygiene; recommends that parents children as little as possible to the crowded public places, reducing the chance of being infected. Fever and rash symptoms timely treatment, isolation in a timely manner.
Parts of the response to medical institutions and centers for disease control and prevention professionals, foot and mouth disease prevention technique training. Centers for disease control and Prevention carried out according to the law on the area of medical institutions, foot and mouth disease prevention guidelines and evaluation.