Health and Disease, Uncategorized

HFMD: Hand Foot and Mouth Disease

What is hand, foot, and mouth (HFMD) disease?

Hand, foot, and mouth disease (HFMD) is a viral infection characterized by fever and a typical rash most frequently seen on the palms of the hands, soles of the feet, and inside the mouth. It should not be confused with foot (hoof) and mouth disease that affects cattle, sheep, and swine.

Picture of Verruca Vulgaris After Treatment

What causes hand, foot, and mouth disease?

HFMD is one of several infectious diseases caused by different members of the enterovirus family of viruses. The most common cause is Coxsackievirus A16; less frequently enterovirus 71 is the infectious agent. The clinical manifestations of routine HFMD are the same regardless of the responsible virus. However, patients infected with enterovirus 71 are more likely to experience rare complications (for example, viral meningitis or cardiac muscle involvement).

What are the risk factors for hand, foot and mouth disease?

Risk factors for developing HFMD include

  • summer and fall seasons,
  • toddler age range,
  • high-risk exposure location (such as daycare and preschool) and close contact (for example, family home) locations,
  • ineffective hygiene — infrequent soap and water hand-washing or not wearing disposable gloves when changing stool-containing diapers, and
  • a compromised immune system.

Picture of characteristic rash and blisters of hand, foot, and mouth disease

Is hand, foot, and mouth disease contagious? How does HFMD spread?

HFMD is spread person to person by direct contact with the infecting virus (either Coxsackievirus A16 or less commonly enterovirus 71). These viruses are most commonly found in the nasal and throat regions but also in the blister fluid or stool of infected individuals. The virus can survive on inanimate surfaces such as desktops, faucets, etc. It can then be transferred by touching contaminated surfaces and then touching your nose, mouth, or eyes before washing your hands. Likewise, changing diapers from an infected infant without wearing gloves or hand-washing can transmit disease. Water contaminated with the virus can also transmit the infection. Women who are infected shortly prior to delivery may pass on the infection to their infant. The baby will generally have a mild illness but should be monitored closely since in rare cases they could develop a more severe infection or experience complications. Infected individuals are most contagious during the first week of their illness. HFMD cannot be contracted from pets or animals.

The viruses that cause HFMD may remain in the person’s respiratory or intestinal tract for several weeks to months after all symptoms have resolved. It is possible, therefore, to transmit the infection even though the formerly ill individual has completely recovered. Some individuals (most commonly adults) may exhibit no symptoms or signs during their infection but may unwittingly transmit the illness to those (commonly infants and children) who are not immune.

Picture of Hand-Foot-and-Mouth Disease in Mouth (2 of 2)

What is the contagious period for hand, foot, and mouth disease?

Once exposed to the virus, those who develop symptoms and signs will do so within 1-3 days. They are most contagious during the first week of the illness. However, the virus may continue to be shed for one to three weeks in respiratory secretions (saliva and/or nasal mucous) and in the stool for two to eight weeks after the primary infection.

What is the incubation period for hand, foot, and mouth disease?

HFMD is moderately contagious and spreads from person to person. It cannot be spread by animals. Usually, the virus is passed via oral secretions (nasal discharge and saliva, etc.) or via stool. There is a short 1- to 3-day incubation period between exposure and development of initial symptoms (fever and malaise). A person is most contagious during the first week of illness.

Picture of characteristic mouth sores of hand, foot, and mouth disease

Can adults get hand, foot, and mouth disease?

An adult who was never exposed to the viruses that cause HFMD as a child could develop the characteristic symptoms and physical signs (vesicular rash with the characteristic distribution) if infected by the virus. Interestingly, the majority of adults exposed to enteroviruses will remain without symptoms. Unfortunately, an infected person is still contagious even though he lacks objective physical findings.

What are the symptoms and signs of hand, foot, and mouth disease?

HFMD is most commonly an illness of the summer and fall seasons.

  • Initial symptoms of a low-grade fever (101 F-102 F) and malaise are followed within 1 or 2 days by a characteristic skin rash.
  • Small (2 mm-3 mm) red spots that quickly develop into small blisters (vesicles) appear on the palms, soles, and oral cavity.
    • The gums, tongue, and inner cheek are most commonly involved in the mouth.
    • The foot lesions may also involve the lower calf region and rarely may appear on the buttocks.
    • Oral lesions are commonly associated with a sore throat, uncomfortable eating and drinking, and as a result, a diminished appetite. It is very rare for an infected child to become dehydrated due to oral discomfort.
  • It is estimated that approximately 50% of those infected with this enterovirus never develop symptoms. Symptoms are much more common in infants, toddlers, and young children. Older children, teens, and adults are more likely to incur no symptoms.

When does hand, foot, and mouth disease usually occur?

In the temperate northern hemisphere, summer and fall are the most frequent seasons for community epidemics of HFMD. The illness is year-round in the tropics. While anyone exposed to the viral causes of HFMD may develop disease, not everyone infected will develop symptoms and signs

Picture of Verruca Vulgaris

How long does hand, foot, and mouth disease last?

The total duration of illness from HFMD is approximately 5-7 days. One to three days after viral invasion of the patient, the first symptoms become evident. These include fever, reduced appetite, sore throat, and a general sense of feeling ill (malaise). One to two days later, the characteristic painful mouth sores develop. The final stage of the illness is manifested by small, tender red spots which progress to blisters in the mouth, palms of the hands, soles of the feet, and less frequently on the arms and legs, as well as the buttock and genital areas.

What is the course of hand, foot, and mouth disease?

The illness is characteristically self-limited and is usually resolved within a week, particularly when due to its most common cause, Coxsackievirus A16. In those outbreaks due to enterovirus 71, the illness may be more severe with complications such as infection of the heart muscle and/or viral meningitis and encephalitis and paralytic disease. As a rule, HFMD is generally a mild and self-limited illness.

Picture of Hand-Foot-and-Mouth Disease in Mouth (1 of 2)

Why haven’t we heard more about hand, foot, and mouth disease?

Recognition of hand, foot, and mouth disease is relatively recent (when contrasted with mumps, measles, and chickenpox, for example). HFMD was first reported in 1956 in Australia. By the early 1960s, it had emerged as a common childhood illness around the world.

How do health care professionals diagnose hand, foot, and mouth disease?

Usually, the diagnosis of HFMD is made on a combination of clinical history and characteristic physical findings. Laboratory confirmation is rarely necessary unless severe complications develop.

Picture of Hand-Foot-and-Mouth Disease on Foot

What is the treatment for hand, foot, and mouth disease?

Treatment of HFMD is directed toward symptomatic relief of fever and sore throat. Antibiotics are not indicated in the treatment of this viral disease. Intravenous immune globulin (IVIG) has been tried as a therapy for severely ill patients or immunocompromised older patients with variable success.

Picture of Verruca Plana

What are complications of hand, foot, and mouth disease?

Complications of HFMD are relatively rare. The more common cause of HFMD (Coxsackievirus A16) is less likely to cause complications when compared with enterovirus-71.

Complications include the following:

  1. “Aseptic” (also called “viral”) meningitis (rare): Symptoms of meningitis are moderate-severe headache, discomfort when bending the head forward (classically tested by trying to touch the chin to the chest), and nausea and vomiting. Meningitis is an infection of the tissues and spinal fluid that surrounds the brain and the spinal cord. The diagnosis is confirmed by a lumbar puncture (also known as a “spinal tap”). Depending upon severity of the patient’s symptoms, they may need to be hospitalized.
  2. Encephalitis (brain infection): Encephalitis is much less common but more ominous when compared with meningitis and requires hospitalization for close monitoring. Other rare neurologic complications include paralysis, Guillain-Barré syndrome, transverse myelitis, and cerebellar ataxia. Transient and permanent impairment can both occur.
  3. Occasionally, the virus may infect the heart muscle fibers and thus compromise the heart’s blood-pumping capabilities.
  4. Young infants may very rarely become dehydrated due to refusal to take oral fluids as a consequence of mouth pain.
  5. In very rare circumstances, the skin vesicles may develop a secondary bacterial infection. A short course of antibiotics are used to treat the secondary infection.

How does hand, foot, and mouth disease affect pregnancy and the baby?

Commonly, HFMD is an illness of children less than 10 years of age; adults generally were exposed during childhood and maintain a natural immunity. Information regarding fetal exposure to HFMD during pregnancy is limited. No solid evidence exists that maternal enterovirus infection is associated with complications such as spontaneous abortion or congenital defects. However, should a baby be born to a mother with active HFMD symptoms and signs, the risk of neonatal infection is high. While such newborns often have a mild illness, a newborn infant is highly vulnerable and may develop an overwhelming and potentially fatal infection involving vital organs such as liver, heart, and brain, which could be fatal.

Picture of Hand-Foot-and-Mouth Disease on Hand (1 of 2)

When can children with hand, foot, and mouth disease return to school?

Children may return to school once without fever for 24 hours (usually day three or four of the disease).

What is the prognosis of hand, foot, and mouth disease?

The prognosis for routine HFMD is excellent. A patient’s symptoms are bothersome but not debilitating. Medications designed to reduce fever and/or pain relievers are helpful, such as acetaminophen(Tylenol) or ibuprofen (Advil or Motrin). Young children often find that cool/soft foods (ice cream, smoothies, etc.) provide some pain relief and are psychologically helpful as “special treats.” An individual assessment is required for those unique individuals who develop complications (such as meningitis). As would be anticipated, those with an immunocompromised status are more likely to develop either a more serious infection or an illness of a more intense nature than those with a normally functioning immune system.

Picture of Hand-Foot-and-Mouth Disease on Hand (2 of 2)

Is it possible to prevent hand, foot, and mouth disease?

There is no vaccine to prevent HFMD. Routine hygiene (soap and water washing of the hands) is a primary strategy to limit transmission of the virus. Cleaning a child’s toys (especially those which would be placed into the mouth or drooled upon) is important. Avoidance of direct saliva exposure (kissing, sharing eating utensils, etc.) is also very helpful to limit transmission. Since transmission of the virus is also possible via stool, wearing disposable gloves during changing of diapers (especially in a preschool or day care setting) is also beneficial.

 

 

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Health and Disease, Uncategorized

Have You Had Mono?

Did you have Mononucleosis?

 

mono

Millions of young Americans have lived through the fatigue and discomfort of mononucleosis.

Now, new research suggests, but doesn’t prove, that the virus that causes the illness may be linked to an increased risk for seven other serious immune-system diseases.

Those diseases include lupus; multiple sclerosis; rheumatoid arthritis; juvenile idiopathic arthritis; inflammatory bowel disease; celiac disease, crohns disease and type 1 diabetes.

“Mono” is a contagious illness that occurs most often in teens and young adults. It’s caused by the Epstein-Barr virus, one of the most common human viruses.

“Epstein-Barr virus infects over 90 percent of adults, and the infection lasts for a lifetime,” said study lead author Dr. John Harley.

“The new results are building a strong case that this virus is also involved in causing a number of autoimmune diseases for at least some patients,” added Harley. He is director of the Cincinnati Children’s Hospital Center for Autoimmune Genomics and Etiology.

“It is the kind of circumstantial evidence that is comparable to a smoking gun,” he added.

And those seven diseases affect roughly 8 million Americans, Harley and his colleagues said.

However, one expert said people who have had mono shouldn’t panic.

The findings “should not be a cause for alarm,” said Dr. David Pisetsky, a professor of medicine at the Duke University School of Medicine in Durham, N.C.

“In modern life everyone has been exposed and infected with Epstein-Barr,” he noted. “And if 99 percent of people have been exposed to Epstein-Barr, and only 0.1 percent have lupus, it means there really must be other factors at play that affect risk,” Pisetsky explained.

“I really don’t think it’s a reason for undue concern,” he added. Pisetsky is also on the scientific advisory board for the Lupus Research Alliance.

Harley’s in-depth genetic analysis revealed that at the cellular level, the Epstein-Barr virus shares a number of abnormal viral on-off switches (“transcription factors”) in common with those seven other illnesses.

Those transcription factors are meant to move along the human genome (DNA roadmap), jumpstarting cells into performing necessary tasks.

But the abnormal switches found in Epstein-Barr hijack this process. First, they bind to a specific protein — known as EBNA2. Then they move about the genome in search of disease trigger points. Once docked at a respective trigger point, the risk for that particular disease goes up, the new research suggests.

Harley said he and other scientists will continue to examine additional factors that likely also contribute to autoimmune risk. Autoimmune diseases occur when your immune system mistakenly attacks your body.

 

 

As the cause of mononucleosis, Epstein-Barr is typically transmitted via saliva, giving rise to its nickname as the “kissing disease.”

Kids and teens with mono may have a fever, muscle aches and sore throat. They often feel exhausted. However, many people — especially young children — experience no symptoms. And in most cases, mono resolves within a couple of weeks.

The new findings stem from an extensive genetic review of potential links between the Epstein-Barr virus and roughly 200 illnesses. However, the study could not prove a cause-and-effect relationship.

The review actually uncovered preliminary links to 94 additional diseases, including breast cancer. But Harley’s team said further investigation is needed to confirm those associations.

Tim Coetzee is chief advocate for services and research with the National Multiple Sclerosis Society. He characterizes the new findings as “an important contribution.”

“We need these kinds of studies to help us unravel how this virus could trigger disease,” he said. “The paper is also a powerful demonstration about how detailed genetic studies can help us understand human diseases.”

Careful research like this, Coetzee added, “will give us the knowledge we need to better understand the complexity of autoimmune diseases, and importantly point the way to potential prevention of these.”

 

Ask yourself if you have had a lot of strep throats, asthma, bronchitis or mono in your life.  Are you one who has allergies, If so, make an appointment with us, and we can work together to prevent any of these diseases from attacking you.

 

Health and Wellness Associates

Archived

P Carrothers

Director of Personalized Health Care

Preventative and Restorative Medicine

312-972-9355 (WELL)

 

HealthWellnessAssociates@gmail.com

 

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Health and Disease, Uncategorized

Why are American Children So Sick?

children

What is Wrong With America’s Children

 

In America, our children are getting sicker and sicker.  Here are the facts about children living in the United States.

 

1 in 3 children are overweight

1 in 5 children are obese

1 in 6 children have a learning disability

1 in 11 children have asthma

1 in 68 children have autism

1 in 423 boys have autism

1 in 10 children have ADHD

1 in 20 children have food allergies

1 in 2 children have a chronic illness

 

This should alarm everyone.  Every one of these problems concerns intake of chemicals that the body can not utilize or diffuse.

Please give us a call to help eliminate chemical intake from you and your families diet. These problerms start when you are pregnant, and they are not filtered out if you breastfeed.

 

Health and Wellness Associates

Archived

312-972-Well

 

HealthwellnessAssociates@gmail.com

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Rx to Wellness

Can Magnesium Prevent Diseases for You

magnesium

There have been several significant studies about magnesium’s role in preventing type 2 diabetes and improving insulin resistance

  • Higher magnesium intake reduces risk of impaired glucose and insulin metabolism and slows progression from pre-diabetes to diabetes
  • For each 100 milligrams of magnesium consumed in a day, the risk of diabetes is decreased by 15 percent

Set up a time with us and we will help  you determine if this is something you should or should not start taking.

Health and Wellness Associates

312-972-WELL