Times of India
15 September 2010
By Pushpa Narayan
Chennai, India

Hand, Foot & Mouth Disease Is Contagious But Needs No Medicines
A large number of children in the city are falling ill with fever, sore throat and rashes, and it is only after several consultations that many are diagnosed with hand, foot and mouth disease (HFMD).

A syndrome caused by a type of virus found in the intestine is also characterised by oral lesions and rashes/blisters on palms and soles. Children, mostly in the age group 3–11, complain of loss of appetite and diarrhoea. There are no official records for the viral fever, but most doctors say they have been seeing a sporadic outbreak for the past one month. There is no specific drug to treat the ‘self–limiting’ fever, and doctors advice rest for at least three days.

"We have had no lab–tested cases," says virologist Dr P Gunasekaran, deputy director, King Institute of Preventive Medicine. "But doctors have been making inquiries. They have been telling us about children with symptoms of the viral infection," he said. Doctors say since the disease is mostly harmless, they don’t want children to go through the test.

"On most occasions, I don’t advise children to avoid school if they have no fever because by the time they come to me it’s at least three days and by then the infectious stage is over. In some cases, when the lesions are bad, the children have to be kept at home," says Dr Deepa Hariharan, pediatrician, Sooriya Hospitals, who sees at least one case a day.

HFMD is caused by viruses of the picornaviridae family. Though the virus is from the same family that causes foot and mouth disease in animals like sheep and cattle, it is a different disease in humans. It affects infants and children and is uncommon in adults. A contagious disease, it can spread when a person comes in contact with mucus, saliva, or faeces of an infected person.

It typically occurs in small epidemics in nursery schools or kindergartens. The usual incubation period is three to seven days. In rare cases, it may require hospitalisation. In very rare cases, it can be fatal as patients can develop neurological complications like encephalitis, meningitis or paralysis, inflammations of lungs or hemorrhage. Hospitals in the city have not yet reported any serious case yet.

"It started with a fever last week," says Padma M, mother of 11–year–old Nakul M residing in Mylapore. "After the fever subsided, he developed rashes on his palms and feet. I took him to the doctor and he was diagnosed with HFMD,"said Padma. And there were some others like five–yearold Bharathwaj S, a resident of Velachery, who developed rashes without fever or sore throat. "He lost his appetite and developed rashes on his hands, mouth, tongue and cheeks.

He complains some of them are painful. He also has mild diarrhoea," said his father Sriram N. Bharathwaj has been given some anti–rash creams and advised rest.

"There is only symptomatic treatment for the disease. Those with high fever are given paracetamol, some others are prescribed creams or pills to ease pain. Infection in older children, adolescents, and adults is normally mild and lasts around a week. Lukewarm baths also help bring temperature down," says pediatrician Dr S Balasubramanian.