Infectious diseasesepidemiology and surveillance

Page content: Victorian statutory requirement | Infectious agent | Identification | Incubation period | Public health significance and occurrence | Reservoir | Mode of transmission | Period of communicability | Susceptibility and resistance | Control measures | Outbreak measures

Victorian statutory requirement

Notification is not required.

School exclusion is required until all blisters have dried.

Infectious agent

Coxsackievirus group A, mainly type 16, is the infectious agent.

Human hand, foot and mouth disease is unrelated to the foot and mouth disease of animals (caused by members of the family Picornaviridae).

Identification

Clinical features
Hand, foot and mouth disease (HFMD) occurs mainly in children under ten years of age and in young adults. Symptoms and lesions usually persist for seven to ten days.

The clinical picture consists of sore throat, fever and vesicular lesions on the buccal surfaces of the cheeks, gums and sides of the tongue.

Papulovesicular lesions of the palms, fingers and soles commonly occur. Occasionally maculopapular lesions appear on the buttocks.

Method of diagnosis
Diagnosis of HFMD is usually clinical. Viral isolation from nasopharyngeal or stool specimens is possible but rarely indicated.

Incubation period

The incubation period is from three to seven days.

Public health significance & occurrence

Hand, foot and mouth disease occurs worldwide sporadically and in epidemics. The greatest incidence is in summer and early autumn. Outbreaks occur frequently among groups of children in child care centres and schools.

Reservoir

Humans.

Mode of transmission

HFMD is transmitted by direct contact with fluid from the vesicular lesions, direct contact with nose and throat discharges and faeces of an infected person, and aerosol droplet spread.

Period of communicability

It is communicable during the acute stage of disease from nose and throat secretions and as long as there is fluid in the lesions. Viruses persist in the stools for several weeks.

Susceptibility & resistance

Everyone is susceptible to infection. Immunity to the specific virus may be acquired due to previous infection. Second attacks may occur with group A coxsackievirus of a different serotype.

Control measures

Preventive measures
Not applicable.

Control of case
Control of the case includes:

• exclusion from school of children with hand, foot and mouth disease until all blisters have dried
• covering lesions on hands and feet if possible and allowing to dry naturally
• avoiding piercing lesions as the fluid within the blisters is infectious
• good hand washing, cleaning and disposal of soiled articles.

Control of contacts
Not applicable.

Outbreak measures

Not applicable.