HAND FOOT AND MOUTH DISEASE

PREPARED BY: JASON E. SENA, RN

Hand-foot-and-mouth disease is an infectious disease that, in most cases, is caused by the coxsackie virus. What are the types of coxsackieviruses and what can they cause? There are two different types of coxsackieviruses: A and B. Type A viruses cause herpangina (sores in the throat) and hand, foot, and mouth disease. Type B viruses cause epidemic pleurodynia, and inflammation in the chest. Both types A and B viruses can cause meningitis (inflammation of the spinal cord or brain), myocarditis (inflammation of the heart muscle), and pericarditis (inflammation of the sac surrounding the heart). They also may have a role in the development of acute onsetjuvenile (type 1) diabetes.

The disease most often occurs in children under 10 and is characterized by a rash of small blister-like sores on the palms of the hands, soles of the feet, and in the mouth

Symptoms include fever, sore throat, and headache. The disease is spread from person to person through saliva, fluid from blisters, or the stools of an infected person. Outbreaks occur most often in the summer and early fall.

There is no treatment other than a pain reliever like acetaminophen. Saltwater mouth rinses may sooth sores in the mouth. The infection usually passes in a week.

PHOTO CREDITS BY WEBMD:

CHICKENPOX (VARICELLA)

is a common illness that causes an itchy rash and red spots or blisters (pox) all over the body. It is most common in children, but most people will get chickenpox at some point in their lives if they have not had the chickenpox vaccine.

caused by the varicella-zoster virus. It can spread easily. You can get it from an infected person who sneezes, coughs, or shares food or drinks. You can also get it if you touch the fluid from a chickenpox blister. A person who has chickenpox can spread the virus even before he or she has any symptoms. Chickenpox is most easily spread from 2 to 3 days before the rashappears until all the blisters have crusted over.

The first symptoms of chickenpox often are a fever, a headache, and a sore throat. You or your child may feel sick, tired, and not very hungry. The chickenpox rash usually appears about 1 or 2 days after the first symptoms start. Some children get the chickenpox rash without having a fever or other early symptoms.

It usually takes 14 to 16 days to get the symptoms of chickenpox after you have been around someone with the virus. This is called the incubation period. After a chickenpox red spot appears, it usually takes about 1 or 2 days for the spot to go through all its stages. This includes blistering, bursting, drying, and crusting over. New red spots will appear every day for up to 5 to 7 days.

Most healthy children and adults need only home treatment for chickenpox. Home treatment includes resting and taking medicines to reduce fever and itching. You also can soak in oatmeal baths to help with itching. People with long-term diseases or other health problems may need more treatment for chickenpox. They may need immunoglobulin treatment (IG) or antiviral medicine. Your doctor can give you these soon after you are exposed to the virus to help you feel better sooner.

You can prevent chickenpox by getting the chickenpox vaccine. Doctors recommend two doses of this shot for healthy children 12 months of age and older who have not had chickenpox. Older children and adults who have not had chickenpox and have not yet had the vaccine also need two doses. If you have been around a person who has the virus and you have not had chickenpox or the vaccine, you still may be able to prevent the illness. Get a shot of chickenpox antibodies or the vaccine right away.

HERPES ZOSTER

an infection resulting from reactivation of the varicella-zoster virus (VZV) that affects peripheral or cranial nerves and usually occurs years after primary infection with the varicella (chickenpox) virus or receipt of the live, attenuated varicella vaccine

The disease manifests as painful cutaneous eruptions over a single dermatome or two or more contiguous dermatomes; they are invariably unilateral and do not cross the midline. These eruptions are most commonly distributed on the thorax but can appear anywhere on the body. In some cases, cranial nerves supplying the eyes, ears, and face are involved, resulting in complicated presentations with potentially severe sequelae

DRUGS:
Acyclovir Famciclovir Herpes Zoster Virus Vaccine Valacyclovir

Herpes zoster. Also called shingles, zona, and zoster. The culprit is the varicella-zoster virus. Primary infection with this virus causes chickenpox(varicella). At this time the virus infects nerves (namely, the dorsal root ganglia) where it remains latent (lies low) for years. It can then be reactivated to cause shingles with blisters over the distribution of the affected nerve accompanied by often intense pain and itching.

Shingles

THE SIGNS AND SYMPTOMS OF SHINGLES USUALLY AFFECT ONLY A SMALL SECTION OF ONE SIDE OF YOUR BODY. THESE SIGNS AND SYMPTOMS MAY INCLUDE:
PAIN, BURNING, NUMBNESS OR TINGLING A RED RASH THAT BEGINS A FEW DAYS AFTER THE PAIN FLUID-FILLED BLISTERS THAT BREAK OPEN AND CRUST OVER ITCHING

Some people also experience: Fever and chills General achiness Headache Fatigue

The causative agent of herpes zoster, VZV, is a linear, double-stranded deoxyribonucleic acid (DNA) genome enclosed in a protein envelope. After a bout of illness with the primary infection (chickenpox), the virus lies dormant in the sensory nerve ganglion until reactivated.

Risk factors: Advanced age (the older the patient, the higher the risk)
In

elderly patients or when cellular immunity becomes compromised, the level of T-cell function decreases until it falls below a threshold that is associated with inadequate containment of VZV reactivation and the subsequent development of herpes zoster

Immunocompromise due to disease or use of immunosuppressive medicationsCancer, human immunodeficiency virus (HIV) infection, organ or bone marrow transplantation, and chronic intake of immunosuppressive medications predispose patients to have poor cell-mediated immunity and, thus, develop herpes zoster Immunocompromised patients are 20 times more likely to develop herpes zoster than immunocompetent patients. They are also more likely to have more diffuse involvement, severe skin lesions, increased severity and duration of pain, and atypical manifestations

Emotional and psychological stress

Emotional

stress, such as bereavement, may be associated with the development of herpes zoster within 6 months after the stressful life event Long-term stress may alter the immune system, and specific VZV cellular immunity is lower among adults with major depression

Mechanical trauma
Believed

to stimulate the nervous system, thus triggering reactivation of dormant VZV in the dorsal root ganglion

White race Female gender