Hand Foot and Mouth Disease in Pediatric Department of Si Sa Ket Hospital between 2006-2008

Abstract

Hand-Foot-and-Mouth- Disease (HFMD) is a common childhood illness. It is caused by coxsackie A16 and others enterovirus. It spreads easily through coughing, sneezing and direct contact to lesion including fecal oral route. Clinical syndromes are fever, sore throat with ulcer, and papulo-vesicular rash at both palms and soles, sometimes at the buttock. It usually goes away by itself in a week or so. The outbreak of HFMD in children in Malaysia in 1997 caused 34 deaths and in 1998, it caused 78 deaths in Taiwan. In Thailand there were 14,530 patients in 2007 of which 2 were deaths. In 2008 ,there were 2,952 cases reported, among which one was death. In Si Sa Ket hospital, there were 27 cases , about which 15 reported in 2007 and 12 in 2008. Twenty-two cases (81.48%) had been treated as the out-patients, while 5 (18.52%) had been hospitalized. The indications for admission were fatigue, could not eat and some degree of dehydration. The average days in the hospital were 2 days. One patient had severe complication which were convulsion and alteration of consciousness. The physical examination revealed no abnormal neurological sign. The Cerebro-Spinal Fluid (CSF) profile showed picture of viral encephalitis. He was full recovered after supportive treatment. There were 21 males, and 6 females. Most were in the age of 1-3 year (19 cases =70.37%), the others were in 3-5 year (6 cases =22.23%), 1 case was below 1 year and 1 case was over 5 years (3.70%).The 19 cases (70.37%) are the residents of Mueng District, Si Sa Ket, 6 cases (22.23%) in other districts, and the rest 2 (7.40%) in the other provinces. The 18 cases (66.66%) were found at the end of rainy and winter seasons, during October and January. The other 7 (25.93%) in summer and 2 (7.41%) in rainy season. The out-patient cases always showed clinical signs of vesicle of hands and feet (100%). There were oral ulcer in 17 cases (77.3%), fever in 10 cases (45.5%), upper respiratory tract symptoms in 7 cases (31.8%). The treatment were supportive and symptomatic. Many cases were treated with antibiotic (10 cases =45.5%). The prognosis was very good, because all of them were full recovery.