Hand foot mouth disease to CDC
Publish: 2021-05-14 17:44:13
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2.
Shenzhen, China Central Broadcasting Network, reported on April 7 that the peak incidence of HFMD is in spring and summer every year. HFMD is highly infectious and easy to be ignored by parents. Severe HFMD can threaten children's lives, so it should be prevented and found as soon as possible. From 2008 to 2015, a total of 12.8 million children suffered from HFMD and 33296 died. In 2016 alone, there were 369052 cases of disease and 17 cases of death in our province. It has brought great pain to millions of families
the predominant pathogens of HFMD were enterovirus 71 (EV71) and coxsackievirus group a 16 (CoxA16), among which EV71 was the main virus type causing severe HFMD and death. At present, there is no specific drug to treat it, and EV71 vaccine can effectively prevent hand foot mouth disease caused by enterovirus 71. Since it usually takes 2-4 weeks to proce protective antibodies after vaccination, it is better to vaccinate in advance
the world's first inactivated enterovirus 71 vaccine independently developed by Institute of medical biology, Chinese Academy of Medical Sciences was launched on March 18, 2015. So far, more than 5 million doses have been used, providing health protection for children. The head of the CDC and Immunization Planning Department of Pingshan district said that EV71 vaccination is applicable to susceptible children over 6 months old and children under 71 months old who have not been vaccinated with EV71 vaccine. People who are allergic to any component of the vaccine, patients with fever and acute diseases, and those with severe chronic diseases and allergic constitution will not be vaccinated or delayed
in order to ensure the maximum protection of the vaccinated population, it is suggested that the school-age children should be vaccinated as soon as possible. After the first vaccination at the age of 6 months and before the age of 12 months, the immune protection can be proced in time. EV71 vaccine belongs to the second category, which can be inoculated voluntarily and at one's own expense. Parents with vaccination intention can take their children to the community health service center for consultation and vaccination. For the high incidence of measles, chickenpox, mumps, influenza and other epidemics in spring and summer, the relevant experts from the Department of epidemiology of CDC answered the corresponding prevention and control measures one by one in the publicity activities< br />
3. Hand foot and mouth disease white blood cells increased significantly, to severe hand foot and mouth disease development, virus invasion brain, lung, kidney, viscera serious, suggest designated hospital treatment, know which hospital designated hospital to health bureau or disease control consultation
4. The cases found by medical units should be reported to the local CDC in time, and the local CDC will report to the superior CDC in time according to the procere Fax (or send the infectious disease report card within the specified time limit) to the local CDC at county level, and CDC will timely dispatch investigators to investigate and verify. The CDC will be responsible for the reporting process in the future
the infectious disease report card is filled in by the first visiting doctor or other personnel. However, if the infectious disease case is found ring the on-site investigation, the on-site investigators of the local CDC shall fill in the report card.
the infectious disease report card is filled in by the first visiting doctor or other personnel. However, if the infectious disease case is found ring the on-site investigation, the on-site investigators of the local CDC shall fill in the report card.
5. There's something wrong with the medication. Let's see the prescription
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7. Two kindergartens in Beijing have been partially closed for HFMD.
at 14:00 on May 6, 2008, Beijing evening news made a comment.
the reporter learned from the Municipal Center for Disease Control and prevention this morning that the Municipal Center for Disease Control and prevention has received a report that a kindergarten in Jinsong District of Chaoyang District and a kindergarten in Haidian District had a cluster of HFMD, At present, the two kindergartens have been partially closed< According to the seasonal distribution characteristics of HFMD, may to July is the high incidence season of HFMD in the city. Therefore, in the next few months, the incidence of HFMD will increase month by month, and there will be local outbreaks mainly in nurseries and kindergartens“ This season in previous years, there will also be concentrated incidence in nurseries and kindergartens. At present, the incidence of HFMD in this city is within the normal range. "
Wu Jiang said that the prevention and control of any infectious disease should grasp three links: controlling the source of infection, cutting off the route of transmission, and protecting the susceptible population. Therefore, if there is a clustering disease in kindergartens, the appropriate suspension of classes is also to protect the majority of children, which is in line with the requirements of infectious disease prevention and control
Wu Jiang also reminded the general public that HFMD can be prevented and controlled, and do not listen to rumors and panic excessively
the Beijing Municipal Bureau of health or the CDC will release the specific information about HFMD to the public in a timely manner. It is reported that at present, the two kindergartens have not been tested in the laboratory, so it can not be proved that they are infected by EV71 or other viruses Reporter Jia Xiaohong)
case situation
the number of cases in Fuyang rose to 4496
the reporter learned from Anhui Provincial Department of Health yesterday that as of 24:00 on May 4, 398 new cases of enterovirus infection in Fuyang had been added, the total number of cases had reached 4496, and the death toll was still 22< More than 1000 cases of HFMD have been reported in Zhejiang Province.
since January this year, up to 0:00 on May 4, 1198 Cases of HFMD have been reported in Zhejiang Province, and 1 case died
at present, the epidemic situation of HFMD in Zhejiang Province is highly sporadic, and there are no clustered cases< As of 0:00 on May 5, 368 cases of HFMD have been reported in Hunan Province, mainly infants under 5 years old. At present, there are no reports of critical cases and deaths in the province< As of 10:00 on May 5, 1692 cases of HFMD have been reported in Guangdong Province, including 3 deaths, including 2 cases in Gaoming District of Foshan City and 1 case in Maoming City.
at 14:00 on May 6, 2008, Beijing evening news made a comment.
the reporter learned from the Municipal Center for Disease Control and prevention this morning that the Municipal Center for Disease Control and prevention has received a report that a kindergarten in Jinsong District of Chaoyang District and a kindergarten in Haidian District had a cluster of HFMD, At present, the two kindergartens have been partially closed< According to the seasonal distribution characteristics of HFMD, may to July is the high incidence season of HFMD in the city. Therefore, in the next few months, the incidence of HFMD will increase month by month, and there will be local outbreaks mainly in nurseries and kindergartens“ This season in previous years, there will also be concentrated incidence in nurseries and kindergartens. At present, the incidence of HFMD in this city is within the normal range. "
Wu Jiang said that the prevention and control of any infectious disease should grasp three links: controlling the source of infection, cutting off the route of transmission, and protecting the susceptible population. Therefore, if there is a clustering disease in kindergartens, the appropriate suspension of classes is also to protect the majority of children, which is in line with the requirements of infectious disease prevention and control
Wu Jiang also reminded the general public that HFMD can be prevented and controlled, and do not listen to rumors and panic excessively
the Beijing Municipal Bureau of health or the CDC will release the specific information about HFMD to the public in a timely manner. It is reported that at present, the two kindergartens have not been tested in the laboratory, so it can not be proved that they are infected by EV71 or other viruses Reporter Jia Xiaohong)
case situation
the number of cases in Fuyang rose to 4496
the reporter learned from Anhui Provincial Department of Health yesterday that as of 24:00 on May 4, 398 new cases of enterovirus infection in Fuyang had been added, the total number of cases had reached 4496, and the death toll was still 22< More than 1000 cases of HFMD have been reported in Zhejiang Province.
since January this year, up to 0:00 on May 4, 1198 Cases of HFMD have been reported in Zhejiang Province, and 1 case died
at present, the epidemic situation of HFMD in Zhejiang Province is highly sporadic, and there are no clustered cases< As of 0:00 on May 5, 368 cases of HFMD have been reported in Hunan Province, mainly infants under 5 years old. At present, there are no reports of critical cases and deaths in the province< As of 10:00 on May 5, 1692 cases of HFMD have been reported in Guangdong Province, including 3 deaths, including 2 cases in Gaoming District of Foshan City and 1 case in Maoming City.
8. Hello! You can go to the community health hospital where you are vaccinated and ask if there is a connection. To tell parents when to get vaccinated. If there is one, you can download one, and then you can know when your child is going to get a prophylactic injection, and there will be a notice on what kind of injection to take, and whether it is free or money is introced.
9. Diagnosis and treatment process
hand, foot, mouth For buttock rash (herpes) or fever, go to pediatrics or hand foot mouth disease diagnosis and treatment area of nearby hospital for treatment
doctor diagnosis
exclusion
real time online report of diagnosis
Beijing and national epidemic monitoring system
general cases (only rash or fever symptoms) return home for isolation rest - community doctors regularly visit
severe cases (high fever, pneumonia, brainstem encephalitis, fever, etc.) Meningitis, heart failure, respiratory failure and other symptoms) reported to the District Health Bureau and CDC
nursing strategies
1. Disinfection and isolation
once the baby is found to be infected with HFMD, he should seek medical treatment in time to avoid contact with the outside world, and generally need to be isolated for 2 weeks
the baby's used articles should be thoroughly disinfected: they can be soaked in chlorine containing disinfectant, and the articles that are not suitable for soaking can be exposed to the sun
the baby's room should be ventilated regularly to keep the air fresh, circulating and the temperature appropriate. Families with conditions can use lactic acid fumigation for air disinfection every day. Rece personnel in and out of the baby's room, prohibit smoking, prevent air pollution, avoid secondary infection
2. Dietary nutrition
if you get sick in summer, your baby is prone to dehydration and electrolyte disorder, so you need proper water and nutrition
babies should stay in bed for one week and drink plenty of warm water
e to fever, oral herpes and poor appetite, the child was unwilling to eat. Should give the baby to eat light, warm, delicious, easy to digest, soft liquid or semi liquid, fasting cold, spicy, salty and other stimulating food
3. Oral care
the baby will refuse to eat, salivate, cry and not sleep e to oral pain. To keep the baby's mouth clean, gargle with normal saline before and after meals. For the baby who can't gargle, gently clean the mouth with cotton swab dipped in normal saline
vitamin B 2 powder can be directly applied to the site of oral erosion, or coated with cod liver oil, or oral vitamin B 2 and vitamin C, supplemented by ultrasonic atomization inhalation, to rece pain, promote the early healing of erosion, and prevent secondary bacterial infection
4. Rash care
baby's clothes and bedding should be clean, comfortable and soft, and should be changed frequently
cut your baby's nails short and wrap your baby's hands if necessary to prevent skin rashes
babies with skin rashes on their buttocks should be cleaned up at any time to keep their buttocks clean and dry
calamine lotion can be applied at the initial stage of skin rash on hands and feet, and 0.5% Iodophor can be applied when herpes forms or breaks
keep skin clean to prevent infection
children with hand foot mouth disease usually have low or moderate fever, and no special treatment is needed, so the baby can drink more water
babies whose body temperature is between 37.5 ℃ and 38.5 ℃ should be given physical cooling such as cooling, drinking warm water and taking warm water bath
first of all, it's the whole body care to give the best support to the children
when a child is suffering from any disease, if the resistance of the whole body is in a good state, the infection of any disease can be well controlled
because the infection of HFMD is mainly caused by virus infection, at present, we still focus on supportive therapy, there is no specific treatment, and ribavirin is also advocated, but the overall effect is not very ideal
antiviral drugs are usually used 24 to 48 hours before the onset of the disease. And often when we diagnosed HFMD, we have passed the most effective stage of treatment, and now we do not advocate the use of these antiviral drugs
in general, it is necessary to improve the children's resistance
for example, provide children with an easy to digest diet and maintain a certain amount of water. If the child's temperature is higher than 38 ℃, use appropriate antipyretic drugs to control the temperature in a more suitable temperature range
if the child has mouth sores in the mouth, let the child gargle with 1% light saline or warm water frequently, so as to control the pain in a lighter degree
if the child has severe oral pain or ulcer, parents can take the child to the hospital, and the doctor can use some antibiotic ointment or liquid with local anesthetic to relieve the child's pain
children's skin rash is mainly to keep clean, clean, do not let the skin be secondary infection, this is the most important
if there are no complications, the child can be cured in 5-7 days in a good nursing atmosphere
western medicine treatment
if there are no complications, children with HFMD can be cured in a few weeks. The treatment principle is mainly symptomatic treatment, taking vitamin B, C and antiviral drugs under the guidance of doctors. In addition, hand foot mouth disease can be combined with myocarditis, encephalitis, meningitis and other diseases, should be timely review
the methods of treating HFMD with western medicine are as follows:
1) contact should pay attention to disinfection and isolation to avoid cross infection
2) closely monitor the changes of the disease, especially the functions of brain, lung, heart and other important organs; Blood pressure, blood gas analysis, blood glucose and chest X-ray were monitored in critically ill patients
3) strengthen the treatment of symptomatic support, do a good job in oral care
4) pay attention to maintain water, electrolyte, acid-base balance and protect important organs
5) patients with increased intracranial pressure can be given mannitol and other dehydration treatment, and severe cases can be given methylprednisolone, intravenous gamma globulin and other drugs as appropriate
6) patients with hypoxemia, dyspnea and other signs of respiratory failure should be treated with mechanical ventilation as soon as possible
7) maintain stable blood pressure and give vasoactive drugs when necessary
other severe treatments, such as DIC, pulmonary edema, heart failure, should be treated accordingly< Hand foot mouth disease (HFMD) is a common infectious disease in infants and young children. Coxsackievirus a16 and enterovirus 71 are considered to be the main causes of the disease. This disease was first seen in Shanghai in 1981, and has been reported in many provinces since then. Clinically, the main manifestations of this disease are fever, rash and ulcer in hands, feet and mouth. Some patients can cause fatal complications such as myocarditis, pulmonary edema and aseptic meningoencephalitis. On May 2, 2008, HFMD was officially listed as class C infectious disease in China for legal infectious disease management. At present, there is no effective treatment for this disease. The drug treatment of this disease is summarized as follows< 1 acyclovir
acyclovir is a kind of acyclic purine nucleotide analogues. Its antiviral effect is that after the drug enters the cells infected by herpes virus, it competes with deoxynucleoside for virus thymus kinase or cell kinase, and the drug is phosphorylated to survive acyclovir triphosphate, Then, the virus replication was inhibited by two ways: ① interfering with the polysaccharide of virus DNA to inhibit the virus replication; ② Under the action of DNA polysaccharide, it can combine with the growing DNA strand and cause the extension interruption of DNA strand. The treatment dose was 20 mg / kg, 10% glucose solution 100 ml, intravenous drip, once a day; Or oral acyclovir 5-10 mg / (kg · d), three times a day. Acyclovir, as a highly effective and broad-spectrum antiviral drug, can significantly shorten the healing time of fever and skin lesions, relieve the pain of oral herpes, and has no side effects ring the treatment< 1.2 ganciclovir is a new broad-spectrum nucleoside antiviral drug developed after acyclovir. The antiviral effect is similar to that of acyclovir. The treatment dose was 5-10 mg / kg, added with 100 ml of 10% glucose solution intravenously, once a day, for 3-5 days. Antibiotics and antipyretics were used as appropriate ring the treatment. Huang Shixiong [2] showed that ganciclovir was better than ribavirin in the treatment of HFMD, and the time of fever and herpes regression was significantly shorter than ribavirin. However, the inhibitory effect of ganciclovir on bone marrow and its long-term toxicity need further study. Chen Yunjian [3] showed that the effect of ribavirin injection combined with ganciclovir in the treatment of children with hand foot mouth disease was better than that of any of the above drugs alone< As a powerful antiviral agent, interferon has obvious curative effect on a variety of viral infectious diseases and has been widely used in clinic. The treatment dose was 1 million IU intramuscular injection, once a day. Its therapeutic mechanism is to prevent virus replication by blocking the translation of virus mRNA in cells and inhibiting the synthesis of virus RNA. At the same time, it can also enhance the host immunity by enhancing the activity of natural killer lymphotoxin. Interferon can improve the cellular immunity of the body, inhibit the virus and promote the recovery of the body. Hu Gong et al. [5] showed that interferon combined with traditional Chinese medicine preparation such as Xiaoer qingrening has obvious curative effect on HFMD
1.4 ribavirin
as a common antiviral drug, ribavirin is effective in the treatment of hand foot mouth disease in children. The treatment dose was 10 mg / kg, added with 100 ml of 10% glucose solution intravenously, 1-3 times a day, for 3 days; Or ribavirin buccal tablets 1 / 4 ~ 1 / 2 tablets, 4 times a day. Antibiotics and antipyretics were used as appropriate ring the treatment. Side effects were rare sweating, loss of appetite and hypoglycemia. This drug is no longer the first choice for the treatment of HFMD in some large hospitals. But because of its less side effects, low price, safety and high curative effect, it is suitable for promotion in primary hospitals
1.5 Smecta
Smecta's active ingredient is octahedral montmorillonite particles, which has a laminar molecular structure. Smecta has a strong fixation, adsorption and clearance effect on viruses, bacteria and toxins in the digestive tract, and has a strong covering ability on the gastrointestinal mucosa. Smecta can combine with mucin to improve the defense function of mucosal barrier against attack factors, It can promote the recovery and regeneration of epithelial tissue. For children with hand foot mouth disease, especially those with severe oral ulcer, appropriate amount of Smecta is stirred into paste with warm boiled water, 4 times a day, and applied to the oral ulcer area in the morning, afternoon, after dinner and before going to bed, which can significantly shorten the healing time of oral ulcer in children, without obvious toxic and side effects. Smecta has sweet taste and is easy to be accepted by children, so it is worthy of clinical application<
2 the treatment of hand foot mouth disease in children with traditional Chinese medicine prescriptions
this disease belongs to the category of "dampness temperature" and "epidemic disease" of traditional Chinese medicine. The disease is caused by dampness heat and pestilence toxin. It is mainly caused by dampness heat in the interior and evil in the exterior. It is left in the lung, spleen and heart meridians. The external evil comes from the mouth and nose and invades the lung and spleen meridians. The lung dominates the skin and hair. Therefore, in the early stage, the symptoms of lung defense are common, such as fever, runny nose and cough; The spleen governs the four limbs, opening the orifices in the mouth, blisters in the hands, feet and mouth e to pathogenic factors, and herpes and ulcers in the mouth and tongue. At present, traditional Chinese medicine mainly adopts three basic methods: syndrome differentiation, disease differentiation and staging, and addition and subtraction of special prescriptions. It can relieve symptoms and shorten the course of disease
traditional Chinese medicine treatment
common type (heat accumulation in heart and spleen): fever, no sweat, herpes in hand, foot and mouth, in which the tongue herpes is red, severe pain, more salivation, poor appetite, unable to eat, constipation, red tongue, yellow and greasy fur. Traditional Chinese medicine treatment: heat clearing, detoxification and dampness removing
prescription: modified Dahuang Huanglian Xiexin Decoction
medicine: 3 G rhubarb, 6 g Scutellaria, 3 G Coptis, 6 g Galla chinensis, 6 g peppermint, 50 ml water decoction, 2 times
common type (dampness heat obstruction): fever, no sweat, herpes on hands, feet and mouth, dark red tongue, mild pain, abdominal distension, poor appetite, normal or slightly loose stool, dark red tongue, white greasy or slightly yellow greasy fur
traditional Chinese medicine: pungent and bitter
hand, foot, mouth For buttock rash (herpes) or fever, go to pediatrics or hand foot mouth disease diagnosis and treatment area of nearby hospital for treatment
doctor diagnosis
exclusion
real time online report of diagnosis
Beijing and national epidemic monitoring system
general cases (only rash or fever symptoms) return home for isolation rest - community doctors regularly visit
severe cases (high fever, pneumonia, brainstem encephalitis, fever, etc.) Meningitis, heart failure, respiratory failure and other symptoms) reported to the District Health Bureau and CDC
nursing strategies
1. Disinfection and isolation
once the baby is found to be infected with HFMD, he should seek medical treatment in time to avoid contact with the outside world, and generally need to be isolated for 2 weeks
the baby's used articles should be thoroughly disinfected: they can be soaked in chlorine containing disinfectant, and the articles that are not suitable for soaking can be exposed to the sun
the baby's room should be ventilated regularly to keep the air fresh, circulating and the temperature appropriate. Families with conditions can use lactic acid fumigation for air disinfection every day. Rece personnel in and out of the baby's room, prohibit smoking, prevent air pollution, avoid secondary infection
2. Dietary nutrition
if you get sick in summer, your baby is prone to dehydration and electrolyte disorder, so you need proper water and nutrition
babies should stay in bed for one week and drink plenty of warm water
e to fever, oral herpes and poor appetite, the child was unwilling to eat. Should give the baby to eat light, warm, delicious, easy to digest, soft liquid or semi liquid, fasting cold, spicy, salty and other stimulating food
3. Oral care
the baby will refuse to eat, salivate, cry and not sleep e to oral pain. To keep the baby's mouth clean, gargle with normal saline before and after meals. For the baby who can't gargle, gently clean the mouth with cotton swab dipped in normal saline
vitamin B 2 powder can be directly applied to the site of oral erosion, or coated with cod liver oil, or oral vitamin B 2 and vitamin C, supplemented by ultrasonic atomization inhalation, to rece pain, promote the early healing of erosion, and prevent secondary bacterial infection
4. Rash care
baby's clothes and bedding should be clean, comfortable and soft, and should be changed frequently
cut your baby's nails short and wrap your baby's hands if necessary to prevent skin rashes
babies with skin rashes on their buttocks should be cleaned up at any time to keep their buttocks clean and dry
calamine lotion can be applied at the initial stage of skin rash on hands and feet, and 0.5% Iodophor can be applied when herpes forms or breaks
keep skin clean to prevent infection
children with hand foot mouth disease usually have low or moderate fever, and no special treatment is needed, so the baby can drink more water
babies whose body temperature is between 37.5 ℃ and 38.5 ℃ should be given physical cooling such as cooling, drinking warm water and taking warm water bath
first of all, it's the whole body care to give the best support to the children
when a child is suffering from any disease, if the resistance of the whole body is in a good state, the infection of any disease can be well controlled
because the infection of HFMD is mainly caused by virus infection, at present, we still focus on supportive therapy, there is no specific treatment, and ribavirin is also advocated, but the overall effect is not very ideal
antiviral drugs are usually used 24 to 48 hours before the onset of the disease. And often when we diagnosed HFMD, we have passed the most effective stage of treatment, and now we do not advocate the use of these antiviral drugs
in general, it is necessary to improve the children's resistance
for example, provide children with an easy to digest diet and maintain a certain amount of water. If the child's temperature is higher than 38 ℃, use appropriate antipyretic drugs to control the temperature in a more suitable temperature range
if the child has mouth sores in the mouth, let the child gargle with 1% light saline or warm water frequently, so as to control the pain in a lighter degree
if the child has severe oral pain or ulcer, parents can take the child to the hospital, and the doctor can use some antibiotic ointment or liquid with local anesthetic to relieve the child's pain
children's skin rash is mainly to keep clean, clean, do not let the skin be secondary infection, this is the most important
if there are no complications, the child can be cured in 5-7 days in a good nursing atmosphere
western medicine treatment
if there are no complications, children with HFMD can be cured in a few weeks. The treatment principle is mainly symptomatic treatment, taking vitamin B, C and antiviral drugs under the guidance of doctors. In addition, hand foot mouth disease can be combined with myocarditis, encephalitis, meningitis and other diseases, should be timely review
the methods of treating HFMD with western medicine are as follows:
1) contact should pay attention to disinfection and isolation to avoid cross infection
2) closely monitor the changes of the disease, especially the functions of brain, lung, heart and other important organs; Blood pressure, blood gas analysis, blood glucose and chest X-ray were monitored in critically ill patients
3) strengthen the treatment of symptomatic support, do a good job in oral care
4) pay attention to maintain water, electrolyte, acid-base balance and protect important organs
5) patients with increased intracranial pressure can be given mannitol and other dehydration treatment, and severe cases can be given methylprednisolone, intravenous gamma globulin and other drugs as appropriate
6) patients with hypoxemia, dyspnea and other signs of respiratory failure should be treated with mechanical ventilation as soon as possible
7) maintain stable blood pressure and give vasoactive drugs when necessary
other severe treatments, such as DIC, pulmonary edema, heart failure, should be treated accordingly< Hand foot mouth disease (HFMD) is a common infectious disease in infants and young children. Coxsackievirus a16 and enterovirus 71 are considered to be the main causes of the disease. This disease was first seen in Shanghai in 1981, and has been reported in many provinces since then. Clinically, the main manifestations of this disease are fever, rash and ulcer in hands, feet and mouth. Some patients can cause fatal complications such as myocarditis, pulmonary edema and aseptic meningoencephalitis. On May 2, 2008, HFMD was officially listed as class C infectious disease in China for legal infectious disease management. At present, there is no effective treatment for this disease. The drug treatment of this disease is summarized as follows< 1 acyclovir
acyclovir is a kind of acyclic purine nucleotide analogues. Its antiviral effect is that after the drug enters the cells infected by herpes virus, it competes with deoxynucleoside for virus thymus kinase or cell kinase, and the drug is phosphorylated to survive acyclovir triphosphate, Then, the virus replication was inhibited by two ways: ① interfering with the polysaccharide of virus DNA to inhibit the virus replication; ② Under the action of DNA polysaccharide, it can combine with the growing DNA strand and cause the extension interruption of DNA strand. The treatment dose was 20 mg / kg, 10% glucose solution 100 ml, intravenous drip, once a day; Or oral acyclovir 5-10 mg / (kg · d), three times a day. Acyclovir, as a highly effective and broad-spectrum antiviral drug, can significantly shorten the healing time of fever and skin lesions, relieve the pain of oral herpes, and has no side effects ring the treatment< 1.2 ganciclovir is a new broad-spectrum nucleoside antiviral drug developed after acyclovir. The antiviral effect is similar to that of acyclovir. The treatment dose was 5-10 mg / kg, added with 100 ml of 10% glucose solution intravenously, once a day, for 3-5 days. Antibiotics and antipyretics were used as appropriate ring the treatment. Huang Shixiong [2] showed that ganciclovir was better than ribavirin in the treatment of HFMD, and the time of fever and herpes regression was significantly shorter than ribavirin. However, the inhibitory effect of ganciclovir on bone marrow and its long-term toxicity need further study. Chen Yunjian [3] showed that the effect of ribavirin injection combined with ganciclovir in the treatment of children with hand foot mouth disease was better than that of any of the above drugs alone< As a powerful antiviral agent, interferon has obvious curative effect on a variety of viral infectious diseases and has been widely used in clinic. The treatment dose was 1 million IU intramuscular injection, once a day. Its therapeutic mechanism is to prevent virus replication by blocking the translation of virus mRNA in cells and inhibiting the synthesis of virus RNA. At the same time, it can also enhance the host immunity by enhancing the activity of natural killer lymphotoxin. Interferon can improve the cellular immunity of the body, inhibit the virus and promote the recovery of the body. Hu Gong et al. [5] showed that interferon combined with traditional Chinese medicine preparation such as Xiaoer qingrening has obvious curative effect on HFMD
1.4 ribavirin
as a common antiviral drug, ribavirin is effective in the treatment of hand foot mouth disease in children. The treatment dose was 10 mg / kg, added with 100 ml of 10% glucose solution intravenously, 1-3 times a day, for 3 days; Or ribavirin buccal tablets 1 / 4 ~ 1 / 2 tablets, 4 times a day. Antibiotics and antipyretics were used as appropriate ring the treatment. Side effects were rare sweating, loss of appetite and hypoglycemia. This drug is no longer the first choice for the treatment of HFMD in some large hospitals. But because of its less side effects, low price, safety and high curative effect, it is suitable for promotion in primary hospitals
1.5 Smecta
Smecta's active ingredient is octahedral montmorillonite particles, which has a laminar molecular structure. Smecta has a strong fixation, adsorption and clearance effect on viruses, bacteria and toxins in the digestive tract, and has a strong covering ability on the gastrointestinal mucosa. Smecta can combine with mucin to improve the defense function of mucosal barrier against attack factors, It can promote the recovery and regeneration of epithelial tissue. For children with hand foot mouth disease, especially those with severe oral ulcer, appropriate amount of Smecta is stirred into paste with warm boiled water, 4 times a day, and applied to the oral ulcer area in the morning, afternoon, after dinner and before going to bed, which can significantly shorten the healing time of oral ulcer in children, without obvious toxic and side effects. Smecta has sweet taste and is easy to be accepted by children, so it is worthy of clinical application<
2 the treatment of hand foot mouth disease in children with traditional Chinese medicine prescriptions
this disease belongs to the category of "dampness temperature" and "epidemic disease" of traditional Chinese medicine. The disease is caused by dampness heat and pestilence toxin. It is mainly caused by dampness heat in the interior and evil in the exterior. It is left in the lung, spleen and heart meridians. The external evil comes from the mouth and nose and invades the lung and spleen meridians. The lung dominates the skin and hair. Therefore, in the early stage, the symptoms of lung defense are common, such as fever, runny nose and cough; The spleen governs the four limbs, opening the orifices in the mouth, blisters in the hands, feet and mouth e to pathogenic factors, and herpes and ulcers in the mouth and tongue. At present, traditional Chinese medicine mainly adopts three basic methods: syndrome differentiation, disease differentiation and staging, and addition and subtraction of special prescriptions. It can relieve symptoms and shorten the course of disease
traditional Chinese medicine treatment
common type (heat accumulation in heart and spleen): fever, no sweat, herpes in hand, foot and mouth, in which the tongue herpes is red, severe pain, more salivation, poor appetite, unable to eat, constipation, red tongue, yellow and greasy fur. Traditional Chinese medicine treatment: heat clearing, detoxification and dampness removing
prescription: modified Dahuang Huanglian Xiexin Decoction
medicine: 3 G rhubarb, 6 g Scutellaria, 3 G Coptis, 6 g Galla chinensis, 6 g peppermint, 50 ml water decoction, 2 times
common type (dampness heat obstruction): fever, no sweat, herpes on hands, feet and mouth, dark red tongue, mild pain, abdominal distension, poor appetite, normal or slightly loose stool, dark red tongue, white greasy or slightly yellow greasy fur
traditional Chinese medicine: pungent and bitter
10. Hand foot and mouth disease (HFMD) is an infectious disease in children, also known as eruptive vesicular stomatitis. It usually occurs in children under 5 years old, and can cause herpes in hands, feet, mouth and other parts. A few children can cause complications such as myocarditis, pulmonary edema and aseptic meningoencephalitis. If the condition of indivial severe children develops rapidly, it will lead to death. The main clinical symptoms of the disease are herpes or ulceration of the hand, foot and oral mucosa. Hand foot and mouth disease (HFMD) is an infectious disease caused by enterovirus. There are more than 20 enteroviruses (types) causing HFMD, among which coxsackievirus a16 (Cox a16) and enterovirus 71 (EV 71) are the most common
disease treatment
mild patients can be given antiviral, anti infection, systemic support treatment; Severe patients should also closely monitor the changes of their condition, especially the functions of brain, lung, heart and other important organs; Blood pressure, blood gas analysis and chest X-ray should be monitored in critically ill patients
antiviral drug therapy
acyclovir, valaciclovir, famciclovir, traditional Chinese medicine and so on are commonly used. As highly effective and broad-spectrum antiviral drugs, they can significantly shorten the healing time of fever and skin lesions, and relieve oral herpes pain
immunomolatory drug therapy
can improve the body's immunity, resist virus infection and prevent the recurrence of viral diseases. Commonly used drugs are transfer factor, thymosin and other drugs
anti infective treatment
gargle and daub with gargle drugs can be used locally
supportive therapy
strengthen nutrition and rehydration. And strengthen symptomatic treatment, good oral care
critically ill patients
need to be hospitalized[ 1] [4] [2] [3]
disease prevention
achieve "washing hands, drinking boiled water, eating cooked food, frequent ventilation, drying clothes and quilts". Spring and summer are the seasons of enterovirus infection, so we should pay attention to the environment, food hygiene and personal hygiene. Do not drink raw water, do not eat cold food, wash hands before and after meals, keep indoor air circulation. Try not to take infants to crowded places. Lactating mothers should bathe frequently, change clothes frequently, and wash their nipples before feeding.
disease treatment
mild patients can be given antiviral, anti infection, systemic support treatment; Severe patients should also closely monitor the changes of their condition, especially the functions of brain, lung, heart and other important organs; Blood pressure, blood gas analysis and chest X-ray should be monitored in critically ill patients
antiviral drug therapy
acyclovir, valaciclovir, famciclovir, traditional Chinese medicine and so on are commonly used. As highly effective and broad-spectrum antiviral drugs, they can significantly shorten the healing time of fever and skin lesions, and relieve oral herpes pain
immunomolatory drug therapy
can improve the body's immunity, resist virus infection and prevent the recurrence of viral diseases. Commonly used drugs are transfer factor, thymosin and other drugs
anti infective treatment
gargle and daub with gargle drugs can be used locally
supportive therapy
strengthen nutrition and rehydration. And strengthen symptomatic treatment, good oral care
critically ill patients
need to be hospitalized[ 1] [4] [2] [3]
disease prevention
achieve "washing hands, drinking boiled water, eating cooked food, frequent ventilation, drying clothes and quilts". Spring and summer are the seasons of enterovirus infection, so we should pay attention to the environment, food hygiene and personal hygiene. Do not drink raw water, do not eat cold food, wash hands before and after meals, keep indoor air circulation. Try not to take infants to crowded places. Lactating mothers should bathe frequently, change clothes frequently, and wash their nipples before feeding.
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