Hand-foot-and-mouth disease is at high season again

Hand-foot-and-mouth disease has reached the high season again. For the majority of parents, it is imperative to do footwork to protect children.

Generally speaking, the peak time of hand-foot-mouth disease epidemic: the first big peak appears from April to June, and there will be a secondary peak from September to November.

What is foot and mouth disease?

Hand, foot and mouth disease is a common, multiple infectious disease, mainly in infants and young children, and can be caused by a variety of enteroviruses, EV71 virus is one of them.

How is hand, foot and mouth disease spread?

Hand, foot and mouth disease is mainly infected through close contact with the patient’s feces, herpes fluid and respiratory secretions, as well as contaminated towels, tooth cups, toys, tableware, bedding, etc.

Who is susceptible to hand, foot and mouth disease?

Infants and children are more common: 6 months to 3 years old, which is the age of babies prone to hand, foot and mouth disease.

What should I do if my child has suspicious symptoms?

If your child has symptoms such as fever and rash, go to a medical institution in time: do not go to kindergartens and public places where people gather to avoid contact with other children.

What are the symptoms of hand, foot and mouth disease?

Symptoms of hand-foot-mouth disease are the cheeks, tongue, soft palate, inside of the mouth, heart of the hands, feet, and other parts of the child’s mouth, with the appearance of millet or mung bean size, red and gray herpes or red papules around them.

Severe illness can lead to physical and intellectual disabilities

Many parents, especially those of newborns, do not understand the hazards of foot and mouth disease, and often have serious consequences due to neglect of prevention and control. So, how terrible is HFMD?

According to reports, hand, foot and mouth disease seriously harms the health of children under 5 years of age, spreads quickly, has many routes of transmission, and can be fatal in severe cases. Outbreaks are more common and it is easy to cause kindergartens to suspend classes.

As far as Henan Province is concerned, the incidence of hand-foot-mouth disease has almost always ranked first among various infectious diseases in Henan Province, with an average of 100,000 children getting sick each year. Moreover, the number of severe cases in Henan Province is the largest in the country. Severe cases of hand-foot-mouth disease may cause many complications and sequelae, especially physical and intellectual disabilities.

In the era without vaccines, the only preventive measures for hand, foot and mouth disease were “hygiene, eating cooked food, diligent ventilation”, and then remind parents to pay attention to whether children have “severe mental illness, vomiting, limb shaking, limb colds” and other early critical illnesses which performed. Although these methods can reduce the incidence of the entire group of children, but for a specific child, it is not “precise protection.” In clinical treatment, because there is no specific drug for this viral disease, only “symptomatic treatment” can be carried out for the symptoms that appear. To put it bluntly, the child’s own immunity is “hard to resist”.

Vaccination with EV71 does not prevent hand, foot and mouth disease

In 2016, we finally looked forward to the enterovirus 71 inactivated vaccine (hereinafter referred to as EV71 vaccine), which brought hope to protect children from hand, foot and mouth disease and try not to severe hand, foot and mouth disease.

Seeing this, parents must ask, why is it called “EV71 vaccine” instead of “Hand, Foot and Mouth Disease Vaccine”? What is “less hand, foot and mouth disease” and “try not to have severe hand, foot and mouth disease” instead of “no hand, foot and mouth disease”?

This is because the EV71 vaccine cannot completely prevent hand, foot and mouth disease, but it can indeed reduce the probability of getting sick and reduce the severity of the disease.

It is understood that there are more than 20 viruses that cause hand-foot-mouth disease, and EV71 is only one of them. But it harms many children and has great power. It is the culprit leading to severe cases (more than 80% of severe cases of hand-foot-mouth disease and more than 90% of deaths are caused by EV71).

Although it is now possible to “capture the thief first,” the EV71 vaccine does not protect against hand, foot and mouth disease caused by other viruses. Scientists are also actively developing vaccines against other viruses that cause HFMD.

Therefore, although the EV71 vaccine cannot completely avoid the disease, it will greatly reduce the probability of severe cases and deaths. According to the survey, the proportion of children with EV71 vaccine suffering from severe hand, foot and mouth disease is indeed much lower than that of unvaccinated children.

For the effect of the EV71 vaccine, experts believe that under the premise of standardizing the entire course of vaccination, its protective effect against hand-foot-mouth disease caused by the EV71 virus can reach more than 90%. According to the results of phase I, II and III clinical trials conducted in Guangxi and Jiangsu, the EV71 vaccine has good immunogenicity and protective efficacy. 28 days after inoculation with EV71 vaccine, the serum antibody positive conversion rate was 88.1%-91.7%, and the protective efficacy against EV71 virus infection-related hand-foot-mouth disease was over 90%.

According to the results of multi-phase clinical trials (involving 10,000 subjects) before the vaccine was launched, the EV71 vaccine has very good safety. Clinical research data show that the local reactions after vaccination are mainly red, induration, pain, swelling, itching, etc. at the vaccination site, mainly mild, lasting no more than 3 days, and can be relieved spontaneously: systemic reactions are mainly manifested as fever , Diarrhea, loss of appetite, nausea, vomiting, etc., were transient; the incidence of all symptoms (such as fever, diarrhea, nausea, vomiting, etc.) with a severity of 3 or above was not significant between the vaccination group and the control group Sexual differences.

EV71 vaccine is not recommended for people over 5 years old

So, how long can the protection effect of EV71 vaccine last? In layman’s terms, it can work for about 2 years or a little longer. According to the results of clinical research, the baby is generally given two EV71 vaccinations (full-time standard vaccination), and the antibody levels and clinical protective efficacy in the body remain at a relatively high level within two years after immunization. The peak stage of baby hand, foot and mouth disease is from 6 months to 3 years old, and the age of EV71 vaccine should not be lower than 6 months of age. In this way, when the baby is 6 months old, the EV71 vaccine can basically protect the most vulnerable period of time.

In general, it is recommended that susceptible children over 6 months of age be vaccinated with the EV71 vaccine, and the sooner they are vaccinated, the better: encourage the completion of vaccination procedures before the age of 12 months in order to play a protective role as soon as possible. Because the incidence of people over 5 years old is very low, EV71 vaccine is not recommended. In addition, the vaccination age range of the vaccines of different manufacturers may be different, and the specific vaccination should be based on the situation.

Precautions for vaccination with EV71

According to experts, people with the following conditions should not be vaccinated with EV71 vaccine:

People who are allergic to vaccine ingredients

Fever

A sick person

Carefully consider whether to vaccinate:

●Those with thrombocytopenia or bleeding disorders, intramuscular injection of this vaccine may cause bleeding at the injection site.

●Patients who are undergoing immunosuppressive therapy or immunodeficiency may have weakened immune responses to this vaccine. It should be postponed until the end of treatment or ensure that they are well protected before vaccination, but for chronic immunodeficiency Patients should recommend vaccination even if the underlying disease may limit the immune response.

● Patients with uncontrolled epilepsy and other progressive neurological diseases (such as Guillain-Barre syndrome, etc.) should carefully consider whether to receive the vaccine.

●It is not recommended to vaccinate EV71 vaccine and other vaccines at the same time. It is recommended to vaccinate EV71 vaccine and other vaccines at least 2 weeks apart, and at least 1 month apart from the injection of human immunoglobulin, so as not to affect the immune effect.

●For other contraindications and cautions, please refer to the vaccine manual of the relevant company.

Preliminary surveys show that in the three years since the EV71 vaccine was launched, the vaccination rate for school-age children in our province has increased from about 3% in 2016 to about 16% in 2018, and the vaccination rate is still very low. Only when most children are vaccinated with the EV71 vaccine can they protect the individual while blocking the spread of the EV71 virus.