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Hand, Foot, and Mouth Disease
手足口病是一种常见的由肠道病毒引起的传染性疾病，多发生于婴幼儿和学龄前儿童。手足口病有很强的传染性，一年四季都可发生，但常见于夏秋季。手足口病和口蹄疫是截然不同的两种传染病。
Hand, foot, and mouth disease (HFMD) is a common viral illness that mainly affects infants and young children. It is contagious and easily spread from one person to another. It is not related to the foot and mouth disease which affects animals.
据统计， 目前有二十多种的肠道病毒可引起手足口病。在中国，最常见的是柯萨奇病毒A16型 （CV-A16）和肠道病毒71型（EV 71）。手足口病绝大多数比较轻微，预后良好， 极少数患儿会并发无菌性脑膜炎，脑炎，肺水肿，心肌炎等疾病，绝大多数重症及死亡病例是由于EV 71病毒引起的。
It is most commonly caused by the coxsackie A16 virus (CV-A16) and some are caused by a different but related virus called enterovirus 71 virus (EV-A71). HFMD rarely causes further complications and is rarely fatal. However, a small number of people with this disease develop severe complications requiring hospitalization or even causing death.
1.手足口病有什么表现呢？
What Are the Symptoms of HFMD?
手足口病的症状一般出现于感染病毒3～7天后，一周左右自愈， 一般不超过10天。发病早期的表现类似普通的感冒，有发热，食欲减退，咽喉疼痛，浑身不适。
HFMD usually start 3 to 7 days after catching the infection and it can last from 7 to 10 days.Symptoms usually begin with a fever, poor appetite, sore throat, and a feeling of being unwell.
一般发烧1～2天后，口腔黏膜，舌和咽喉部，会出现小而扁平的红色斑点，并且逐渐发展为小疱疹，然后破溃形成疼痛的小溃疡。这些小红点和溃疡，有时候也会出现在嘴唇及周围皮肤。患儿常因嘴里的溃疡疼痛而不愿进食和喝水，A day or two after the fever starts, red spots can develop in the mouth, tongue, or throat which may turn to blisters and ulcers. These painful sores may appear on the lips or around the mouth as well. Since the mouth sores area quite painful, some young children are not able to swallowing enough liquid, thus may have the risk of dehydration.
小年龄的孩子会有流口水比平时增多。同时手心和脚底会有这些扁平的小红点，有时还会出现在膝盖，肘关节，臀部和肛门周围， 这些皮疹也会发展成小疱疹， 周围有红晕。手足口病皮疹的另一个特点是不会发痒。大多数患儿在一周内体温下降，皮疹逐渐消退。疱疹也在3～5天逐渐干燥结痂，脱痂后不留疤痕。
Small skin rash with flat red spots may also develop on the palms of the hands and soles of the feet. Sometimes a rash also occurs on the knees, elbows, buttocks and nappy area. This rash may also become blisters or bumps but won't itch.
需要注意的是，不是所有人都会有以上所有症状，有些人感染了病毒或许一点症状都没有，却仍可能传染病毒给其他人，就是我们平时说的无症状带毒者或隐性感染者，多见于成人。
Not everyone will get all of these symptoms. Other people may show no symptoms at all, but they can still pass the virus to others.
2. 手足口病是什么引起的？
What Are the Causes of HFMD?
手足口病是由多种肠道病毒所引起的，据统计有二十多种，其中包括柯萨奇病毒A组的2、4、5、7、9、10、16型，B组的2、5、13型，以及埃可病毒11型和肠道病毒71型。在中国，最常见的是柯萨奇病毒a16型和肠道病毒71型。虽然绝大多数手足口病患者会自然痊愈，但极少数会发展为重症。据统计，这些重症病例中有82%是由肠道病毒71型引起的，死亡病例中有93%。（数据来源：杨维中，2008年中国手足口病疫情概况和防治策略。手足口病国际研讨会，北京2009,1）
HFMD is caused by about 20 serotypes of the EnterovirusA species. It is most commonly caused by the Coxsackine virus A16, with Enterovirus 71 being less common. Enterovirus 71 sometimes may associated with severe disease, such as encephalitis and meningitis.
3. 手足口病的易感人群是哪些?
Who Is at Risk for HFMD?
手足口病大多常见于婴幼儿和10岁以下的儿童，特别是5岁以内的孩子是高发人群，所以在托幼机构作多见。成人和大年龄儿童也会被感染手足口病。在感染引起手足口病的肠道病毒或柯萨奇病毒以后，人体会对此次感染的这一型病毒产生抗体，但是因为会导致手足口病的病毒有20多种，所以会再次感染发生手足口病。
HFMD mostly affects infants and children younger than 10 years old, often those under 5 years. However, older children and adults can get it, too.
Whensomeone gets HFMD, they develop immunity to the specificvirus that caused their infection. However, because HFMD iscaused by several different viruses, people can get the diseaseagain.
4. 手足口病会传染吗？
Is HFMD Contagious?
是的，潜伏期通常是3～7天。
Yes. The incubation period is 3 to 7 days usually.
手足口病的传播途径多种多样，在感染者的鼻腔和咽喉部分泌物里，水疱的疱液里，肠道和大便里会存在病毒颗粒。因此，不难想象，手足口病会通过呼吸道， 胃肠道和频繁密切接触传播。 举几个栗子看看：
∙ 密切接触，比如亲吻，拥抱，共用杯具和器皿；
∙ 咳嗽和打喷嚏；
∙ 接触到便便，比如换尿布；
∙ 接触到疱液；
∙ 接触已经存在病毒的玩具，衣物，家具等物品或其表面。
所以，手足口病在年幼儿童中比较常见有一个原因是在更换尿布或者如厕训练时病毒的播散，并且也和幼儿经常会有吃手的习惯有关。
The viruses that cause HFMD can be found in the infected person's nose and throat secretions, blister fluids, or stool. Therefore HFMD is transmitted through the following ways:
• close contact, such as kissing hugging, or sharing cups and eating utensils,
• coughing and sneezing,
• contact with stools, for example when changing a diaper,
• contact with blister fluid, and
• touching objects or surfaces that have the virus on them.
HFMD is common in young children because of frequent diaper changes and potty training. Also, young child often put their hands in their mouths.
隐性感染者也是传染途径之一，有些儿童或者成年人虽然感染了手足口病的病毒后没有表现出任何症状，但是仍然可以把病毒传给其他人。
Some people, especially adults, may not develop any symptoms, but can still spread the viruses to others.
手足口病患儿在生病的第一周传染性是最强的，病毒在症状消失数周以后仍然可能存在身体内一段时间，有研究发现发病后4～6周仍能从大便中分离出柯萨奇病毒A16颗粒，而肠道病毒71则可能存在10周之久。
Children with HFMD are most contagious during the first week of their illness. It may still be infectious for several weeks after the symptoms are gone because the virus still remains in their stools or saliva.
5. 手足口病严重吗？
Is HFMD Serious?
虽然手足口病传染性很强，但绝大多数病情都比较轻微，一般在7～10天内，自然痊愈。
Usually not. The illness is usually a minor illness and nearly all patients recover in 7 to 10 days without medical treatment.
通常很少见有并发症，因为口腔溃疡的疼痛，有些患儿会有几天的时间不愿进食和喝水。另外，据统计，只有约1.1%的患儿可能发展为重症，比如脑膜炎，脑炎，肺水肿，心肌炎等。（参考文献：Weijia Xing,Qiaohong Liao,Cecile Viboud,et al.Hand,foot,and mouth disease in China,2008-12:an epidemiological study.Lancet Infect Dis 2014;4:308-318）
Complications are uncommon. The pain sores in the mouth may make child eats and drinks unwell for a few days. Rarely, in a very small number of EV 71 infected cases, the virus may involve the brain and cause the infected person viral meningitis and encephalitis
6. 手足口病在中国是常见的疾病吗？
Is It Common In China?
是的。
Yes.
虽然手足口病的大规模爆发在美国是少见的，但是过去15年里，东亚以及东南亚地区手足口病的还是有频繁流行和大规模发生，常常2～3年会有一次规律性的高峰。
It is uncommon for the HFMD large outbreaks in the United States. However, in East and Southeast Asia, outbreaks are large and occur often in the past 15 years.
在中国，手足口病的发病率较高，多发于学龄前儿童，2008年5月，卫生部将其列入传染病防治法规定的丙类传染病。截止2015年12月，我国已经累计报告达1381万病例。仅2016年1～11月，我国确诊的手足口病例达232万（数据来源：中华人民共和国国家卫生和计划生育委员会官网）。手足口病四季均有散发，但由于肠道病毒偏好温热和潮湿的环境，所以常见于夏秋季。但近年的统计数据显示，手足口病发病形式与以往只有一个高峰不同，呈现两个发病高峰——4～6月和11～12月，这可能和气候有关。另外，手足口病每年流行的主要病毒也不一样，导致每年感染传播率也都不一样。
The Chinese Center for Disease Control and Prevention (CDC) acknowledges that HFMD is an epidemic disease in Chinawith periodic outbreaks among young children.It has been documented that there have been 13,000,000 cases of the HFMD in China since 2008 to 2015. The incidence of the HFMD has been the top one of the contagious diseases in China in recent five years. Summer and Autumn are the seasons that HFMD more often occurred.
According to CDC regulation, kindergarten and school will be advised to suspend classes for thorough disinfection to stop virus transmission and will be put under medical surveillance once there is an outbreak of HFMD.
7. 得了手足口病怎么办？
Can HFMD Be Treated?
手足口病是一种病毒感染疾病，有自限性的特点，不需要特殊治疗，使用抗生素无效。通常症状和体征会在7～10天内消失。治疗的主要目的在于减轻症状，尽可能缓解患儿的不舒适感。
There is no specific treatment for HFMD. It is a viral disease and antibiotics will not work on it.Symptoms and signs usually clear up in 7 to 10 days. Treatment is aim to ease symptoms and make the person as comfortable as possible until it resolved.
可以使用退热镇痛药，比如泰诺或美林缓解疼痛，发热和不舒服的感觉。
Fever reduces and pain killers, such as Tylenol, Panadol, Advil, or Motrin can be used to relieve the pain, fever and general discomfort.
吃吃喝喝对宝宝来说是个头等大事啊，但是因为口腔溃疡的疼痛和发热生病的不适感，宝宝会不愿意进食或喝水。这个时候呢，我们要适当鼓励孩子尽量多饮水或其他液体，也可以频繁地小口啜吸，以防止脱水。这里小编列出来几点小贴士鼓励宝宝进食并减少进食和饮水时的疼痛：
Encourage the child drink fluid, even frequent sip of drinks to prevent dehydration. Tips for eating and drinking more tolerable are as follows:
∙ 给宝宝吮吸棒冰或冰沙；
∙ 给宝宝吃冰激凌或果汁奶冻；
∙ 给宝宝喝冷的饮料，比如冷牛奶或冰水；
∙ 给宝宝吃比较软的不需要咀嚼的或流质食物；
∙ 给宝宝用温盐水漱口；
∙ 避免酸性的食物及饮料，比如柑橘类水果，果汁，以及苏打水；
∙ 避免咸的，辣的或其他刺激性的食物。
· Suck on ice pops or ice chips.
· Eat ice cream or sherbet.
· Drink cold beverages, such as milk or ice water.
· Eat soft foods that don't require much chewing.
· Rinse the mouth with warm salt water.
· Avoid acidic foods and beverages, such as citrus fruits, fruit drinks and soda.
· Avoid salty or spicy foods.
另外，不要刺破或挤压手心和足底，或身体其他部位的水疱，应该让其自然干结。
Leave the blisters to dry naturally. Do not pierce or squeeze them.
8.我的孩子得过手足口病了，还会再得吗？
Can My Child Get HFMD More Than Once?
是的。现在发现大约有二十多种病毒可以导致手足口病，宝宝感染手足口病以后只是对引起此次感染的肠道病毒或柯萨奇病毒产生一定的免疫力，并不是对其他的相关病毒有抵抗力。不同病毒之间是没有交叉免疫作用的，所以比较郁闷的事实是完全有可能感染手足口病不止一次，但是病毒的相似性会帮助免疫系统更快更好地在下一次感染的战役中取得胜利。
Yes. There are about 20 viral strains that can cause HFMD. A person will develop immunity to the specific virus that he infected, but will have HFMD again when catches a different virus.
9.手足口病可以预防吗？
Can HFMD Be prevented?
目前手足口病可以通过两个途径预防，接种疫苗和切断传播途径。
1) 疫苗接种
从2016年的上半年开始，全球首个手足口病疫苗---由中国自主研发的EV71疫苗，在全国各地陆续上市了。值得注意的是，这个疫苗主要预防肠道病毒EV71所引起的手足口病，将会降低患重症，危重症手足口病的危险和住院率，但并不能预防其他病毒所引起来的手足口病。
In 2016, a new vaccine, targets enterovirus 71, has been available on the market in China. It is a China developed shots which can effectively prevent enterovirus 71 - associated disease as well as hospitalizations of the severe HFMD.
那么，问题来了，为什么这个疫苗只针对肠道病毒71型呢？为什么不能覆盖所有的引起手足口病的病毒呢？因为肠道病毒71型所引起的手足口病是相对最严重的，引起重症手足口病风险最高的类型。统计发现，重症病例中82%和死亡病例中的93%都是这个类型病毒所引起来的。另外，引起手足口病的病毒类型较多，很难在短期内研发出针对每一型病毒的疫苗。
EV71疫苗目前属于二类疫苗，是自费接种的，接种对象为6个月到3岁的孩子，一共接种2次，间隔一个月。最好在1岁以前完成接种，早日获得保护性。
2) 切断传播途径
除了给宝宝进行预防接种疫苗来防止感染肠道病毒EV71所引起来的手足口病和增强宝宝的免疫力去对抗病毒以外，我们还可以通过以下预防措施来远离病毒，减少手足口病的发生。
However, it should be noted that this vaccine will only help protect against HFMD caused by enterovirus 71. But you can reduce the chance of passing on HFMD by practicing good hygiene and teaching your child how to keep away from the virus:
∙ 洗手：宝宝和爸爸妈妈都要记住要经常用肥皂和流动的水洗手，每次至少二十秒，特别是大小便或更换尿布前后，准备食物或进食以前，以及外出回家后。
Wash hands. keep in mind to washthe hands often with soap and water for 20 seconds, especially after using the toilet or changing diapers andbefore preparing food and eating;
∙ 培养良好的个人卫生习惯：避免用没有洗过的手接触眼睛，鼻子和嘴巴，比如吃手，揉眼睛，抠鼻子等。咳嗽和打喷嚏时要遮住口和鼻子，可以用一次性纸巾或胳膊肘。因为成人也有可能感染手足口病的病毒，而且因为免疫力比儿童强所以往往是无症状的隐性感染，所以也要注意培养良好的个人卫生习惯，避免成为传染源。
Good hygiene.Avoid touching eyes, nose and mouth with unwashed hands. Cover the nose and mouth when cough and sneezing.
消毒经常接触的物品表面和公共区域，比如餐桌，料理台，玩具和门把手之类：因为病毒可以在这些物品上生存数天，所以可以先用肥皂和水，然后用稀释的含氯漂白剂和水擦洗。
Disinfect frequently touched surfaces and common areas, such as toys, doorknobs. First with soap and water then with diluted solution of chlorine bleach and water because the virus can live on these objects for days.
∙ 手足口病流行的高峰期尽量避免带宝宝去人流密集，空气流通差的公共场所。
∙ 隔离确诊的手足口病患者： 避免密切接触已确诊的手足口病患儿2周以上 （比如亲吻拥抱，共用杯具，餐具， 毛巾等），患儿应该隔离在家2周后并且水疱干结为止才能返校。
Separate people who are infected. Avoid close contact (kissing, hugging) . Not to share cups, eating utensils, towels etc for several weeks. Children who get HFMD should stay home from school, kindergarten, child care or play group for 2 weeks and until all the fluid in the blisters has dried.
不要故意去挤破或戳破水疱：因为疱液具有传染性，而且挤破会有继发感染的风险。
Do not deliberately pierce blisters, as the fluid is infectious.
10.手足口病是不是就是口蹄疫呢？
Is HFMD theSame as Foot-and-Mouth Disease?
不是，手足口病和口蹄疫没有关联，是由不同病毒引起的。口蹄疫通常感染猪，牛，羊等偶蹄类家畜。
No. HFMD is not related to the foot-and -mouth disease which is caused by different virus that affects cattle, sheep and swine.
口蹄疫在动物中有高度传染性，可呈暴发流行，但口蹄疫病毒一般不传染给人，不会在人群中流行。而动物不会被传染到人类的手足口病。
Humans do not get the animal disease, you can't contract foot-and-mouth disease from pets and animals. Animals do not get the human disease. You can't transmit the HFMD to pets and animals.
手足口病简要
HFMD Quick Facts
∙ 传染性疾病
∙ 通常引起发烧，口腔溃疡，手心足心红色小斑点，
∙ 最多见于5岁以下的婴幼儿和学龄前儿童，但较大儿童和成年人也可以被感染
∙ 没有特殊治疗，一般不危及生命
∙ 如果出现头痛，颈项强直，和背部疼痛，需要马上就医
∙ 良好的个人卫生习惯会减低被感染的风险，比如，勤洗手，吃熟食，喝开水，常通风，晒太阳。
• Is a contagious disease
• Usually causes fever, painful sores in the mouth, and a rash on the hands and feet
• Mostly affects infants and children younger than 5 years old, but people of any age can be infected
• Has no specific treatment and is not life threatening
• If developed headache, stiff neck or back pain, seek medical advice immediately
• Infection risk can be reduced by practicing good hygiene, such as washing hands often
