When it comes to hand, foot, and mouth disease (HFMD), many parents worry. HFMD has multiple causes, and since children are often playful and get dirty easily, this can also lead to infection. HFMD presents different symptoms at different stages. Beyond home prevention, kindergartens also need to implement preventive measures for infected children. So, how can kindergartens prevent HFMD?
I. The Progression of Hand, Foot, and Mouth Disease
1. Herpetic Pharyngitis Stage.
1) General Care: Ensure isolation to prevent cross-infection, provide adequate rest, offer light meals, and maintain oral and skin hygiene.
2) Symptomatic Treatment: Address fever, vomiting, diarrhea, and other symptoms as needed.
2. Neurological involvement stage.
Patients exhibit neurological symptoms and signs such as headache, vomiting, lethargy, irritability, drowsiness, limb weakness, myoclonus, convulsions, or acute flaccid paralysis.
1) Control intracranial pressure: Limit fluid intake, adjust medication dosing intervals and doses based on condition. Add furosemide if necessary;
2) Administer intravenous immunoglobulin.
3) Administer glucocorticoids as appropriate; short-term high-dose pulse therapy may be given in severe cases;
4) Other symptomatic treatments: such as cooling, sedation, and anticonvulsants;
5) Closely monitor clinical changes, maintain intensive surveillance, and watch for severe complications.
3. Cardiopulmonary failure stage.
Sudden onset of dyspnea, pallor, cyanosis, cold sweats, tachycardia, white or pink frothy bloody sputum, increased pulmonary crackles, markedly abnormal blood pressure, frequent myoclonus, seizures, and/or worsening altered consciousness, along with hyperglycemia, hypoxemia, significantly worsened chest X-ray abnormalities, or signs of pulmonary edema.
1) Maintain airway patency and administer oxygen;
2) Secure two intravenous access lines; monitor respiration, heart rate, blood pressure, and oxygen saturation;
3) For respiratory failure, promptly intubate and initiate positive-pressure mechanical ventilation. Recommended initial ventilator settings for pediatric patients: inspired oxygen concentration 80%–100%,pip 20–30 cmH₂O, peep 4–8 cmH₂O, respiratory rate 20–40 breaths/min, tidal volume approximately 6–8 ml/kg. Subsequently adjust ventilator settings based on arterial blood gas results;
4) Restrict fluid intake while maintaining stable blood pressure;
5) Elevate head and shoulders 15–30 degrees, maintain neutral position; insert nasogastric tube and urinary catheter(do not use bladder compression for urination);
6) Pharmacological management.
(1) Administer intracranial pressure-lowering agents;
(2) Administer glucocorticoids, with pulse therapy if necessary;
(3) Administer intravenous immunoglobulin;
(4) Administer vasoactive agents and other medications;
(5) Suppress gastric acid secretion.
(6) Antipyretic therapy;
(7) Monitoring blood glucose levels, administering subcutaneous or intravenous insulin as needed;
(8) Administering sedatives during seizures;
(9) Effective antibiotic treatment for pulmonary bacterial infections;
(10) Protecting vital organ function.
II. Prevention of Hand-Foot-and-Mouth Disease in Kindergartens
1.During epidemic seasons, ensure adequate ventilation in classrooms, dormitories, and other areas;
2. Daily cleaning and disinfection of toys, personal hygiene items, tableware, and other objects;
3. Staff must wear gloves during cleaning or disinfection tasks (especially toilet cleaning). Wash hands immediately after completing cleaning tasks;
4. Essential disinfection supplies: iodine tincture, disinfectant cotton balls, etc.
III. Home Care for Hand, Foot, and Mouth Disease
1. Wash infants' and toddlers' hands with soap or hand sanitizer before meals, after using the toilet, and upon returning home. Avoid giving them untreated water or raw/cold foods. Keep them away from infected children;
2. Wash hands before touching children, after changing diapers, or handling feces. Dispose of soiled items properly;
3. Thoroughly clean infant feeding bottles and nipples before and after use.
4. During outbreaks, avoid taking infants to crowded public spaces with poor ventilation. Maintain household hygiene by regularly ventilating living areas and sun-drying bedding.
The above outlines methods for preventing hand, foot, and mouth disease in kindergartens, along with home prevention measures. As this disease poses certain risks, parents must take protective actions. If a child exhibits any symptoms of hand, foot, and mouth disease, seek medical treatment immediately.To prevent HFMD, parents should promptly air-dry or disinfect the child's clothing and ensure timely disinfection of the child's feces.