Review of Related Literature

Hand, foot and mouth disease (HFMD) is a common childhood infectious disease that

typically presents as vesicular exanthema of the oral mucosa and peripheral extremities [1].

Enteroviruses, such as Coxsackievirus A6, A16 and Enterovirus A71, are the most common

etiological agents [2]. HFMD is typically characterized by a brief febrile illness, typical

vesicular rashes on the palms, soles, or buttocks, and oropharyngeal ulcers. In some cases,

patients may also develop neurological complications, such as encephalomyelitis, aseptic

meningitis, and acute accid paralysis.

Stages of growth and development

HFMD occurs mainly in children under ten years of age, but can also affect older children

and adults due to their high sensitivity to the enterovirus 71 (EV71) and CVA16 [7].

However, it can also occur in immunocompetent adults [5, 6]. According to American

Institute of learning in middle childhoood, the sense of an inner subjective self develops for

the first time, and this self is alive with images taken in from the outer world, and brought up

from the depths of the unconscious. Older children have acquired a wide range of social and

technical skills that enable them to come up with marvelous strategies and inventive solutions

for dealing with the increasing pressures that society places on them. Children who are tend

to develop their abilities they tend to forget or extend their capabilities to deal with their new

discoveries thus, affect their health. In addition to Joseph EitelJan 27, 2015 studies Children

who are surrounded, both at home and at school/daycare facilities, by a strong learning

environment that is both informative and supportive may improve their development.

EffectivePhilanthropy.com reports that research has shown children exposed to poor and
underprivileged educational environments tend to be at a higher risk of being negatively

affected in terms of their development.

Unhealthy Lifestyle

According to a study in the Archives of Internal Medicine(2014), an unhealthy lifestyle is

defined as a lifestyle where a person engages in activities that are known to be detrimental to

one's health, such as not exercising regularly or enough, eating unhealthy foods on a regular

basis. An unhealthy lifestyle can vary by degrees, and some may determine that being slightly

unhealthy is acceptable for the sake of quality of life.

Childrens life nowadays is quite different that they tend to have unhealthy lifestyle. Some

people believe that schools must responsible to change this bad lifestyle while the other

people believe that parents is the most vital agents for this changes. In view of (Angelique

Martin 2015) with regards to HMFD the other unhealthy lifestyle is that children do not care

to keep their area clean. In school, some students like to litter the rubbish everywhere. Also,

they like to play with their friends without care whether the place clean or dirty. After

playing, they hold the food using their hands without washing their hands first. All of what

they do potentially affect their health. Because of that, teachers in school must direct their

children to have healthy life and make strike rules for this. Parents also must teach their

children to usually keep clean.

Altered Nutrition

(Gil Wayne 2016)The body is like a machine that needs to be supplied with the right kind and

amount of fuel. This may refer to nutrition or the food requirements of a person or patient.

Adequate nutrition is essential to meet the bodys demands.

Like many viral infections, the illness often starts with a feeling of being unwell for a day or

so. This might include a high temperature (fever). After this, a sore throat commonly occurs,

quickly followed by small spots that develop inside the mouth. These soon progress into

small mouth ulcers. Spots may appear on the lips or around the mouth as well or instead of

inside the mouth. In many cases, spots also develop on the skin. This is typically a day or so

after the mouth ulcers develop. The spots are small lumps that are a few millimetres in

diameter and usually appear on the hands and feet. Spots sometimes also appear on the

buttocks, legs and genitals. They rarely develop on other parts of the body. The spots are

similar to chickenpox but are smaller. Unlike chickenpox, they are not usually itchy but

sometimes they can be a little bit sore.

However, management of the illness is mainly through the symptomatic relief from pain

caused by fever, mouth sores and joint aches. Patients are advised to drink adequate fluid to

prevent dehydration (lack of body fluids).

Body Image Disturbance

Body image is how you feel about your body and what you do about those feelings. Some

people feel bad about their bodies and try to change them though a variety of means called

appearance management behaviors. In connection with the knowledge of National Center for

Immunization and Respiratory Diseases, Division of Viral Diseases HFMD is usually not

serious. The illness is typically mild, and nearly all people recover in 7 to 10 days without

medical treatment. Patient may develop fever, reduced appetite, sore throat, a feeling of being

unwell, painful sores in the mouth that usually begin as flat red spots, a rash of flat red spots

that may blister on the palms of the hands, soles of the feet, and sometimes the knees, elbows,

buttocks, and/or genital area.

Proper Hygiene

The HFMD patient is potentially contagious for the duration of the initial symptoms, until the

vesiculobullous skin lesions disappear. Therefore, patients diagnosed with HFMD should be

excluded from group participation until the fever and skin and mucosal lesions have

disappeared. Furthermore, the virus is known to be shed in the feces for several weeks. It is

therefore necessary for patients and family members to know that the disease is spread

through direct contact with blisters and secretions from the nose and throat, as well as

through hands or utensils contaminated with the feces or secretions of infected people. It is

therefore important to emphasize washing hands well and to avoid sharing contaminated

utensils

In addition, (Written by Marissa S. and Elizabeth Boskey, PhD Medically Reviewed by Mark

R Laflamme, MD on February 11, 2016). Practicing good hygiene is the best defense against

hand, foot, and mouth disease. Regular hand-washing can greatly reduce your risk of

contracting this virus.Teach your children how to wash their hands using hot water and soap.

Hands should always be washed after using the restroom, before eating, and after being out in

public. Children should also be taught not to put their hands or other objects in or near their

mouths. Its also important to disinfect any common areas in your home on a regular

basis. Get in the habit of cleaning shared surfaces first with soap and water, then with a

diluted solution of bleach and water. You should also disinfect toys, pacifiers, and other

objects that may be contaminated with the virus.

References: http://www.healthline.com/desktop-article/hand-foot-mouth-disease?

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9&lazyloadscrolldepth=40&stickytimetlb1=3&stickytmr=tmr2,tmr3,tmr4&stickydepthtmr={

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mr16:150/tmr17:150/tmr18:150/tmr19:150/tmr20:150%20&rwd1

. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4791924/

https://www.cdc.gov/features/handfootmouthdisease/

http://www.sparkpe.org/blog/the-importance-of-early-childhood-

activity/#sthash.TEq84uVH.dpuf

References: http://www.institute4learning.com/resources/articles/the-12-stages-of-life/

RCH.org: The Underlying Factors Affecting Child Health and Development and

Family Functioning

http://www.sciencedirect.com/science/article/pii/S2352621115000935

BMC Res Notes. 2016; 9: 165.

Published online 2016 Mar 15. doi: 10.1186/s13104-016-1973-y

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both-schools-and-parents-are