Response:

Blisters on the mouth, hands, feet, knees, or buttocks are common signs of hand, foot, and mouth disease (HFMD), but not all children develop distinct blisters. Some children may only have erythema, small spots, or mouth ulcers. Children infected with the EV71 strain can develop rashes in private areas such as the buttocks and groin, which can be mistaken for heat rash or diaper rash. Therefore, HFMD can still occur without blisters.

Parents should observe the overall symptoms: fever, mouth pain, mouth ulcers, loss of appetite, unusual fussiness, or abnormal skin lesions. If there is suspicion, children should be taken for an early medical examination without waiting for blisters to appear.

The disease is common in children under 10 years old, particularly those under 6 years old. In the initial stage, children may experience fatigue, fever, sore throat, runny nose, and vomiting; subsequently, painful mouth ulcers and skin blisters appear. The severity of the disease should not be assessed solely based on skin manifestations, as HFMD can cause severe complications such as meningoencephalitis, myocarditis, and pulmonary edema, especially with the EV71 strain.

A child with a fever but no blisters may still have hand, foot, and mouth disease. *Illustration: Vecteezy*

Once a child has been diagnosed, parents need to monitor them closely. If the child shows significant fatigue, vomiting, unusual fussiness, limb tremors, drowsiness, or rapid or abnormal breathing, they should be taken for immediate medical examination.

In summary, hand, foot, and mouth disease can present atypically; disease identification must rely on a combination of symptoms and medical examination, not just a single sign. Early detection and careful monitoring help prevent missed diagnoses or delayed treatment.

The Ministry of Health has licensed a hand, foot, and mouth disease vaccine since March. This vaccine helps prevent the EV71 virus strain that causes HFMD and is for children from 2 months old to under 6 years old. The VNVC Vaccination System is expediting procedures and making comprehensive preparations to deploy it soon in Vietnam.

Doctor Nguyen Van Mac Toan

Medical Manager, VNVC Vaccination System