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Foot and Mouth Disease
Pathology
Hand, foot and mouth disease symptoms
Symptoms generally start to appear 3-7 days after becoming infected with the virus;
Initial symptoms are mild fever, tiredness, reduced appetite, and sore throat;
The characteristic features mouth sores and skin rash usually develop one or 2 days
after the onset of fever;
The rash appears as flat or raised red spots, which may form blisters;
The rash is not itchy, and usually affects the palms of the hands and soles of the feet;
In younger children, especially those still wearing nappies, the rash may also appear on
the buttocks;
The mouth sores, which start as small red spots and form painful blisters, often turn into
ulcers.
HFM is caused by several members of the enterovirus family of viruses. The most common
cause is Coxsackie virus A-16; less frequently enterovirus 71 is the infectious agent. The clinical
manifestations of routine HFM are the same regardless of the responsible virus. However,
patients infected with enterovirus 71 are more likely to experience rare complications (for
example, viral meningitis or cardiac muscle involvement). These viruses remain in the body for
weeks after symptoms have gone away, so infected people can pass the disease to others even
when they appear well.
The disease spreads easily from person to person, often resulting in outbreaks in schools or child
care centres. Outbreaks are most common in summer and early autumn. You can catch the virus
from an infected person if you come into contact with their saliva, secretions from their nose or
throat (through coughing or sneezing), fluid from blisters, or faeces.
People usually become infected by picking up the virus on their hands from contaminated objects
and then placing their hands near their mouth or nose. It is also possible to breathe in the virus if
it is suspended in airborne droplets.

Pathogenicity
HFMD is usually a mild disease, and children generally recover within 7-10 days. Rarely, a child
with HFMD may develop complications such as meningitis (inflammation of the membrane
surrounding the brain). If your child develops a stiff neck, headache or back pain then you should
consult your doctor.
Transmission, Epidemiology, and Pathogenesis
Transmission of FMD is generally by contact between susceptible and infected animals. Infected
animals have a large amount of aerosolized virus in their exhaled air, which can infect other
animals via the respiratory or oral routes. All excretions and secretions from the infected animal
contain virus, and virus may be present in milk and semen for up to 4 days before clinical signs
appear. Aerosolized FMD virus can spread a considerable distance as a plume, depending on
weather conditions, particularly when the relative humidity is >60% and when the topography of
the surface over which it is dispersing does not cause turbulence. FMD has been transmitted to
calves via infected milk, and milk tankers carrying infected milk have been implicated in the
spread of disease between farms. Fodder can become contaminated after contact with infected
animals and iatrogenic spread of FMD has been reported.
Although horses, dogs, and cats are not affected by FMD, they can act as mechanical vectors, as
can humans. Also, avian species are not susceptible to infection, but they can carry virus on their
feet and feathers and will excrete virus after ingesting infected material. Therefore, birds may
carry the virus, although their role in dissemination is unclear.
A typical scenario for the introduction of FMD into a previously clear area is for pigs to be fed
imported food derived from an infected animal (as meat, offal, or milk); virus then spreads by
aerosol from the infected pigs to cattle, which are the most likely species to be infected by the
respiratory route because of their large respiratory volume. FMD virus can survive in dry fecal
material for 14 days in summer, in slurry up to 6 mo in winter, in urine for 39 days, and on the
soil between 3 (summer) and 28 (winter) days.
Ruminants that have recovered from infection and vaccinated ruminants that have contact with
live FMD virus can serve as foci of infection and carry the virus in the pharyngeal region for up
to 3.5 yr in cattle, 9 mo in sheep, and 5 yr in African buffalo. Experimentally, it has not been
possible to show transmission from a carrier bovid to an in-contact susceptible animal, but there
is evidence that under field conditions these carrier animals initiate new outbreaks of disease.
FMD virus can be recovered from carrier animals by culturing a sample of pharyngeal mucus
and superficial cells (collected using a probang cup) on susceptible tissue culture, such
as primary bovine thyroid cells. However, the technique is probably only 50% reliable in
identifying a carrier using a single sample because the quantity of virus found in the pharynx
varies on different occasions.
The primary site of infection and replication is usually the mucosa of the pharynx, although the
virus can enter through skin abrasions or the GI tract. Virus is distributed through the lymphatic
system to sites of replication in the epithelium of the mouth, muzzle, feet, and teats, and also to
areas of damaged skin (eg, the knees and hocks of pigs kept on concrete). Vesicles develop at
these sites and rupture, usually within 48 hr. The viremia persists for 45 days.
Antibody production can be detected from 34 days after the first clinical signs and is usually
sufficient to clear the virus.

Pharmaceutical remedy:
Hand, foot and mouth disease is very contagious. The best way to avoid catching and spreading
it is to avoid close contact with people who have the disease and to practise good hygiene.
Always wash your hands after going to the toilet and handling nappies, and before
preparing food. If your child has hand, foot and mouth disease, encourage them to wash
their hands regularly as well.
Avoid sharing utensils with people who are infected with hand, foot and mouth disease.
Make sure that shared work surfaces are clean.

http://www.merckmanuals.com/vet/generalized_conditions/foot-and-
mouth_disease/overview_of_foot-and-mouth_disease.html
http://www.medicinenet.com/coxsackie_virus/article.htm
http://www.co-operativepharmacy.co.uk/pharmacy/medicine-chest/nhs-articles/h/hand-foot-and-
mouth-disease/

Influenza Virus
It is common to confuse flu with a bad cold. Flu and cold symptoms may include a
runny/blocked nose, sore throat, and cough. Here are some symptoms which a person with flu
will have. These are not common heavy cold symptoms:
high temperature
cold sweats, shivers
headache
aching joints, aching limbs
fatigue, feeling utterly exhausted
gastro-intestinal symptoms, such as nausea, vomiting, and diarrhea, are much more
common among children than adults
Ear infection (otitis media)
http://www.healthcommunities.com/influenza/symptoms.shtml
The influenza virus spreads from one person to the other through droplets in the air, when an
infected person coughs or sneezes. The virus enters your body, in case you happen to inhale any
of these droplets. At times, talking can also cause the virus to get transmitted from one person to
the other. Another way in which you could pick up the germs is by touching objects that have
already been used by an infected person. Many of us get infected because of sharing utensils and
other similar items with those who are already suffering from the flu.
In case the viruses that enter your body are similar to the ones that you had before, the antibodies
could be useful in preventing the infection. However, the antibodies present in your system are
not capable of protecting your body from the new strains of the virus. Unfortunately, these new
strains can be passed on to humans from animals, such as birds or pigs.
In the last decade or so, there have been a few types of influenza that have created a pandemic,
which is an epidemic on a worldwide scale. Bird flu and Swine flu are two common examples of
such new strains of influenza that caused several cases of death, throughout the globe.
http://www.home-remedies-for-you.com/remedy/Influenza.html
Pharmaceutical Remedies:
If you have flu you should:
stay at home
try to avoid contact with other people
keep warm and rest
make sure you consume plenty of liquids
don't consume alcohol
if you are a smoker stop smoking or cut your consumption down as much as you can
try to get some food down (eat what you can)
if you live alone, tell a relative, friend or neighbor that you have flu. Make sure someone
can check in on you and do your shopping
Health experts and government agencies throughout the world say that the single best way to
protect yourself from catching flu is to get vaccination every year. There are two types of
vaccinations, the flu shot and the nasal-spray flu vaccine. The flu shot is administered with a
needle, usually in the arm - it is approved for people older than six months, including healthy
people and those with chronic medical conditions. The nasal-spray flu vaccine is a vaccine made
with live, weakened flu viruses that do not make you ill.

A flu vaccine will contain three influenza viruses - One A (H3N2) virus, one A (H1N2) virus,
and one B virus. As viruses adapt and change, so do those contained within the vaccines - what is
included in them is based on international surveillance and scientists' calculations about which
virus types and strains will circulate in a given year. You are protected about two weeks after
receiving the vaccination.
http://www.medicalnewstoday.com/articles/15107.php

Pathogenicity
How serious is flu?
In the majority of cases flu is not serious - it is just unpleasant. For some people, however, there
can be severe complications. This is more likely if you are elderly or have some other
longstanding illness that can undermine your immune system. Your risk of experiencing severe
flu complications is higher if:
you are over 65
you are a baby or a very young child
you are pregnant
you have some kind of heart or cardiovascular disease
you have a chest problem, such as asthma or bronchitis
you have a kidney disease
you suffer from diabetes
you are taking steroids
you are undergoing treatment for cancer
you have any longstanding disease that can significantly lower your immune system