La malattia mani – piedi – bocca è una malattia virale pediatrica, causata da virus Coxsackie o, più raramente, da altri enterovirus, caratterizzata da vescicole sul palmo della mano, sulla pianta del piede e al cavo orale, da cui il nome.
Trasmissione
Il contagio avviene per contatto diretto con secrezioni nasali, saliva (quindi starnuti, colpi di tosse o semplicemente parlando) di pazienti nella prima settimana di malattia o per contatto orale di feci di pazienti anche dopo un mese dalla guarigione. Il contagio è maggiore nella prima settimana della malattia. Frequenti sono le epidemie nei bimbi di età inferiore ai 10 anni, soprattutto negli asili nido nei periodi autunnali e primaverili.
Incubazione
In genere 3-5 giorni
Sintomi
I primi segni sono aspecifici: febbre (circa 38.0°C), scarso appetito, malessere generale e dolori addominali. Dopo un paio di giorni si manifestano macule rosse di 4-8 mm in bocca e sulla lingua che tendono a rompersi, causando dolorose ulcerazioni con conseguente difficoltà a mangiare; dopo successivi 2 giorni le manifestazioni cutanee si presentano anche su mani e piedi e frequentemente anche sui glutei (sedere). Anche queste sono inizialmente delle macchie rosse di 2-10 mm che si trasformano in vescicole di un caratteristico colore grigio. Non danno prurito. La guarigione avviene spontaneamente in circa una settimana.
Complicazioni
La malattia è benigna, ma è importante prevenire la disidratazione soprattutto nei bambini molto piccoli. Le donne in gravidanza invece sono a rischio di gravi complicazioni, anche se la relazione causa-effetto non è del tutto chiara.
Terapia
Non esiste cura specifica. Si somministra paracetamolo per la febbre ed eventualmente rimedi locali per attenuare il dolore in bocca.
Prevenzione
Non è possibile attuare alcuna prevenzione, a parte evitare il contatto con bambini malati finchè presentano le bollicine. Non esiste un vaccino.
Riammissione
Poichè il contagio è estremamente difficile da prevenire e la malattia, è benigna, non è necessario l’isolamento per cui la ripresa della scuola è possibile appena scomparsa le febbre. Per i bimbi del nido invece la ripresa è possibile solo quando sono scomparse le ulcere in bocca.
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