Distinguish hand, foot and mouth disease from chickenpox, shingles (shingles) and Herpes simplex

This is an automatically translated article.

Hand, foot and mouth disease is a disease that often occurs in summer and autumn, at the same time as other skin diseases and skin lesions are blisters, so it should be distinguished from diseases caused by herpes simplex virus infection or chickenpox, shingles.

1.Distinguish hand, foot and mouth disease from chickenpox, shingles (shingles) and Herpes simplex 1.1. Hand, foot and mouth disease Hand, foot and mouth disease is caused by viruses belonging to the group of enteric viruses (poliovirus, coxsackievirus, echovirus…) The outbreak time is usually March-May and September-November. The disease usually occurs in children under 10 years of age.
When hand, foot and mouth disease, children will have oval blisters and grow in typical locations such as palms, soles, elbows, knees, buttocks. Blisters can grow in the mouth and throat, causing ulcers in the mouth and throat. However, these blisters are neither itchy nor painful.
1.2. Chickenpox Chickenpox is caused by a virus called the Varicella Zoster Virus (VZV) and is contagious. The disease occurs all year round, but the peak is from February to June. The disease occurs mostly in children aged 5-11, but also many adults suffer from this disease.
When you have chickenpox, the rash will grow in many stages, starting on the trunk and then spreading to the whole body, head, face, hands and feet; old vesicles mixed with new, concave in the middle when new, clear and opaque (pus) due to bacterial superinfection; The rash develops blisters that cause itching, pain, and discomfort.

Besides blisters, young children often have a mild fever, anorexia, but in adults or older children often have high fever, headache, muscle pain, vomiting. After the disease is in remission, the rash will dry, scab, darken the skin where the blisters appear, leaving no scars if not infected.
1.3. Shingles (shingles) Shingles, also known as shingles, is caused by a virus and only occurs in people who have had chickenpox before. Shingles usually does not break out into a pandemic like chickenpox or hand, foot and mouth disease, but is common in all ages if the resistance is poor.
When infected with shingles, the patient feels a burning pain in an area of ​​​​the skin and then appears many large and small blisters in a cluster. These blisters appear only on one side of the body, rarely spreading to other skin areas. Blisters can be mild or intense, depending on the case. If there are blisters in the armpits, groin and neck, swollen lymph nodes will appear, accompanied by low-grade fever and fatigue.
1.4. Herpes simplex Herpes Simplex Virus has 2 types: HSV – 1 and HSV – 2 and recurs in episodes.
Herpes type 1: Causes sores around the mouth, lips, eyes, in some cases can lead to genital herpes. Feel a burning sensation around the mouth before the sores appear. When the blisters burst, they leave behind a slide, or a deep ulcer, scabbing or exuding, causing unsightly, in some cases, crusting or oozing. Herpes type 2: Causes sores around the genitals or rectum, mainly transmitted sexually. The common symptom in Herpes type 2 is the appearance of sores on the genitals and anus. Besides the sores can include fever, body aches and swollen lymph nodes.

Bệnh Herpes simplex gây lở loét xung quanh miệng, môi

2. Hand, foot and mouth treatment for chickenpox, shingles (shingles) and Herpes simplex

2.1. Treatment of hand, foot and mouth disease Currently, there is no specific treatment for hand, foot and mouth disease. The main treatment is to reduce fever, reduce pain and increase resistance.
Reduce pain and fever with Paracetamol or Acetaminophen, do not use Aspirin or drugs containing Aspirin. Body hygiene: Reduce the risk of skin infections by cleaning the body, rinsing the mouth every day, taking a warm bath, washing gently, avoiding breaking water bubbles or scratching the skin, changing clean clothes daily . Keep fingernails short and wear baby gloves to reduce skin damage. Nutrition: Children should eat nutritious food, eat thin, cool foods; keep warm and give plenty of water. Take your child to a medical facility immediately when there are signs of a more serious illness such as high fever, confusion, convulsions, pus-filled blisters, blood. 2.2. Treatment of Chickenpox Chickenpox is a mild disease. However, without proper care, the disease can cause dangerous complications and another complication of chickenpox is shingles, also known as shingles. To support the treatment of symptoms and prevent dangerous complications, the treatment of chickenpox requires:
Use of drugs: Antipyretic drugs, vitamins, topical drugs to reduce itching but need to be prescribed by a doctor. Cleanliness: Wash and clean regularly to avoid bacteria accumulating on the skin causing infection, do not rub and break the blisters. Nutrition: When you have chickenpox, you should avoid fatty foods, butter, milk, cheese, etc., limit your intake of hot spicy foods, acidic foods such as oranges and lemons. Limit going to windy places, keep the body warm to avoid other opportunistic diseases, but the patient needs to be in a cool, not secretive place, when it is hot, the fan must be turned on to avoid sweating a lot.

2.3. Treatment of shingles (shingles) There is currently no cure for shingles, but your doctor can prescribe medication to control the infection, shorten the healing time, fight inflammation, and relieve pain. Regularly wash your hands with soap, both before and after using the toilet, to avoid scratching and scratching the skin. Apply antiseptic and prevent superinfection with methylene blue. Wash the body with warm water, gently wipe to avoid breaking the bubbles.

Sử dụng thuốc sát khuẩn bôi ngoài da ngừa bội nhiễm bằng Methylen

2.4. Herpes simplex treatment The treatment of Herpes simplex is mainly against superinfection, anti-viral and counseling the possibility of disease recurrence, complications and avoiding infecting others. Specifically:
Medication: Antiviral drugs to relieve systemic symptoms. If there is superinfection, use broad-spectrum antibiotics. Nutrition: Enhance health with a diet rich in protein, vitamins and proper rest. Body hygiene: Clean the body, do not share personal items with others.

3. Prevention of hand, foot and mouth disease with chickenpox, shingles (shingles) and Herpes simplex

3.1. Prevention of hand , foot and mouth disease Currently there is no vaccine or specific method to prevent hand , foot and mouth disease . The main methods of disease prevention include:
Regularly washing hands with soap under strong running water Ensure cooked food and drink; Use clean water to ensure hygiene. Do not give food to children and especially do not let children eat, suck, suck on toys; Let children use their own personal items. Keep the house clean and well ventilated. Using hygienic latrines When a child shows signs of illness, parents need to take the child to a doctor or notify the nearest medical facility. 3.2. Chickenpox Prevention The best way to prevent chickenpox is to get the chickenpox vaccine, which helps the body make antibodies against the chickenpox virus. The protective effects of the chickenpox vaccine can be long-lasting. At the same time, wash and change often, clean the body, house, and personal items every day. Do not go to places where there is an outbreak of disease. 3.3. Shingles prevention Regularly wash hands, clean the house, personal items daily. Eat, rest, live in moderation, avoid body fatigue and stress.

Tiêm chủng đầy đủ theo lịch có thể giúp phòng một số bệnh truyền nhiễm

3.4. Herpes simplex room Do not share personal items with others. Practice safe, healthy sex and use vaccines to prevent sexually transmitted diseases. Limit some intimate actions such as hugging, kissing, holding hands, contact with open wounds. Clean and properly clean the genitals. Vinmec International General Hospital is a high-quality medical facility in Vietnam with a team of highly qualified medical professionals, well-trained, domestic and foreign, and experienced.
A system of modern and advanced medical equipment, possessing many of the best machines in the world, helping to detect many difficult and dangerous diseases in a short time, supporting the diagnosis and treatment of doctors the most effective. The hospital space is designed according to 5-star hotel standards, giving patients comfort, friendliness and peace of mind.

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XEM THÊM:

• How to handle when children have shingles
• The reason why children get red rashes like mosquito bites
• Hand, foot and mouth disease in children continues to develop complicatedly in the southern provinces

Difference Between Chickenpox and Hand Foot and Mouth

Chickenpox vs Hand Foot and Mouth | Causes, Clinical Features, Complications, Diagnosis, Management
 

The key difference between chickenpox and hand foot and mouth disease is that chickenpox is caused by a herpes virus while hand foot mouth disease is caused by a picorna virus.

Chickenpox and hand foot and mouth disease, both of which are caused by viral infections, share some common characteristics and causes diagnostic confusion. But several features of the two diseases are significantly different. This article points out the differences between chickenpox and hand foot mouth disease with regard to the organism responsible, clinical picture, complications, diagnosis, and management.

CONTENTS

1. Overview and Key Difference
2. What is a Chickenpox 
3. What is Hand Foot and Mouth Disease
4. Side by Side Comparison – Chickenpox and Hand Foot vs Mouth Disease in Tabular Form
5. Summary

What is Chickenpox?

Varicella zoster, which belongs to the herpes virus family, is responsible for this disease. It is a DNA virus and has the ability to cause latent infections. The disease transmission is by respiratory droplets and direct contact with the lesions. It is highly infectious and more severe in adults, pregnant women, and immune-compromised people. Immunity following the disease is lifelong.

Vesicular eruption begins following an incubation period of 14-21 days, often on the mucosal surfaces first and then rapid dissemination in a centripetal distribution mostly involving the trunk. The rash progresses from small pink macules to vesicles and pustules within 24 hours and then crust. Moreover, the lesions appear to be in different stages of development. The pocks are more superficial, and the vesicles collapse on puncture.

Figure 1: Varicella-zoster Virus

Furthermore, the lesions are itchy, and scratching can lead to secondary bacterial infection, which is the most common complication. Rare complications involve self-limiting cerebella ataxia, varicella pneumonia, encephalitis, and Reye’s syndrome, especially in children who are on aspirin.

Physicians make the clinical diagnosis by the classic appearance of the rash. In addition, aspiration of the vesicular fluid and PCR or tissue culture confirms the diagnosis.

Acyclovir is effective in the management of the disease, especially, if commenced within 48 hours of the rash. Moreover, live attenuated VZV is given for highly susceptible contacts.

What is Hand Foot and Mouth Disease?

Hand foot and mouth disease is a systemic infection caused by coxsackievirus A16, which belongs to the picornaviridae family. The disease is moderately infectious. Transmission of the disease is by direct contact with mucus, saliva or feces of an infected person. It mostly affects children and rarely adults.

Following an incubation period of 10 days, mild illness of fever and lymphadenopathy occur. After 2-3 days, a vesicular rash appears on palmoplantar surfaces of the hands and feet with associated mouth lesions that ulcerate rapidly. A papular erythematous rash may appear on buttocks and thigh, as well.

Figure 2: Coxsackievirus

Isolating the virus or observing a rise in titer of neutralizing antibodies help in making the diagnosis.

The disease is self-limiting and usually resolves within 2 weeks after the onset. In case if the lesions are painful, analgesics can be given. However, passive immunization is not recommended.

The complications of the disease are very rare and include mild viral meningitis, encephalitis, and paralysis.

What is the Difference Between Chickenpox and Hand Foot and Mouth Disease?

Herpes virus causes chickenpox while a picorna virus causes hand foot and mouth disease. This is the key difference between chickenpox and hand foot and mouth disease. Moreover, the incubation period of chickenpox is 14-21 days, while the incubation period of hand foot and mouth disease is 10 days. In chickenpox, lesions appear mostly in the trunk, but in hand foot mouth disease, they appear on palmoplantar surfaces of the hands and feet, with associated mouth lesions that ulcerate rapidly. This is another important difference between chickenpox and hand foot and mouth disease.

Although chickenpox needs to be treated with acyclovir, hand foot mouth disease is self-limiting. Moreover, an effective vaccine is available against chickenpox, but there is no need for vaccines in hand foot mouth disease.  Finally, chickenpox is highly infectious, but hand foot mouth disease is moderately infectious. This is another major difference between chickenpox and hand foot and mouth disease.

Summary – Chickenpox vs Hand Foot and Mouth Disease

The key difference between chickenpox and hand foot and mouth disease is their viral origin;  herpes virus causes chickenpox while a picorna virus causes hand foot and mouth disease. There are other differences between the two diseases based on the clinical picture, complications, diagnosis, and management.

Image Courtesy:

1. “Varicella-zoster Virus” By NIAID (CC BY 2.0) via Flickr
2. “Coxsackie B4 virus” (Public Domain) via Commons Wikimedia

GBUZ “City Polyclinic” | What you need to know about chickenpox |

Chickenpox (Varicella) is a worldwide acute, highly contagious disease with a characteristic blistering rash. Susceptibility to chickenpox is unique – it reaches, according to various sources, 90-100%. After the appearance of the first case of this infection in a particular children’s group, it is almost impossible to prevent an outbreak. Prior to the start of immunization for varicella in the United States, up to 4 million cases of this infection were recorded annually, with 10 thousand cases requiring hospitalization. In our country, up to 700 thousand cases of chickenpox are registered per year. In Udmurtia, more than 10,000 people get chickenpox every year.

The causative agent of chicken pox is the Varicella-Zoster virus (varicella-zoster, VVZ), belonging to the herpesvirus family, according to modern classification, it is type III herpesvirus. Despite the fact that the description of chickenpox has been known since ancient times, and its infectious nature was proven in 1875, the virus itself was isolated only in 1958.

Varicella (chickenpox) is traditionally considered a typical childhood infection and can affect young children or preschoolers. While in childhood it is a relatively mild disease, in adults it occurs in a more severe form – in the form of herpes zoster – lichen (herpes zoster). The fact is that, like for herpes simplex viruses, the causative agent of chickenpox is characterized by the ability to persist (stay) for a long time in the ganglia of nerve cells, where it enters during infection of the child and continues to stay there after his recovery in the form of a “dormant infection”. Virus reactivation can occur after many years and even decades. This is mainly due to a decrease in the intensity of immunity in adulthood and old age. According to various studies, about 20% of the elderly suffer from herpes zoster.

Susceptibility to the causative agent of varicella (varicella zoster virus refers to herpes viruses) is quite high. About 90% or more of contact persons who have not been ill develop chickenpox. This virus has a high degree of volatility, is transmitted by airborne droplets and a child can become infected in close proximity to the patient. The patient is considered contagious already in the last days of the incubation period and during the entire period of rashes. You can also get infected from a patient with herpes zoster, since the causative agents of these infections are similar. The incubation period ranges from 14 to 21 days, with an average of 14 days. The disease begins with the appearance of a rash. Usually it is one or two reddish spots, similar to a mosquito bite. These elements of the rash can be located on any part of the body, but most often they first appear on the stomach or face. Usually the rash spreads very quickly – new elements appear every few minutes or hours. Reddish spots, which at first look like mosquito bites, the next day take the form of bubbles filled with transparent contents. These blisters are very itchy. The rash spreads throughout the body, to the limbs, to the scalp. In severe cases, there are elements of the rash on the mucous membranes – in the mouth, nose, on the conjunctiva of the sclera, genitals, intestines. By the end of the first day of the disease, the general state of health worsens, the body temperature rises (up to 39-40 degrees C and above). The severity of the condition depends on the number of rashes: with scanty rashes, the disease proceeds easily, the more rashes, the more difficult the child’s condition. For chickenpox, a runny nose and cough are not characteristic, but if there are elements of the rash on the mucous membranes of the pharynx, nose and on the conjunctiva of the sclera, then pharyngitis, rhinitis and conjunctivitis develop due to the addition of a bacterial infection. Bubbles open in a day or two with the formation of sores, which are covered with crusts. Headache, feeling unwell, fever persist until new rashes appear. This usually happens from 3 to 5 days (depending on the severity of the course of the disease). Within 5-7 days after the last sprinkling, the rash disappears.

Treatment of chickenpox is to reduce itching, intoxication and prevent bacterial complications. The elements of the rash must be lubricated with antiseptic solutions (usually an aqueous solution of brilliant green or manganese). Treatment with coloring antiseptics prevents bacterial infection of rashes, allows you to track the dynamics of the appearance of rashes. It is necessary to monitor the hygiene of the mouth and nose, eyes – you can rinse your mouth with a solution of calendula, the mucous membranes of the nose and mouth also need to be treated with antiseptic solutions. In order to avoid secondary inflammation, you need to rinse your mouth after each meal. In addition, you need to do general baths with a weak solution of potassium permanganate. Diets for chickenpox are not required, but easily digestible warm semi-liquid dairy and vegetable dishes are preferable, and meat dishes are ground, steamed. You need a plentiful cool drink – tea with lemon, berry fruit drinks, juices, compotes. Bed rest is determined by the condition of the child: if he feels well, the regimen can be at home. In severe cases, hospitalization in infectious diseases hospitals is indicated. It is important to ensure that the baby’s fingernails are cut short (so that he cannot comb the skin – scratching predisposes to bacterial infection). To prevent infection of rashes, bed linen and clothes of a sick child should be changed daily. The room in which the child is located must be regularly ventilated, making sure that the room is not too hot. These are general rules. Complications of chickenpox include myocarditis – inflammation of the heart muscle, meningitis and meningoencephalitis (inflammation of the meninges, brain matter), inflammation of the kidneys (nephritis). Fortunately, these complications are quite rare. After chickenpox, as well as after all childhood infections, immunity develops. Re-infection happens, but very rarely.

Cases of congenital varicella in children born from women who had this infection in the first half of pregnancy, and varicella in newborns whose mothers fell ill with chickenpox in the period 5 days before or 48 hours after the birth of a child are described.

Immunoprophylaxis against varicella is carried out in many countries of the world, is included in the national vaccination schedules of Japan, USA, Canada, Germany, Finland, etc.

The first country where the varicella vaccine was first registered and immunoprophylaxis was started is Japan. Here, a lot of experience has been accumulated in evaluating its effectiveness. According to Japanese researchers, immunity to chicken pox after vaccination persists for 10-20 years. The work of American researchers has shown that varicella vaccine provides protection against infection in 70-90% of vaccinated children and more than 95% of them can be protected from severe disease within 7-10 years after immunization.

Vaccination against varicella in healthy children is indicated from 12 months of age, its inclusion in the national calendar for young children would allow, with proper coverage (90-95%), to eliminate this infection. Today, vaccination against chickenpox is not included in the national vaccination calendar and is recommended as an individual immunization of healthy children and children from “risk groups”, in particular, patients with oncological, autoimmune diseases, people with immunodeficiency or immunosuppression; contact persons in the foci of infection, professional groups, pupils of institutions with permanent residence of children. At the same time, vaccination is contraindicated for pregnant women (pregnancy should also be avoided within 3 months after vaccination), AIDS patients; persons undergoing or within the last 3 months who have undergone a course of steroid and / or immunosuppressive therapy, including radiotherapy.

Immunization against this infection is recommended to be carried out according to epidemic indications to groups at increased risk of varicella (who have not had this infection; children aged 1-6 years entering preschool institutions; children from orphanages, orphanages, orphanages; children traveling to summer recreational institutions; children with oncohematological pathology; children from preschool institutions and schoolchildren who have been in contact with the disease who had chicken pox in a group/class; women of childbearing age; medical personnel serving pregnant women and children; employees of educational institutions who had contact with a case of chicken pox; students of secondary specialized and higher educational institutions living in hostels;

In a number of regions of the Russian Federation, vaccination against varicella is included in the regional vaccination calendar. Vaccines used for immunization against varicella have been registered in the Russian Federation.

Infectious disease specialist at Polyclinic No. 14
City Polyclinic S.V. Fedulaeva

Coxsackie virus. Memo to the tourist | Association of Tour Operators

ATOR Bulletin collected the main questions that concern tourists in connection with the spread of information about the Coxsackie virus in Turkey, and answers to them from specialists – doctors, lawyers and tourism industry professionals.

IN TURKEY REALLY AN EPIDEMIC OF COXACHI?

No. Not a single federal authority in Russia or Turkey confirms the existence of an epidemic. The fact that the current situation cannot be characterized as an epidemic is said not only by the Turkish Ministry of Health, but also by the Russian Rospotrebnadzor. The Consulate General of the Russian Federation in Antalya also does not see mass appeals of Russians on this issue.

This type of virus is characteristic of the southern coastal countries and its manifestations were observed both in Turkey and in other countries before – on hotel forums you can find panic questions from tourists regarding the Coxsackie virus and the “epidemic”, dating back to 2014 and 2015.

Finally, insurance companies, which have a real opportunity to quickly count those who fall ill, unanimously say that the number of requests for medical assistance due to enterovirus diseases in Turkey this year is within the statistical norm for the summer season – in other words, “this was the case before, this is not an epidemic.”

WHAT IS AN EPIDEMIC AND WHO ANNOUNCES IT?

An epidemic is the rapid and continuous spread of an infectious disease within a defined population or region. At the same time, the spread of the disease should0032 is significantly higher than the incidence rate normally recorded in the area and thus be a possible source of emergency.

Usually, the official announcement of an epidemic in a country is given by its Ministry of Health. In Russia, informs citizens about the epidemiological situation Rospotrebnadzor . In the future, information about the unsafe situation in a particular country appears on the website of Rostourism . Specifically for this information should be guided by tourists and travel agencies. We note, for our part, that even there are no warnings about the “need to be careful” on vacation in Turkey from government agencies at the moment .

HOW DOES THE COXSACKIE VIRUS MANIFEST, WHAT IS IT?

The virus called Coxsackie belongs to the group of enteroviruses . The disease is manifested by fever (high temperature) and rash (red or brownish spots on the body with blisters in the center). The rash is usually located on arms, legs and mouth . Therefore, the Coxsackie virus is called hand-foot-mouth virus .

A rash on the skin may resemble chickenpox (red spots / papules, and / or full-fledged watery vesicles) – but the Coxsackie virus has nothing to do with chicken pox (chickenpox) – so you do not need to be vaccinated against it in the hope of avoiding Coxsackie enterovirus. A rash in the mouth may resemble herpetic stomatitis – however, if it is Coxsackie, then drugs like Zyrtec will not help.

WHO CAN GET COXACKIE ILL?

Most often, children under 5-6 years old get sick – as a rule, on a beach holiday. Quite often, children, however, “bring” the virus from a regular kindergarten (perhaps other children who returned from vacation bring it).

Adults can also get Coxsackie virus. It is believed that the risk of recurrence is extremely unlikely – Coxsackie gives lifelong immunity.

IN WHAT COUNTRIES CAN COXACKIE POSSIBLE? IS IT ONLY Türkiye?

No, the hand-foot-mouth virus is also found and spreading in other countries of the world (above we indicated the countries in which the virus has been noted in the past few years). The most favorable conditions for the spread of the virus are hot weather and a humid climate.

Rosgosstrakh notes that most of the calls with enterovirus infection this year are about the illness of children under 7 years old on a beach holiday – not only in Turkey, but also, for example, in Thailand, Bulgaria, Spain, etc.

Finally, outbreaks of virus infection in different years were repeatedly recorded and in various regions of Russia – especially during those periods when hot weather was established in a particular region.

HOW IS COXACKIE TRANSMITTED? IS THERE A COXACKIE VIRUS VACCINATION?

If one child falls ill in a family, then all other family members are at risk, especially children under 10 years old, says pediatrician Sergei Butriy. The virus does not “fly through the air”, but is transmitted only by contact . Therefore, a sick child should have their own separate dishes and toys, and it is recommended that all family members often treat their hands with alcohol-containing antiseptics.

Vaccinations against Coxsackie enterovirus do not exist – neither in our country nor abroad.

HOW CAN YOU PREVENT A CHILD TO COXACKIE VIRUS ON HOLIDAYS?

Travel agent and doctor Svetlana Oboyanskaya gives the following recommendations for parents who want to minimize the risks of a child getting the Coxsackie virus on vacation:

• Be sure to observe personal hygiene – wash your hands, vegetables and fruits, children’s plastic dishes.
• If possible, avoid visiting the children’s pool, try to swim only in the sea.
• In the kids club, children should wear only socks; during peak seasons with a large number of children, it is better to exclude visiting it altogether.
• Raise the child’s immunity even before rest: fresh vegetables, fruits, physical exercises, a lot of fresh air in the child’s everyday “pre-holiday” life reduce the risk of getting sick on vacation, because. First of all, children with weak immunity become victims of any viruses.

HOW LONG DOES COXACKIE TAKE?

As a rule, the period of infection with the virus lasts about 10 days. The temperature can last for 1-4 days, then it usually returns to normal on its own. Pain when swallowing persists for 1-6 days.

A person who has been ill with Coxsackie can return to the team after normalization of body temperature and general condition, but the main indicator will be the disappearance of the elements of the rash. Up to this point, the sick person may be contagious.

HOW TO TREAT A CHILD WITH COXSACKIE? SHOULD I TAKE ANTIBIOTICS?

No, you don’t need to take antibiotics – doctors say so. Coxsackie is a virus, and antibiotics only kill bacteria. The disease belongs to the category passing independently . The patient only needs relief. Parents and physicians need just to stay hydrated and monitor for complications (only then antibiotics may be needed, but they must be prescribed by a doctor).

To reduce body temperature , you can take antipyretics such as ibuprofen or paracetamol . In order to avoid dehydration, especially in children, it is recommended to frequently give the patient cool water to drink – cold can serve as an anesthetic, because ulcers make swallowing difficult. Pediatrician Sergey Butriy also recommends to give the patient ice cream – this is additional calories, and light anesthesia in the throat .

HOW TO DO NOT MISS COXSACKIE COMPLICATIONS AND CALL THE DOCTOR IN TIME

The most common complications of these diseases are dehydration and secondary bacterial infection .

Dr. Evgeny Komarovsky recommends URGENTLY see a doctor or call an ambulance in two cases:

If the child is dehydrated due to complete refusal to eat and drink . Signs of this condition:

child has not urinated for more than 8 hours

A sharply sunken fontanel on the head is palpable in an infant

child cries without tears

His lips are chapped and dry.

If there are signs of a secondary bacterial infection . They can be:

Blisters on the body filled with pus or became sharply painful.

The aphthae in your child’s mouth are so painful that he does not open his mouth, completely refusing to eat and drink.

CANCELLED TOUR TO TURKEY. WHAT COMPENSATION CAN YOU COUNT?

Officials of did not impose any restrictions on the sale and formation of tours to Turkey . Thus, if a tour is canceled before its start date, the tour operator has the legal right to withhold the costs incurred for organizing this tour.

The final amount of expenses actually incurred by him depends on the date of termination of the contract and many other factors. The exact figure is not indicated in the law and depends only on the terms of the contract for the sale of the tourist product, but the closer to the date of the trip, the greater the fine will be .

IF THE SITUATION IS SUDDENLY RECOGNIZED AS UNSAFE, THEN IT WILL BE POSSIBLE TO REFUND THE WHOLE AMOUNT OF THE TOUR?

Nadezhda Efremova, head of the ATOR legal service, explains that the statements of the Federal Tourism Agency in case of danger to tourists in a particular country can be divided into two types.

The first is a recommendation to be careful on vacation. This formulation of does not introduce any prohibitions or restrictions on travel to country . In this case, if the tourist wishes to abandon the tour “because he is afraid”, the refund is made in accordance with the terms of the contract for the sale of the tourist product – on the terms signed by the parties.

The second option may include restrictions on the formation and implementation of tours to a particular country. In this regard, changes in flight programs may also be made. In this case, the return of funds for unfulfilled obligations to the tourist is made in full – but there are currently no such notifications for Turkey .

HOW TO REFUND MONEY FOR EARLY RETURN HOME.

Such a question can be asked by tourists who are afraid that upon arrival at the hotel they will find vacationers with suspicious rashes. If the situation is not recognized as an epidemic , the tourist can apply to the operator with a request for compensation for lost services.

However, since the refusal of services occurred at the time of their provision, then the partners of the tour operator will not be able to sell them to other tourists. The same applies to the return flight. Thus, a refund for unused services unlikely .

WHAT TO DO IF A TOURIST OR HIS CHILD IS ILL ON HOLIDAY ON THE EVE OF THE FLIGHT BACK TO THE HOMELAND AND THE DOCTOR DOES NOT RECOMMEND FLIGHT BECAUSE OF THE RISKS TO YOUR OWN HEALTH OR THE RISK OF INFECTION TO OTHERS?

On this issue, it makes sense to contact your insurance company . The answer to the question will depend on the conditions of the insurance company in which the policy was purchased. Sometimes such risks are included in the standard package, but it happens that the contract does not provide for this.

Yulia Alcheeva, Executive Director of ERV, recommends that tourists contact their insurer on the eve of the trip and clarify whether such risks are covered by the insurance policy under quarantine . If the standard policy does not include such risks, it makes sense to purchase extended insurance .

WHAT ELSE SHOULD YOU PAY ATTENTION TO WHEN ISSUING INSURANCE FOR GOING ABROAD?

An insurance policy is cheaper if it provides for the so-called franchise . Usually this is an amount of about 50-100 euros, which the tourist will have to pay for treatment from his own pocket. The insurance company compensates for expenses only in excess of the specified amount.