Pathology Perspectives
Hand, Foot, and Mouth Disease (HFMD): This
virus usually affects children under 5 years old
with fever, sore throat, and a blistering rash in the
mouth and on palms and soles. It is sometimes
subclinical without major symptoms, but extreme
cases can lead to the permanent loss of fingernails
or toenails. More serious complications include
encephalitis, severe dehydration, or viral meningitis.
In a recent spike of HFMD diagnoses in the United
States, 24 percent of the cases were adults, and all
the patients had had recent contact with day-care
or elementary-school settings. The strain of virus
tied to this outbreak is unusually virulent, leading
to blisters covering much more of the body, so
this is an infection that bears watching. As of this
writing, HFMD is not a reportable disease, so it is
difficult to determine how common it might be.4
HFMD is a bigger issue outside of the
United States. Recent travelers from China,
India, Singapore, and other locations in Asia are
at increased risk for exposure to this extremely
contagious and potentially painful infection.
make a habit of inquiring about the health of people
living with a client, so we may not know that our
massage client had recently been picking at the
impetigo lesions on her 5-year-old, or soaking the
eye-crusties off her toddler who has pinkeye.
Contrary to how it may seem, this article isn't
intended to discourage massage therapists from
practice. Rather, it is meant to point out that we
cannot fulfill our potential to serve our clients if
we are blindsided by a preventable infection. The
potential for these conditions to cross from a family
member to a client to a therapist, and then on to
other clients, is yet another reason to be extremely
conscientious about managing hygiene in our
places of work. (See "Hygiene Fact and Fiction,"
Massage & Bodywork, May/June 2012, page 36.)
In the meantime, be aware that the best
defense is knowledge and appropriate action—
consider yourself well armed!
Notes
1. Medscape, "Pertussis Incidence Rises as Fifth DTaP
Dose Immunity Wanes," accessed August 2013,
Impacts on Massage
How do these "childhood" infections impact
decisions about massage therapy? A client with
an acute case of pinkeye or chickenpox is unlikely
to keep an appointment, so that is not a big issue.
But a client who has a child at home with one of
these problems may well come for a session and
leave some microscopic passengers behind that
may infect the massage therapist or subsequent
clients. Most massage therapists probably don't
www.medscape.com/viewarticle/780551.
2. Wall Street Journal, "Can Adults Catch Childhood Diseases?"
accessed August 2013, http://online.wsj.com/article/SB10
001424127887324423904578523194066341344.html.
3. Centers for Disease Control and Prevention, "Measles," accessed
August 2013, www.cdc.gov/vaccines/pubs/pinkbook/meas.html.
4. Washington Post, "A More Virulent Version of Hand, Foot
and Mouth Diseases Hits Kids—and Parents," accessed
August 2013, www.washingtonpost.com/national/healthscience/a-more-virulent-version-of-hand-foot-and-mouthdisease-hits-kids--and-parents/2012/09/16/63807780f5f0-11e1-8398-0327ab83ab91_story.html.
Ruth Werner is a former massage therapist, a writer, and a continuing education provider
approved by the NCBTMB. She wrote A Massage Therapist's Guide to Pathology (Lippincott
Williams & Wilkins, 2009), now in its fifth edition, which is used in massage schools worldwide.
Werner is available at www.ruthwerner.com or wernerworkshops@ruthwerner.com.
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