Microbiology and Immunology

Hand-foot-mouth disease WORLD OF MICROBIOLOGY AND IMMUNOLOGY

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at U.B.C. (which has continued to the present day). In 1986,

he became a professor at U.B.C.

From 1989 until 1996, he was the first Scientific

Director of the newly established Canadian Bacterial Diseases

Network. Under his direction, the network of academic and

applied microbiologists and molecular biologists made funda-

mental discoveries of the mechanisms of bacterial infection.

Presently, he is a board member of the network. From 1990

until 1993, Hancock was the Chair of the Medical/Scientific

Advisory Committee of the Canadian Cystic Fibrosis

Foundation. Finally, beginning in 1997, Hancock has been the

Director of the Centre for Microbial Diseases and Host

Defense Research at UBC.

Hancock has served on the editorial boards of ten inter-

national peer-reviewed journals and his expertise in bacterial

pathogenesis and antibiotic resistance is utilized in a consulta-

tive and directorial role in a myriad of government and indus-

trial settings.

Through his research, Hancock has revealed some of

the molecular aspects of the mechanisms by which

Pseudomonas aeruginosais able to cause disease or death,

particularly in those afflicted with cystic fibrosis. His research

has determined the structure of some outer membrane proteins

that functions as transport pores. Additionally, he is among the

group that has completed the sequencing of the genome of the

bacterium. The latter work will lead to further discoveries of

genes that are vital in disease processes.

Hancock’s best-known research has been the unraveling

of what is termed the “self-promoted uptake” of aminoglyco-

side, polymyxin and cationic antibioticsand antimicrobial

peptides. This uptake is a major reason for the acquisition of

antibiotic resistance by the bacterium, and so will be the target

of treatment strategies.

In recognition of his fundamental contributions to bacte-

riology, Hancock has been the recipient of numerous awards

and honors, including the Canadian Society of Microbiologists

Award in 1987, the 125th Anniversary of Canada Silver Medal

in 1993, inclusion in the American Men and Women in Science,

1989–2000, and the MRC Distinguished Scientist Award,

1995–2000.

See alsoBacterial adaptation; Infection and resistance

HHand-foot-mouth diseaseAND-FOOT-MOUTH DISEASE

Hand-foot-mouth disease is a contagious illness that strikes

predominantly infants and children that is characterized by

fever, mouth sores, and a rash with blistering. Two types of

virusescause the disease. The majority of cases are due to sev-

eral members of the Coxsackie virus group (subtypes A16, A5,

and A10). A type of enterovirus designated as enterovirus 71

also causes the disease, but is of minor importance.

The name of the disease has caused confusion with the

well-known hoof and mouth disease. However, hand-foot-

mouth disease is entirely different from hoof and mouth dis-

ease that strikes cattle, sheep, and swine, causes entirely

different symptoms, and which is caused by a different virus.

The disease was initially described and the viral agents

determined in 1957.

Hand-foot-mouth disease begins with a general feeling

of being unwell. A mild fever, poor appetite, and sore throat

leads within a few days to the appearance of sores in the

mouth. The blister-like rash develops soon thereafter on the

palms of the hands, soles of the feet, on the inside of the

mouth, and sometimes on the buttocks. The hands tend to be

involved more than the other regions of the body. These symp-

toms are more inconvenient than threatening to health.

Recovery is typically complete within a week or two. Rarely,

a stiff neck and back pain reminiscent of meningitiscan

lead to hospitalization. This precaution is prudent, since one of

the enteroviruses that causes hand-foot-mouth disease,

enterovirus 71, can also cause viral meningitis. During out-

breaks of hand-foot-mouth disease, cases of viral meningitis

can concurrently appear.

Children fewer than ten years of age are most suscepti-

ble. However, the disease can occur in adults as well. In chil-

dren the fever, which can peak in the range of 103 to 104° F

(39.4 to 39.9° C), is a concern. Also, the sores in the mouth

can discourage children from eating and drinking. Thus, an

important aspect of managing the disease is the maintenance

of a sufficient diet.

The disease is contagious and can be spread from per-

son to person by direct contact with nose or throat fluids.

There is no geographic restriction on the occurrence of the

disease. There is some seasonal distribution, with the majority

of cases being reported during the summer and early fall.

Treatment of hand-foot-mouth disease is confined to the

relief of the symptoms, and observance of good hygienic prac-

tices to minimize the spread of the virus. Antibioticsare use-

less, given the viral nature of the disease. An actual cure, such

as a vaccine, does not yet exist. Even if specific immunityto

one episode of the disease has been produced, a subsequent

infection with a different subtype of Coxsackie virus can cause

another bout of the disease. In this sense, hand-foot-mouth

disease is similar to the immune variation that is the hallmark

of influenzae viruses.

HAND WASHING•seeHYGIENE

HHantavirusand Hanta diseaseANTAVIRUS ANDHANTA DISEASE

Hantavirus (family Bunyaviridae, genus Hantavirus) infection

is caused by virusesthat can infect humans with two serious

illnesses: hemorrhagic fever with renal syndrome (HFRS), and

Hantavirus pulmonary syndrome (HPS).

Hantaviruses are found without causing symptoms

within various species of rodents and are passed to humans by

exposure to the urine, feces, or saliva of those infected

rodents. Infection is commonly associated with disturbing the

droppings or nests of rodents within confined spaces. The dis-

turbed particles are inhaled to cause infection. Ten different

hantaviruses have been identified as important in humans.

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