23 June 2024

Boston disease – what is it?

choroba bostońska u dzieci

Boston Disease is a viral infection with a characteristic rash. It most often affects children under 10 years of age. The name of the disease refers to the epidemic that took place in Boston – it is a colloquial name. According to the correct medical nomenclature, Boston is also known as HFMS (hand, foot and mouth disease). Other names for the condition are:

  • enteroviral stomatitis with a rash
  • vesicular rash
  • enteroviral rash fever
  • hand, foot and mouth disease

Some people call it “foot-and-mouth disease”, but the term refers to a completely different disease caused by Picorna viruses. Boston’s disease is diagnosed by pediatricians more and more often, although it was a rarity until a few years ago. The greatest number of cases of Boston tissue infection is recorded in late summer and autumn. What are the main symptoms of Boston Disease? How to cure the disease and does it cause complications that are dangerous to health? What to look for when it comes to prevention? Detailed information can be found in the article.

Boston disease – how does it get infected?

An unpleasant disease is caused by Coxsackie viruses from the entrovirus group, and the incubation period is several days (from 3 to 6). Coxsackie viruses can also cause strep throat, diarrhea and colds. Viruses in this group are also the cause of many serious diseases, such as pancreatitis. The most common are Coxsackie A10, A5, A9, A16, B1 viruses.

After infection, the virus settles in the throat and spreads within one day in the lymphatic tissue, even reaching the intestines! Although infection is usually caused by airborne droplets, indirect contact with the stool of a sick person is also dangerous – for example when using the same toilet as an infected person. Bostonka belongs to the group of diseases called “Dirty hands” and is very easy to move, especially in large groups of children – for example in a nursery, kindergarten or school. That is why frequent hand washing is so important. The cause of Boston infection may also be contact with surfaces contaminated with the virus (this applies, for example, to shared children’s toys). Factors that increase the risk of developing Bostonien include young age, reduced immunity, time of year, and inadequate hygiene.

Boston Disease - Causes

Symptoms of Boston Disease

The main symptom of Boston Disease is a characteristic pink rash which looks like small blisters and affects the palms, the inside of the feet, and the mouth. Sometimes it also appears on the buttocks and around the genitals. In some people, allergies can also be observed on the face and neck. The bubbles are embedded in severely reddened skin. A rash in the mouth can cause painful erosions, contributing to a lack of appetite in the patient.

Due to the rash, Boston’s disease is often mistaken for chickenpox. Another misdiagnosis of the disease is food allergy. Sometimes Boston is also confused with exudative erythema multiforme. However, it’s worth remembering that with Boston the rash is not all over the body.

In addition to the rash, additional symptoms may appear, such as:

  • energy drop
  • sore throat
  • weakening of the body
  • gastrointestinal complaints (diarrhea, vomiting, nausea)
  • higher temperature
  • lack of appetite

Sometimes the patient may also develop enlarged lymph nodes as well as recurrent muscle and joint pain.

Boston disease – how long does the sick keep contagious?

People with Boston virus infect for a long time – until all bubbles are dry. Although Boston is most infectious in the first week, the virus is cleared from the body in the faeces for about 4 weeks. During this time, people from the immediate vicinity of the patient should follow the rules of hygiene and exercise particular care.

Boston Disease – What Viruses Is It Confused With? Similar conditions

Due to the rash, Boston is very often confused with other conditions that cause similar symptoms. These include:

Chickenpox (air pox) – with smallpox, the pustules are scattered throughout the body; on the face, torso, limbs, back and abdomen. The vesicles are clear, round, and break quickly to small scabs. Importantly, there is itching in the windbreaker. Chickenpox also lasts much longer than Boston – it usually takes two weeks for the spots to disappear. Smallpox patients stop infectiously as soon as the rash has cleared, while in Boston’s case the virus is contagious for several weeks. Importantly, a child only gets chickenpox once in a lifetime.

Erythema multiforme exudative – in this disease, eruptions are much larger and turn into painful erosions after a short time. Skin changes occur mainly on the hands, arms and lower legs. The disease is caused by the herpes virus and bacterial infections. Erythema multiforme can also be a reaction of the body to some medications that you are taking.

Sweat eczema – fluid-filled blisters are deep-seated and occur primarily on the toes and soles of the feet. The ailment occurs without any additional symptoms. In the treatment of sweat eczema, steroid preparations are used, which are not given to children.

Herpes simplex – infection with the virus is common in both adults and children. Most often it appears only around the mouth and face. The skin lesions occur in groups, and the vesicles are very close to each other.

Bostonka in children

The virus is most common in children under the age of 10. Children who attend nursery schools or kindergartens are particularly vulnerable, as the virus spreads in large clusters. The most common complication of Boston in children is dehydration, which is why it is very important to hydrate the body regularly during treatment. Bostonka in young patients is most often mild, and only children with severely immunocompromised children are exposed to complications.

Boston Disease in Adults

Bostonka in adults

Adult bostonitis is rare. However, while Boston’s disease is mild in children, in adults it can cause serious systemic complications, such as meningitis, encephalitis, lung infections and myocarditis. A secondary bacterial infection of the skin may also be the aftermath of Boston, so it is important to use appropriate measures for the rash that occurs during the disease.

Boston disease in pregnancy – is it dangerous for the baby?

Boston disease in pregnancy can quickly transmit the virus to the fetus – this is especially dangerous in the first trimester. Bostonka can lead to a miscarriage or birth defects to the fetus. According to some experts, the Boston Flu can cause a baby to develop serious heart defects. It is also possible that the virus will spread to the newborn. Therefore, pregnant women should take the necessary precautions – it is worth avoiding contact with preschool children who are most at risk of falling ill. In the second and third trimesters of pregnancy, the disease does not pose a threat to the baby, but nevertheless appropriate prophylaxis principles should be applied. Throughout your pregnancy, it is worth taking supplements containing essential vitamins and minerals that increase the body’s immunity.

Remember that Boston is a disease that affects mainly children, so the risk of falling ill during pregnancy is not high.

Diet during Boston Disease

Because the rash also affects the mouth, some foods can irritate the painful areas additionally. There is a burning inflammation inside the mouth with eczema, which should be soothed by an appropriate, easily digestible diet. What foods should a person with Boston avoid? Here is a list of ingredients that are better to do without:

  • citrus fruits
  • salty snacks (chips, sticks)
  • processed dishes
  • fruit drinks
  • hard meals
  • carbonated drinks
  • salty and spicy foods

The patient’s diet should include mainly milk, cool cocktails, ice cream, sorbets, fruit mousses and delicate, creamy soups. You can also suck on ice cubes to help reduce the swelling of the throat. It is also worth giving your child jars intended for babies.

Boston Disease – Treatment

The diagnosis of Boston Disease is mainly based on a visual examination by a physician and an interview with the patient. Due to the fact that Boston is very easily confused with other diseases, it is very important to visit a specialist who will make a diagnosis. To detect the disease, you do not need to perform specific tests, although theoretically, a doctor may order them. In some cases, morphology and pharyngeal swab are recommended. The disease clears up on its own within a few days, thanks to the immune system, but it is very important to relieve symptoms quickly. Disinfect the bubbles on the hands and feet with special antiseptic dyes, for example with a solution of gentian violet. You can use antihistamines to prevent itching and burning. Very important is,

If your child has a fever, we can give him paracetamol or anti-inflammatory drugs that your doctor will recommend. For skin lesions in the mouth that may make swallowing difficult, painkillers or lozenges are used. Getting enough rest and sleep is very important, as well as drinking plenty of cool drinks to help you breathe easier. The patient’s room should be ventilated frequently. It is worth taking vitamin A2 during the disease. If the symptoms persist, see a specialist who will provide us with additional information. Unfortunately, children who have had the disease are not protected against falling ill again.

Boston Disease - Symptoms

Boston disease – how to protect against it? Prevention

How can I prevent infection with a disease? There are methods by which we can avoid contamination. It is worth introducing some necessary hygiene rules, such as:

  • Regularly cleaning and disinfecting toys and items that your child takes to school. This applies to stuffed animals as well as notebooks and pens.
  • Washing clothes and changing bedding frequently (the virus spreads easily to all fabrics) and can stay on them for weeks.
  • Avoiding contact with sick children.
  • Eating meals containing a lot of vitamins and nutrients (the disease most often attacks when the body’s immunity is reduced). In the autumn and winter season, it is worth using dietary supplements available at a pharmacy without a prescription.
  • Frequent hand washing is a very important habit, especially before and after using the toilet, and also after playing with other children. It will help to protect the child from both Boston and other diseases of dirty hands.
  • Teaching children not to eat together with others from the same cutlery, and not to share their sandwiches or drinks with others. Remember that the Boston virus is also transmitted in saliva.

Due to the fact that in adults the course of the disease is more severe, it is extremely important to keep contact with a sick child to a minimum. If there is a Boston epidemic in the facility where our child attends, it is worth staying at home for a while.

Katarzyna Kroteniuk

Editor-in-chief of diet4u.org blog

View all posts by Katarzyna Kroteniuk →

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