Hand, Foot, and Mouth Disease

Hand, Foot, and Mouth Disease

Hand, foot, and mouth disease (HFMD) is a viral infection caused by human enteroviruses and transmitted through contact with saliva, nasal discharge, blisters, or rashes on the skin of a diseased person. Because HFMD is most commonly found in infants, young children, or school-age children under the age of five, outbreaks are frequently found in schools or nurseries. Typically, a large outbreak occurs during the rainy season, when the weather is cool and humid, allowing the infection to spread more quickly. Even though the diseased lesions have recovered from the symptoms of hand, foot, and mouth disease, they can act as a vector to spread the infection to others for several weeks.

What are the early symptoms of hand, foot, and mouth disease?

Hand, foot, and mouth disease begins with symptoms in children such as fever, sore throat, loss of appetite, and fussiness. Children who contract hand, foot, and mouth disease during the rainy season experience an incubation period of three to six days, followed by a fever that lasts for one to two days, clear fluid blisters on the front of the mouth and throat, and a non-itching rash that may include clear water blisters or tiny bumps on the palms, soles of the feet, or buttocks. While only a few of the aforementioned symptoms may appear in some cases, others may experience all of them. HFMD symptoms are typically not severe and can go away on their own in 7–10 days.

Children who have pediatric hand, foot, and mouth disease may experience seizures caused by the herpangina virus, a pediatric hand, foot, and mouth disease virus in the same family as hand, foot, and mouth disease. In addition, a sudden high fever, and clear blisters at the back of the mouth and throat may appear, as well as blisters on the hands, feet, or other parts of the body.

When to see the doctor

If your child is younger than six months or unable to eat or drink, seek immediate medical care, as this can lead to dehydration. If symptoms last longer than ten days, consult a doctor.

Causes

The coxsackievirus 16, one of the viruses in a group called nonpolio enteroviruses, is the cause of hand-foot-and-mouth disease. However, other types of enteroviruses can also cause the disease.

The disease spreads from person to person through exposure to saliva, nasal discharge, respiratory droplets from coughing or sneezing, blister fluids, or stool of an infected person.

Risk factors

• Young age
  Anyone can contract hand-foot-and-mouth disease, but children younger than 5-7 years old are most affected by the disease. Because the highly contagious virus spreads through person-to-person contact, children in childcare centers can become easily infected. Older children and adults usually develop immunity after viral exposure.

Complications

Hand-foot-and-mouth disease usually causes mild symptoms which can clear on their own. However, some children may develop complications as follows.

• Dehydration
  Children tend to drink and eat less because of mouth sores. If they cannot eat or drink anything, your doctor may recommend a hospital stay for intravenous (IV) fluids.
• Viral meningitis
  If the enterovirus enters the central nervous system, it can cause inflammation of the meninges and cerebrospinal fluid surrounding the brain and spinal cord. However, this is rare.
• Encephalitis
  A rare brain inflammation that can be severe and life-threatening.

Prevention

• Wash hands with soap and water before eating or preparing food. Clean your hand thoroughly after sneezing, coughing, changing diapers, or using the toilet. 
• Clean toys and common areas, such as doorknobs 
• Teach your children how to wash their hands properly. Explain and remind them why they should not put their fingers, toys, or any other objects in their mouths. 
• Avoid direct contact with sick people. Refrain from going to the childcare center if your child is sick.

Diagnosis

The doctor will ask you about the child’s age and evaluate the symptoms of mouth sores to assess if it is from hand-foot-and-mouth disease or other viral infections. The doctor may order a throat swab or stool exam to check the type of virus.

Treatment

Currently, there are no specific medications for hand-foot-and-mouth disease. It usually resolves on its own within 7-10 days. Mouth soreness can be relieved with a topical oral anesthetic, acetaminophen, or ibuprofen.

Home remedies

Due to pain from the blisters in the mouth and throat, your child may lose their appetite. You can follow the tips below to encourage them to eat or drink and lessen the soreness.

• Rinse the child’s mouth with saline solution to relieve the inflammation and pain. 
• Avoid eating or drinking citrus fruits, juice, or soda as they are acidic. 
• Give your children something cold such as popsicles, ice chips, ice cream, and yogurt, to soothe the pain.
• Sip cold water.
• Try soft foods if chewing hurts.

Preparation before seeing a doctor.

• List your child's symptoms and medical history.
• Write down all medications or dietary supplements and their dosages your child takes.
• Write down questions you would like to ask the doctor.

Sample of questions you may want to ask the doctor.

• What's the cause of the symptoms?
• Does my child need to undergo any tests?
• How can I alleviate symptoms to make my child comfortable?
• Are there restrictions I should know?