Hand, Foot and Mouth Disease
Hand, foot, and mouth disease (HFMD) is a common viral illness usually affecting infants and children but also can affect adults. The cause of hand, foot and mouth disease is mainly due to Coxsackievirus A type 16 and Enterovirus 71 (EV71). Hand, foot, and mouth disease usually resolves on its own within a week or so. But there are things you can do to help relieve the symptoms.
Symptoms of hand, foot and mouth disease
The main symptoms are sores in the mouth, and on the hands, feet, buttocks, and sometimes genitals. They can look like small spots, bumps, or blisters. Symptoms often appear three to seven days after being infected and might persist for seven to ten days. Some children may also develop fever too
The sores in the mouth can make swallowing food and liquid to be painful causing poor appetite and reduced oral intake. The sores on the hands and feet might sometimes be painful too. Not every person gets them on all the specified areas.
How does hand, foot and mouth disease spread?
The virus that causes HFMD can travel in body fluids of an infected person. For example, the virus can be found in:
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Mucus from the nose
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Saliva
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Fluid from one of the sores
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Traces of bowel movements (in the poo) for several weeks after having recovered from the infection
People with HFMD are most likely to spread the infection during the first week of their illness. But the virus can live in their body for weeks or even months after the symptoms have gone away.
Is there a test for hand, foot and mouth disease?
Yes, but it is not usually necessary. The doctor should be able to tell if a child has it by learning about their symptoms and performing a physical examination.
When should your children visit the doctor?
You should call the doctor if your child
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is drinking less than usual with very dry mucosa (tongue)
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has not had a wet diaper for 4 to 6 hours (for babies and young children)
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has not pass urine, very little,concentrated urine in the past 6 to 8 hours (for older children).
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is inactive, sleeping all the time, condition seems to be getting worsening, or not or is not getting better after a few days.
How is hand, foot and mouth disease being treated?
HFMD is usually self-limiting and it usually goes away on its own within about a week. But children who are in pain can take over-the-counter medicines such as paracetamol (sample brand name: Panadol) or ibuprofen (sample brand names: Brufen) to relieve pain and discomfort they are experiencing. Never give aspirin to a child younger than 18 years. In children, aspirin can cause a serious problem called Reye syndrome. HFMD is caused by viruses and hence, antibiotics will not be effective to be used for this infection. Blisters should be left to dry naturally and do not pierce or squeeze them. Since HFMD is easily contagious from one person to another, it is important to nurse the child unwell person from other family member, especially other younger children at home.
The sores in the mouth can make swallowing painful, so some children might not want to eat or drink. It is important to make sure that children get enough fluids so that they don't get dehydrated. Cold foods, like popsicles and ice cream, can help to numb the pain. Soft foods, like pudding and gelatin, might be easier to swallow in this situation.
Prevention of hand, foot and mouth disease
The most important thing you can do to prevent the spread of this infection is to wash your hands often with soap and water, even after the child is feeling better. Teach children to wash their hands often, especially after using the bathroom.
It is also important to keep your home clean and to disinfect tabletops, toys, and other things that a child might touch. Make sure your child does not share items such as cutlery, drinking cups, towels, toothbrushes.
If a child has hand, foot, and mouth disease or herpangina, keep them out of school or day care, especially if they have a fever or do not feel well enough to go. You should also keep the child home if they are drooling a lot or have open sores (wait until the blisters are completely dried off).
Medically reviewed by Ashwini Nair, MB BCh BAO.
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References:
1. Guerra AM, Orille E, Waseem M. Hand Foot And Mouth Disease. In: StatPearls. StatPearls Publishing; 2022. Accessed May 28, 2022. http://www.ncbi.nlm.nih.gov/books/NBK431082/
2. Patient education: Hand, foot, and mouth disease and herpangina (The Basics) - UpToDate. Accessed May 28, 2022. https://www.uptodate.com/contents/hand-foot-and-mouth-disease-and-herpangina-the-basics?search=hand%20food%20mouth&source=search_result&selectedTitle=3~150&usage_type=default&display_rank=3
