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Hand-Foot-And-Mouth Disease

Overview

Hand-foot-and-mouth disease (HFMD) is a common, usually mild illness that often affects young children. It's caused by a virus, most often a type called coxsackievirus. This virus leads to a few key symptoms. The most noticeable are sores inside the mouth, and a rash that appears on the hands and feet.

Unfortunately, there's no medicine to cure HFMD. The best way to protect children is to practice good hygiene. Regular handwashing is very important, especially if someone in your child's environment has HFMD. Also, keeping your child from being in close contact with anyone who's sick with this virus can help prevent them from catching it.

Symptoms

Hand, foot, and mouth disease (HFMD) is a common childhood illness that can cause a range of symptoms. While not everyone experiences all the symptoms, some of the most frequent ones include:

  • Fever: A rise in body temperature.
  • Sore throat: Pain or discomfort in the throat.
  • Feeling unwell: General discomfort or a lack of energy.
  • Mouth sores: Small, painful, blister-like sores can develop on the tongue, gums, and inside the cheeks. These sores are often very uncomfortable.
  • Skin rash: A rash appears on the palms of the hands, soles of the feet, and sometimes on the buttocks. This rash is typically not itchy, but it might have small blisters. The rash's appearance can vary depending on skin tone, ranging from red and white to gray, or it might just look like tiny bumps.
  • Irritability (in infants and toddlers): Babies and young children might become more fussy or cranky.
  • Loss of appetite: A reduced desire to eat.

These symptoms typically appear a few days after infection. It's important to note that the severity of symptoms can differ greatly from person to person. If you have concerns about HFMD, consult a healthcare professional.

When to see a doctor

Hand-foot-and-mouth disease (HFMD) is typically a mild illness. Most people who get it only have a fever and a few other, relatively mild symptoms that last for just a few days. These symptoms are usually easy to manage.

However, it's important to contact a doctor if your child is under six months old. Babies younger than six months are more vulnerable to illness. Also, if your child has a weakened immune system, this could make them more susceptible to complications. If your child has mouth sores or a sore throat so painful that it's hard for them to swallow, it's crucial to seek medical advice. This is because these symptoms can lead to dehydration.

If your child's symptoms don't get better within about 10 days, it's a good idea to call your healthcare provider. This is especially important if the symptoms are worsening or causing discomfort.

Causes

Hand-foot-and-mouth disease (HFMD) is often caused by a virus called coxsackievirus 16. This virus is part of a larger family of viruses called enteroviruses, which also include other types that can sometimes cause HFMD.

Most people catch the virus, and therefore HFMD, through their mouths. The virus spreads easily from one person to another through various ways of contact with an infected person. These include:

  • Droplets from the nose and throat: When someone with HFMD coughs or sneezes, tiny droplets containing the virus are released into the air. If you breathe these droplets in, you can get infected.
  • Saliva: The virus can be found in saliva, so kissing or sharing utensils with someone who has HFMD can spread the infection.
  • Fluid from blisters: Small blisters often appear on the hands, feet, and mouth of people with HFMD. Touching these blisters and then touching your mouth or eyes can spread the virus.
  • Stool: The virus can also be found in the stool of infected people. Contamination of surfaces or objects from infected stool is a common way of spreading the disease, so handwashing is crucial.
  • Direct contact: Simply touching a contaminated surface (like a doorknob) and then touching your mouth can spread the virus. Frequent handwashing is vital for preventing the spread.
Risk factors

Hand-foot-and-mouth disease (HFMD) is most common in young children, typically those under 5 to 7 years old. This is because the illness is spread easily from one person to another through close contact. Kids in daycare or preschool settings are particularly at risk due to the close proximity of children.

While young children are most susceptible, anyone can catch HFMD.

Older children and adults often have some protection against HFMD. This is because their bodies have developed antibodies to the viruses that cause the disease. They've likely been exposed to these viruses before, and their immune systems have learned to fight them off. Even so, older children and adults can sometimes still get HFMD.

Complications

Hand, foot, and mouth disease (HFMD) is often a mild illness. It typically causes a fever and some discomfort for a few days. The most common problem is dehydration. The sores in the mouth and throat can make it hard to eat and drink, leading to a loss of fluids.

It's important to encourage your child to drink plenty of liquids while they have HFMD. This can help prevent dehydration. If your child becomes significantly dehydrated, they might need fluids given directly into a vein (intravenous, or IV) at the hospital.

While most cases are mild, there's a small chance HFMD can lead to more serious complications. Sometimes, the virus that causes HFMD can affect the brain. These complications are rare:

  • Viral meningitis: This happens when the membranes around the brain and spinal cord (the meninges) become infected and inflamed. It's a rare but possible complication of HFMD.
  • Encephalitis: This is a more serious complication where the brain itself becomes inflamed. This is rare but can be life-threatening. Encephalitis is a serious condition that can cause swelling in the brain. Symptoms might include high fever, headache, stiff neck, confusion, seizures, or loss of consciousness.

If you notice any unusual symptoms like a stiff neck, confusion, seizures, or loss of consciousness, seek immediate medical attention. These rare complications, while serious, are treatable if caught early.

Prevention

Protecting Your Child from Hand, Foot, and Mouth Disease

Hand, foot, and mouth disease (HFMD) is a common childhood illness. You can take steps to lower your child's risk of getting it.

Frequent Handwashing is Key: Washing hands thoroughly is the most important thing you can do. This means washing for at least 20 seconds with soap and water. Make sure to wash hands:

  • After using the bathroom or changing diapers.
  • Before and after preparing or eating food.
  • After blowing your nose, coughing, or sneezing.

If soap and water aren't available, use hand sanitizer.

Teach Good Hygiene Habits: Show your child how to wash their hands properly and encourage frequent handwashing. It's also vital to teach them good overall hygiene. Explain why touching their mouth, nose, or eyes with their hands is not a good idea. This includes touching shared objects or toys.

Clean and Disinfect Regularly: Clean high-traffic areas and surfaces in your home or child care setting often. Start by cleaning with soap and water, then follow up with a diluted bleach solution. (Always follow the instructions on the bleach container for proper dilution.) This is especially important in child care settings where the virus can live on surfaces for several days. This includes door handles, toys, and other shared items.

Limit Close Contact During Illness: HFMD is very contagious. To protect others, anyone with HFMD symptoms should limit contact with other people. Keep children with HFMD out of school or daycare until their fever is gone and their mouth sores have healed. If you are sick with HFMD, stay home from work. This helps prevent the spread of the illness.

Diagnosis

Doctors usually figure out if a child has hand-foot-and-mouth disease (HFMD) or another viral illness by looking at a few things.

First, the doctor will consider the child's age and symptoms. Things like how the child is feeling (e.g., fever, tiredness, aches) and how long they've been sick are important clues. The doctor will also carefully examine any rash or sores on the child's hands, feet, mouth, or other parts of the body. The appearance of these spots – their size, shape, and color – helps determine what's going on.

Sometimes, the doctor might need more information. They might take a small sample from the child's throat or stool. This sample is sent to a lab to identify the specific virus causing the illness. This extra step helps the doctor make a more precise diagnosis and can guide treatment decisions.

Treatment

Hand-foot-and-mouth disease (HFMD) doesn't have a special cure. The symptoms, like sores in the mouth, on the hands, and feet, typically go away on their own within a week or ten days.

To help with the pain from mouth sores, you can use a medicine that numbs the area. For general discomfort, over-the-counter pain relievers like acetaminophen (often sold as Tylenol) or ibuprofen (like Advil or Motrin) can be helpful. Important note: Never give aspirin to children or teenagers, as it can cause a serious condition called Reye's syndrome.

Self-care

Mouth sores can be uncomfortable for kids. Certain foods and drinks can make them worse. Here are some simple ways to help your child feel better and eat more easily:

If your child can rinse without swallowing, gently swishing warm salt water in their mouth a few times a day can help reduce pain and swelling from mouth sores. (Dissolve a small amount of salt in warm water. Too much salt can hurt, so start with a small amount and adjust as needed.)

Here are some other ways to make eating and drinking more comfortable:

  • Cold treats: Ice pops or chips, and ice cream or sherbet can help numb the pain.

  • Cool drinks: Cold water is soothing.

  • Warm drinks: Warm drinks like tea can also be comforting for some children.

  • Avoid the triggers: Foods and drinks that are acidic, like citrus fruits, juices, and soda, can irritate the sores. Try to avoid these until the sores heal.

  • Easy-to-eat foods: Soft foods like mashed potatoes, yogurt, or applesauce are easier to eat without needing much chewing. This can help avoid further discomfort.

Preparing for your appointment

Taking your child to the doctor for hand-foot-and-mouth disease? Here's how to prepare.

First, schedule an appointment with your child's primary doctor. Before the appointment, it's helpful to prepare.

Getting Ready for Your Appointment

When you book the appointment, ask if there are any special preparations needed, like fasting for a test. Make a list of:

  • Your child's symptoms: Include all symptoms, even those that seem unrelated to the main concern.
  • Important personal details: Write down any major stress, recent life changes, and the family's medical history.
  • All medications, vitamins, and supplements: List the names and doses of everything your child takes.
  • Questions for the doctor: Write down questions you want to ask.

Questions to Ask the Doctor

It's important to ask questions to get the best care for your child. Here are some examples:

  • Possible causes: What's the most likely cause of my child's symptoms? What are other possibilities?
  • Testing: What tests does my child need?
  • Treatment plan: What's the best course of action?
  • Managing existing conditions: If my child has other health conditions, how can we manage them together?
  • Home remedies: What can I do at home to help my child feel better?
  • Restrictions: Are there any restrictions or precautions I need to follow?
  • Information resources: Are there any brochures or printed materials I can get? Do you recommend any websites?

Information the Doctor May Ask You

The doctor will likely ask you questions too. Be prepared to answer:

  • Onset of symptoms: When did your child's symptoms start? Were they constant or occasional?
  • Severity of symptoms: How bad are the symptoms?
  • Exposure to others: Has your child recently been around anyone who was sick? Have you heard of any illnesses at their school or daycare?
  • Symptom triggers: What seems to improve your child's symptoms? What seems to make them worse?

Helping Your Child Feel Better at Home

To ease your child's discomfort, try these tips:

  • Rest: Encourage plenty of rest.
  • Hydration: Make sure your child drinks enough fluids to avoid dehydration.
  • Avoid irritants: Keep your child away from cigarette smoke (both direct and secondhand) and anything else that might irritate their mouth and throat.

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Disclaimer: August is a health information platform and its responses don't constitute medical advise. Always consult with a licenced medical professional near you before making any changes.

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