Hand, Foot and Mouth Disease


Have a family member with hand, foot and mouth disease? Be sure to wash your hands regularly.
Have a family member with hand, foot and mouth disease? Be sure to wash your hands regularly.
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Before 1995, U.S. parents sometimes held "chickenpox parties." A neighborhood child laid up with the itchy bumps would be invited to mingle with healthy kids in the hopes that they would develop immunity to the virus due to exposure.

While we can now inoculate our little ones against chickenpox, there's an assortment of other illnesses that prefer children as their hosts.

Croup, for example, with its signature barking cough, most often finds its home in a 2-year-old's body. Impetigo, a highly contagious bacterial skin infection, targets kids ages 2 to 6. And hand, foot and mouth disease, a viral illness, tends to select its victims from the 5-and-under pool.

If you mention that your child has hand, foot and mouth disease to someone without a medical background, we can almost guarantee that someone will say, "Wait, don't you get that from pigs?" Rest assured that hoof-and-mouth disease is not the same thing, although it's sometimes called foot-and-mouth disease, further adding to the confusion. (Some very literal people named both illnesses.) It's not the same virus.

The culprit behind hand, foot and mouth in the U.S. is usually a coxsaccievirus (coxsackievirus A16 is the most prevalent), and the virus crops up in summer and fall. In east and Southeast Asia, enterovirus 71 sometimes strikes, and with deadlier results; 153 deaths were reported in Vietnam between Jan. 1 and Nov. 15, 2011 [source: World Health Organization]. Most cases of hand, foot and mouth disease, however, are mild, as we'll discuss on the next pages.

Hand, Foot and Mouth Disease Symptoms

Hand, foot and mouth disease usually doesn't require any diagnostic tests because the symptoms are so distinct.

It takes about three days for hand, foot and mouth to show itself. A child may have a fever, headache or sore throat and seem lethargic or irritable. But the symptoms of hand, foot and mouth that confirm its victory are a skin rash and mouth sores.

In a child showing all symptoms, you would notice red spots on palms and soles, and perhaps on knees, elbows or buttocks (hand, foot, mouth and rear-end disease is just too wordy). Inside his or her mouth, you would see what look like blisters with fluid in them. These sores can turn into painful ulcers. (There's a very similar condition called herpangina, but those blisters tend to be toward the back of the mouth instead of the front, and there's no skin rash involved [source: Perlstein].

Because it hurts to swallow, kids might not want to take in any fluids, so dehydration is a real danger. If a child isn't peeing much or has dark urine and has a dry tongue or sunken eyes, you need to see a doctor. In some cases, an IV is needed to deliver the proper amount of fluids.

It is possible for hand, foot and mouth disease to lead to serious complications. It's rare, but viral meningitis and encephalitis have both been known to follow, so trust your gut and call the doctor if symptoms get more serious and if a high fever and excruciating headache develop.

Some lucky people, particularly adults, don't show any symptoms at all, which is worrisome considering that the virus is very contagious, especially in the first week. That's why prevention is so important, which we'll learn more about on the next page.

Hand Foot and Mouth Disease Treatment

If you have hand, foot and mouth disease, good news: It usually goes away by itself after about a week.

But in the meantime, if you or a loved one isn't feeling fabulous, there are some things you can do to ameliorate the discomfort:

  • Use over-the-counter pain medications, such as ibuprofen. (Note: Do not give aspirin to any child under the age of 14. Its usage is linked to a rare-but-serious illness called Reye's syndrome.)
  • Pick up some oral numbing spray.
  • Try sucking on ice cubs, popsicles and anything else cold.
  • Stay away from spicy, salty and acidic foods and beverages.
  • Rinse with warm saltwater after meals.

As with most illnesses, taking measures to prevent infection is much easier than dealing with the subsequent symptoms. You get the virus from infected people -- who may or may not show symptoms. What to watch out for: contact with saliva, mucus and poop. That may not sound hard to do, except when you remember that this particular virus loves kids, and kids love getting their bodily excretions pretty much everywhere. And, the hand, foot and mouth virus can stick around for weeks, even after the person seems to have recovered completely.

That means we give you free license to wash your hands like Lady Macbeth and disinfect every surface within reach. Be especially careful at child care centers. If you're the one applying antibiotic cream to skin blisters that have burst, wear gloves while you do it.

Absolutely, positively keep kids at home until they're better and stay home from work until you are, too, lest you infect an entire classroom of 4-year-olds -- or an office of adults.

Now, ready to learn more? We have lots more information on the next page.

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Sources

  • Centers for Disease Control (CDC). "Hand, Foot and Mouth Disease (HFMD)." Oct. 13, 2011. (Dec. 5, 2011) http://www.cdc.gov/hand-foot-mouth/index.html
  • Mayo Clinic. "Hand-foot-and-mouth disease." Aug. 26, 2011. (Dec. 5, 2011) http://www.mayoclinic.com/health/hand-foot-and-mouth-disease/DS00599
  • MedlinePlus. "Hand foot mouth disease." Aug. 7, 2011. (Dec. 7, 2011) http://www.nlm.nih.gov/medlineplus/ency/article/000965.htm
  • Mersch, John. "Hand Foot and Mouth (HFM) Disease." MedicineNet.com. (Dec. 7, 2011) http://www.medicinenet.com/hand-foot-and-mouth_syndrome/article.htm
  • Perlstein, David. "What is the difference between herpangina and hand foot and mouth disease?" MedicineNet.com. Feb. 8, 2011. (Dec. 9, 2011) http://www.medicinenet.com/herpangina/page3.htm
  • WebMD. "Hand-Foot-and-Mouth Disease." April 14, 2011. (Dec. 5, 2011) http://children.webmd.com/tc/hand-foot-and-mouth-disease-topic-overview
  • World Health Organization (WHO). "Hand, Foot and Mouth Disease (HFMD)." Nov. 29, 2011. (Dec. 7, 2011) http://www.wpro.who.int/health_topics/hfmd/