Hand, foot & mouth Disease

By Sr Teresa Hayward (RN, RM, Lactation consultant, Infant & Paediatric Nutritionist, Baby Sleep Consultant)

Hand-foot-and-mouth disease is a mild, contagious viral infection common in young children, and is characterized by sores in the mouth and a rash on the hands and feet. Hand-foot-and-mouth disease is caused by a coxsackievirus.

There's no specific treatment for hand-foot-and-mouth disease. Frequent hand-washing and avoiding close contact with people who are infected with hand-foot-and-mouth disease may help reduce your child's risk of infection.

Symptoms

• Hand-foot-and-mouth disease often causes a rash of painful, red, blister-like lesions on the palms of the hands.

• Hand-foot-and-mouth disease often causes a rash of painful, red, blister-like lesions on the soles of the feet.

• Fever

• Sore throat

• Feeling of being unwell (malaise)

• Painful, red, blister-like lesions on the tongue, gums and inside of the cheeks

• A red rash, without itching but sometimes with blistering, on the palms, soles and sometimes the buttocks

• Irritability in infants and toddlers

• Loss of appetite

The usual period from initial infection to the onset of signs and symptoms (incubation period) is three to six days. A fever is often the first sign of hand-foot-and-mouth disease, followed by a sore throat and sometimes a poor appetite and malaise.

One or two days after the fever begins, painful sores may develop in the front of the mouth or throat. A rash on the hands and feet and possibly on the buttocks can follow within one or two days.

Sores that develop in the back of the mouth and throat may suggest that your child is infected with a related viral illness called herpangina. Other distinguishing features of herpangina include a sudden high fever and in some instances, seizure. Sores that develop on the hands, feet or other parts of the body are very rare.

When to see a doctor

Hand-foot-and-mouth disease is usually a minor illness causing only a few days of fever and relatively mild signs and symptoms. Contact your doctor if mouth sores or a sore throat keep your child from drinking fluids. And contact your doctor if after a few days, your child's signs and symptoms worsen.

Causes

Oral ingestion is the main source of coxsackievirus infection and hand-foot-and-mouth disease. The illness spreads by person-to-person contact with an infected person's:

• Nasal secretions or throat discharge

• Saliva

• Fluid from blisters

• Stool

• Respiratory droplets sprayed into the air after a cough or sneeze

Common in child care setting

Hand-foot-and-mouth disease is most common in children in child care settings because of frequent diaper changes and potty training, and because little children often put their hands in their mouths.

Although your child is most contagious with hand-foot-and-mouth disease during the first week of the illness, the virus can remain in his or her body for up to 2weeks after the signs and symptoms are gone. That means your child still can infect others.

Some people, particularly adults, can pass the virus without showing any signs or symptoms of the disease.

Prevention

Certain precautions can help to reduce the risk of infection with hand-foot-and-mouth disease:

• Wash hands carefully. Be sure to wash your hands frequently and thoroughly, especially after using the toilet or changing a diaper and before preparing food and eating. When soap and water aren't available, use hand wipes or gels treated with germ-killing alcohol.

• Disinfect common areas. Get in the habit of cleaning high-traffic areas and surfaces first with soap and water, then with a diluted solution of chlorine bleach and water. Child care centers should follow a strict schedule of cleaning and disinfecting all common areas, including shared items such as toys, as the virus can live on these objects for days. Clean your baby's pacifiers often.

• Teach good hygiene. Show your children how to practice good hygiene and how to keep themselves clean. Explain to them why it's best not to put their fingers, hands or any other objects in their mouths.

• Isolate contagious people. Because hand-foot-and-mouth disease is highly contagious, people with the illness should limit their exposure to others while they have active signs and symptoms. Keep children with hand-foot-and-mouth disease out of child care or school until fever is gone and 5 days after mouth sores have healed.