Hand, foot and mouth disease (HFMD) is a contagious viral infection that most often affects children under 5 years old but can happen to anyone. This infection can cause a lot of misery during the week or so that symptoms are present, but it usually resolves without specific treatment or interventions.
Symptoms and Cause
The cause of this miserable fever and rash is a virus known as the coxsackievirus. Symptoms are usually mild and include:
Rash: Small, red spots with blisters appear around or in the mouth. Blisters also occur often on the palms of the hands and soles of the feet, as well as arms and legs.
Fever: HFMD often begins with a mild fever, which usually only lasts a few days before resolving.
Sore throat: This often leads to excessive drooling.
Decreased appetite: Painful mouth sores can reduce a child’s appetite or even lead to refusal to eat or drink.
Behavior changes: Children may be more fussy or irritable than usual.
Supportive Care and Treatment
HFMD is a viral illness, and there are no specific medications to improve symptoms faster.
- Cold and frozen food and drinks help soothe and numb the mouth sores. Smoothies and Popsicles are great options!
- Offer cold beverages frequently throughout the day to decrease the risk of dehydration.
- After bathing, pat the blisters dry. Don’t rub or scratch at them.
- Cover the blisters or use mittens/gloves if your child can’t stop scratching.
- Avoid foods and beverages that may worsen discomfort:
- Warm or carbonated beverages
- Acidic foods like oranges and tomatoes
When to Seek Medical Attention:
While HFMD is usually mild, some symptoms do require further medical evaluation.
Dehydration is the biggest concern. Some children simply refuse to eat or drink due to the painful sores. Signs of dehydration in young children include:
- Dry mouth
- Sunken eyes
- Crying without tears
- Fewer wet diapers
- Extreme fatigue or difficulty waking from sleep
The second concern is a fever that lasts more than three days.
As always, call your doctor’s office if you have concerns about your child’s symptoms or behavior.
Returning to School, Daycare and Activities
HFMD is a highly contagious virus that spreads easily in schools, daycares and among family members. The virus is present in mucus (snot), feces (poop) and blister fluid.
People infected with HFMD are contagious before the rash appears, which makes it challenging to control the spread. Most children feel better within a week of symptom onset, even if they still have blisters.
Most schools and daycares follow guidelines for return similar to those for other viral illnesses. Children should be fever-free for at least 24 hours (without using fever-reducing medication). The rash should be improving but does not have to be completely gone.
Prevention Measures
Hand hygiene: Teach your kids to wash their hands thoroughly with soap and water, especially after using the toilet or playing with other kids. This is the best way to prevent spread.
Surface cleaning: The virus that causes HFMD can live on surfaces for several days. Regularly disinfect frequently touched surfaces, toys and play areas to reduce this transmission risk.
Avoid close contact: Encourage children to avoid close contact with anyone showing symptoms of HFMD. This includes hugging, kissing and sharing utensils or cups.
Respiratory hygiene: Teach children to cover their mouth and nose when coughing or sneezing. Provide tissues and encourage proper disposal.
Joleen Sams is a family nurse practitioner who lives in Shawnee with her family.
References
Children's Hospital of Philadelphia; Nemours Kids Health.