Childhood Diseases – On a Mission to Educate: Hand, Foot, & Mouth ...

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My last article, ”Childhood Diseases – On a Mission to Educate: Kawasaki Syndrome“ we learned that Kawasaki Syndrome is an acute childhood illness that causes inflammation of the blood vessels in many areas of the body. We learned that if it is not diagnosed and treated early, it can cause damage to the coronary arteries which supply the heart with oxygen. Most children with Kawasaki disease will have a fever lasting five or more days, redness in both eyes, changes around the lips, tongue or mouth, swelling, peeling and color changes in the fingers and toes, a rash, large swollen lymph node in the neck and red, swollen palms of the hands and soles of the feet. Most children who have the disease usually recover if treated early. . Today I would like to move onto another childhood illness called Hand, Foot, & Mouth Disease.”

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What Is Hand, Foot, & Mouth Disease?

According to Cleveland Clinic (https://my.clevelandclinic.org/health/articles/hand-foot-mouth-disease) Hand, Foot, & Mouth Disease (HFMD) is a mild, infectious childhood illness that is caused by a number of different viruses. This illness is caused most often by the Coxsackie Virus. HFMD gets its name from the blister-like rash that usually forms on the hands, feet & mouth.

This common & benign viral disease of childhood occurs most often in the late summer and early fall. It is not considered a serious disease and will actually disappear within a week or so. It should be noted that this disease "Is Not" the common foot and mouth disease which appears in cattle, otherwise known as mad cow disease.

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What Are the Symptoms of Hand, Foot, & Mouth Disease?

The following symptoms, according to Mayo Clinic (https://www.mayoclinic.org/diseases-conditions/hand-foot-and-mouth-disease/symptoms-causes/syc-20353035), may all be present due to Hand, Foot & Mouth Disease or only some of them:

Fever

Sore throat

Feeling of being unwell (malaise)

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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

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What Causes Hand, Foot, & Mouth Disease & How Is It Spread?

According to Health Line (https://www.healthline.com/health/hand-foot-mouth-disease#causes3)”Hand, foot, and mouth disease is often caused by a strain of coxsackievirus, most commonly coxsackievirus A16. The coxsackievirus is part of a group of viruses called Enteroviruses. In some cases, other types of Enteroviruses can cause hand, foot, and mouth disease. “

Per Health Line viruses can be easily spread from person-to-person. Children may contract hand, foot and mouth disease by contact with an infected person’s:

Saliva

Fluid from blisters

Feces

Respiratory droplets sprayed into the air after coughing or sneezing

Another way of spreading the HFMD virus is through direct contact with unwashed hands or touching a surface that contains traces of the virus.

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Who Is at Risk for Hand, Foot, & Mouth Disease?

Young children have the highest risk of getting HFMD according to Health Line. Because young children attend daycare or school, the viruses can spread quickly and easily in these settings. Those children who are exposed to the viruses that cause HFMD usually build up immunity because of this exposure. Due to this immunity there are rarely children over the age of 10 that get HFMD. But it must be stressed there can be incidents of older children and adults who get this infection due to a weakened immune system.

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According to Medicine Net (https://www.medicinenet.com/hand-foot-and-mouth_syndrome/article.htm) the following are risk factors for developing HFMD:

Summer and fall seasons,

Toddler age range,

High-risk exposure location (such as daycare and preschool),

Ineffective hygiene -- infrequent soap and water hand-washing or not wearing disposable gloves when changing stool-containing diapers, and

A compromised immune system is more likely to develop HFMD.

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How Long Does It Take For Hand, Foot, & Mouth Disease Symptoms to Show?

It takes 3-6 days from the time the child is exposed to HFMD for the initial symptoms to show. According to Northeast Ohio Parent (https://www.northeastohioparent.com/?blogger=10-things-i-wish-i-knew-about-hand-foot-and-mouth-disease-before-my-son-had-it) the first symptom to show up is usually a fever. The child will be lethargic and exhibit a poor appetite. Due to a sore throat, a child may not want to drink water. The fever then tends to go away the next day and later the child will develop rash and blisters all over his/her hand, foot, mouth areas. By then most parents take their children to the doctors.

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How Is Hand, Foot, & Mouth Disease Diagnosed?

HealthOsphere (https://healthosphere.com/hand-foot-and-mouth-disease-in-children/) stated that Hand, Foot & Mouth Disease can be identified by the lesions on the hands, feet and mouth during an examination of the child. “These viruses can be grown in culture and can be verified by immunologic methods. One test called Tzanck smear is performed to isolate the condition from herpes simplex because hand, foot, and mouth disease is usually mistaken as herpes disease.”

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Treatment For Hand, Foot, & Mouth Disease

Health Line stated that the HFMD infection will generally go away within 7 – 10 days. Treatment is generally supportive. Some physicians may recommend certain treatments to ease the symptoms until the disease runs it course:

Prescription or over-the-counter topical ointments to soothe blisters and rashes

Pain medication, such as acetaminophen or ibuprofen, to relieve headaches

Medicated syrups or lozenges to ease painful sore throats

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Certain at-home treatments can also provide relief from hand, foot, and mouth disease symptoms. Health Line stated that you can try the following home remedies to help make blisters less bothersome:

Suck on ice or popsicles.

Eat ice cream or sherbet.

Drink cold beverages.

Avoid citrus fruits, fruit drinks, and soda.

Avoid spicy or salty foods.

Another suggestion is to swish warm salt water around the mouth to relieve the pain from the mouth blisters and throat sores. This can be done several times a day or as needed.

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Prevention Techniques to Reduce Hand, Foot, & Mouth Disease Infection

There are certain things parents can do to help reduce the risk of infection with HFMD according to Mayo Clinic:

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 mouth sores have healed. If you have the illness, stay home from work.

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Complications of Hand, Foot, & Mouth Disease

The most common complication of HFMD per Mayo Clinic is dehydration. The sores in the mouth and throat make swallowing painful and difficult. Parents need to monitor the child’s liquid intake and ensure that he/she takes frequent sips of fluid throughout the course of the illness. Sometimes if dehydration is severe, the doctor may have to have intravenous fluids (IV) to ensure fluid intake.

Hand, foot & mouth disease is generally a mild disease but in very rare situations the coxsackievirus can involve the brain and cause complications:

Viral meningitis. This is a rare infection and inflammation of the membranes (meninges) and cerebrospinal fluid surrounding the brain and spinal cord.

Encephalitis. This severe and potentially life-threatening disease involves brain inflammation caused by a virus. Encephalitis is rare.

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Advice to Parents About Hand, Foot, & Mouth Disease

Because HFMD is contagious parents need to know that the virus can be transmitted through nose and throat secretions & the fluid in the blisters or stool. According to the Baby Center (https://www.babycenter.com/0_hand-foot-and-mouth-disease_1614.bc) this disease is “most contagious during the week your child first shows symptoms but the virus can be transmitted for weeks afterward.” Baby Center recommends that if your child goes to daycare or school, parents should inform the staff that your child was diagnosed with HFMD. They stated that children should be kept at home if he/she:

Has a fever

Doesn't seem well enough to participate in class

Is drooling excessively

Has open blisters (which usually dry up in about seven days)

Meets your school's criteria for keeping a sick child at home

Parents should check with the child's doctor if they aren't sure when their child can return to daycare or school.

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In conclusion Hand, Foot, & Mouth Disease is a contagious but mild viral infection that is commonly diagnosed in infants & young children. It is caused by the coxsackievirus and it can be spread from person to person through direct contact. HFMD symptoms include fever, painful sores in the mouth, a rash on the palms of the hand, soles of the feet and occasionally on the buttocks. Eventually the rash turns into bumps or blisters. This disease is most common during the summer and fall. Good hand washing can help to prevent the spread of HFMD. Treatment is generally supportive.

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I hope you learned something from this article about Hand, Foot, & Mouth Disease. There are many resources on the internet if you need more specific information. I will continue this series with another childhood disease post. I hope you will continue to join me in this quest to learn about these illnesses that children usually encounter when they are young. Thank-you for reading my article on ”Childhood Diseases – On a Mission to Educate: Hand, Foot, & Mouth”. If you would like to follow me, please check HERE