Hand-Foot-And-Mouth Disease

Hand-foot-and-mouth disease is a contagious, viral disease characterized by sores in the mouth and a rash on the hands and feet, which usually affects young children. It is caused by a virus called coxsackievirus.

No specific treatment are available and only symptoms can be managed with current treatments. Good hygiene practice is the key to preventing hand-foot-and-mouth disease in your child.

A hand-foot-and-mouth may have some or all of the following symptoms:

• Fever
• Sore throat 
• Feeling ill (malaise) 
• Painful, red, blister-like lesions on the tongue, gums and inside of the cheeks
• A red rash that does not itch. Sometimes rash may be present with blistering, on the palms, soles and sometimes the buttocks 
• Irritability in infants and toddlers 
• Loss of appetite 

The symptoms become noticeable within 3 to 6 days after you were exposed to some risk factors. The symptoms may occur in sequence with a fever at the start followed by a sore throat and less often a poor appetite and malaise. Once the fever begins, symptoms like painful sores in mouth or throat develop within one or two days, followed by a rash on the hands and feet within next one or two days. Sometimes, the rash may be present on the buttocks. When to see a Doctor 

In most cases, this is a mild infection. Talk to your doctor if mouth sores or a sore throat is interfering with drinking in children. Schedule an appointment if the symptoms do not resolve within some days or worsen over time.

In most cases, hand-foot-and-mouth disease is caused by coxsackievirus A16, a member belonging to a group of viruses called nonpolio enteroviruses. The virus enters your body during swallowing or drinking. It can be transmitted through contact with an infected person's respiratory discharges, saliva, stool or fluid from blisters.

Children in child care setting are more likely to develop hand-foot-and-mouth disease. Though the first week of infection is the most infectious period, your child can transmit the virus to others even after weeks when the symptoms have resolved. Adults can appear healthy and show no signs and symptoms but they may still spread the infection.

In United States, occurrence of hand-foot-and-mouth disease is high in summer and autumn. Remember that foot-and-mouth disease and hand-foot-and-mouth disease are not same. Foot-and-mouth disease (sometimes called hoof-and-mouth disease) is an infectious viral disease found in farm animals.

A doctor can often diagnose hand-foot-and-mouth disease simply by performing a physical exam.

How to prepare yourself for the visit?

Getting prepared for the visit can optimize the therapy and help make the visit more fruitful.

List out all the symptoms in your child.

Write down your key medical information.

Write down the names of all your medications, vitamins or supplements.

Make a list of the questions to ask your doctor.

Some questions you might want to ask your doctor include:

• What could be probable causes of the symptoms?
• Does my child need any tests? 
• What's the best treatment approach? 
• Does my child need to take medicine? 
• How can I make my child more comfortable? 

What your doctor wants to know?

A clear talk with your doctor can optimize the therapy and improve the outcomes. Prepare yourself to answer some essential questions from your doctor. Your doctor might ask you typical questions like:

• When did symptoms first appear?
• How severe are the symptoms? 
• Has your child recently been exposed to an infected person? 
• Have you heard of any illnesses at your child's school or child care? 
• Does any factor improve or worsen the symptoms?

What you can do in the meantime?

You may follow these suggestions to reduce discomfort:

• Provide your child proper rest.
• Keep your child hydrated: Offer your child milk-based fluids instead of more acidic juice or soda. 
• You may give over-the-counter pain relievers like acetaminophen or ibuprofen but “not” aspirin.
• Encourage your child to use mouthwash or oral spray to reduce pain. 

Your doctor analyzes the factors like age of the affected person, appearance of rashes to differentiate hand-foot-and-mouth disease from other similar viral infections. S/he may also recommend tests for throat swab or stool specimen to identify the virus that caused the illness.

No specific treatments for hand-foot-and-mouth disease are available.

Under normal conditions, the signs and symptoms usually resolve in 7 to 10 days.

You may use a topical oral anesthetic to relieve pain of mouth sores. 

The following precautions help prevent infection with hand-foot-and-mouth disease:

• Properly wash your hands: Properly wash your hands with soap and water after using the toilet or changing a diaper and before preparing food and eating. If soap and water are not available, you may use antimicrobial hand wipes or gels.
• Disinfect common areas: Clean the surfaces first with soap and water and then with a diluted solution of chlorine bleach and water. Child care centers should strictly keep the environment clean, this includes all common areas, including shared items such as toys where the virus can survive.
• Wash properly your baby's pacifiers. 
• Teach good hygiene: Talk to your child about the health benefits of a good personal hygiene maintenance. 
• Isolate contagious people: Anyone suffering from this condition should to limit his/her exposure.
• Keep your child at home until all the symptoms have cleared up. 
• You may give your office a miss if you have this condition.

Lifestyle modifications are necessary in order to cope with hand-foot-and-mouth disease.

Blisters can be irritated by certain foods or drinks. Here are some tips that help to make the blisters more manageable:

• Take some ice cubes to keep the blisters cool. Likewise, you may take ice cream.
• Drink cold beverages, such as milk or ice water. 
• Avoid salty, acidic or spicy foods and beverages
• Eat soft foods that don't strain you while chewing. 
• Rinse or swish your mouth with warm water after meals.

There are several risks and complications associated with hand-foot-and-mouth disease.

Risks

• Kids below 10 years, often those under 5 years.
• Children in child care centers 

Complications

• Dehydration: The painful sores in your baby decrease water intake. Intravenous (IV) may be used if dehydration is severe.

Coxsackievirus may cause following complications:

• Viral meningitis: It causes inflammation if the covering of your brain and spinal cord (meninges).
• Encephalitis: It is a severe condition in which your brain becomes swollen.