Hand, foot and mouth disease: what you need to know

(Photo provided)

Parents have been asking me a mouthful of questions about an illness called hand, foot and mouth disease. While commonly associated with younger children, it has begun to show up in teens and young adults as well.

When does this happen?

Hand, foot and mouth disease is often seen in the summer in younger children. However, it’s also seen in the fall when school starts as students gather in classrooms and dormitories. This is the perfect space for the illness to spread. It is caused by a virus, most commonly one named “Coxsackie A16” that infects the body’s digestive tract and spreads due to poor hand washing. For older teens living in dorms, the close quarters together promote this illness.

Symptoms of hand, foot and mouth disease

So what are the symptoms of this viral illness? Fever is almost always present at some point, but the “mouth” name comes from small, painful sores that appear on the throat, gums, tongue and inside the cheeks. These sores are combined with a rash of tiny blisters on the hands and soles of the feet, hence the “hand and foot” part of this illness’s name.

In older children there may also be complaints of headache or a decreased appetite. Unfortunately, since this is a virus that likes to frolic in the intestines, it can cause diarrhea as well.

Treating hand, foot, and mouth disease

So how do we treat hand-foot-mouth disease? Sadly, there is no medicine we can prescribe to kill the virus other than our own immune systems, which do destroy the virus over time.

Thus, treatment involves symptomatic care. This involves good hydration and acetaminophen for fever and mouth pain until the virus is gone. Your child’s health care professional may recommend a prescription mouthwash that can ease the mouth pain by numbing the sores. Additionally, cold foods like ice cream and popsicles can help this pain.

The good news is that even without treatment, children usually recover within seven to 10 days. However, remember they can continue to shed the virus from their nose, mouth and lungs for another one to two weeks. This shedding can continue in their bowel movements for weeks to months after the infection starts.

Common complication

The most common complication of having this viral disease is dehydration from children’s mouths hurting too much. Unfortunately, your child may require intravenous rehydration.

Even rarer would be if the virus got into the fluid surrounding the brain. This would cause a type of viral meningitis. If the virus got into the heart muscle, it can cause a type of heart disease called viral myocarditis. Your child’s health care professional can diagnose these very rare complications if you are worried they might be occurring. Look out for changes in your child’s level of alertness or if they appear short of breath.

Best prevention practices

As to prevention, like with most viruses, the secret to prevention and spread is good hand washing. If a child becomes ill with this type of infection, they should stay out of school, summer camps and swimming pools so as not to increase the chance that the virus will spread to other children.

Hopefully tips like these will have you hand over foot ahead of the game when it comes to knowing more about hand, foot and mouth disease.

Lewis First, MD, is chief of pediatrics at the University of Vermont Children’s Hospital and chair of the Department of Pediatrics at the University of Vermont College of Medicine. You can also catch “First with Kids” weekly on WOKO 98.9FM and WPTZ Channel 5, or visit the First with Kids video archives at www.UVMHealth.org/MedCenterFirstWithKids.


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