Hand, Foot, And Mouth Disease (HFMD) In Children: Causes, Symptoms

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Hand, foot, and mouth disease (HFMD) is a common viral illness that primarily affects infants and children younger than 5 years old. It's characterized by sores in the mouth and a rash on the hands and feet. While highly contagious, HFMD is usually mild and most children recover within a week to ten days.

What Causes Hand, Foot, and Mouth Disease?

HFMD is most commonly caused by the coxsackievirus A16. Other coxsackieviruses and enteroviruses can also cause the disease. The virus spreads through:

  • Direct contact with nasal secretions, saliva, blister fluid, or stool of an infected person.
  • Respiratory droplets produced when an infected person coughs or sneezes.
  • Contact with contaminated surfaces, such as toys or doorknobs.

It's important to note that HFMD is not related to foot-and-mouth disease, which affects livestock.

Symptoms of Hand, Foot, and Mouth Disease

The symptoms of HFMD typically appear 3-6 days after infection (the incubation period). Common symptoms include:

  • Fever: Often the first symptom.
  • Sore throat: Making it difficult or painful to swallow.
  • Loss of appetite: Due to the discomfort of mouth sores.
  • Painful sores in the mouth: Usually starting as small red spots that blister and then ulcerate. These are commonly found on the tongue, gums, and inside of the cheeks.
  • Skin rash: Flat or slightly raised red spots, sometimes with blisters. The rash typically appears on the palms of the hands and soles of the feet but can also occur on the buttocks, knees, and elbows.
  • Irritability: Infants and young children may be fussier than usual.

When to See a Doctor

While HFMD is usually mild, it's important to contact a doctor if your child:

  • Has a high fever.
  • Is dehydrated (shows signs like decreased urination, dry mouth, and no tears when crying).
  • Has a stiff neck or severe headache.
  • Experiences seizures.
  • Has symptoms that worsen or don't improve after 10 days.

How is Hand, Foot, and Mouth Disease Diagnosed?

HFMD is usually diagnosed based on a physical examination of the sores and rash. The doctor will also ask about your child's symptoms. In most cases, lab tests are not necessary.

Treatment for Hand, Foot, and Mouth Disease

There is no specific treatment for HFMD. Treatment focuses on relieving symptoms:

  • Pain relievers: Over-the-counter pain relievers like ibuprofen (Advil, Motrin) or acetaminophen (Tylenol) can help reduce fever and pain. Always follow the dosage instructions on the label and consult with your doctor or pharmacist if you have any questions.
  • Mouthwash or sprays: These can help numb the pain in the mouth. Consult with your doctor before using these, especially for young children.
  • Fluids: Encourage your child to drink plenty of fluids to prevent dehydration. Cold liquids, such as water or milk, are often soothing. Avoid acidic drinks like juice, which can irritate mouth sores.
  • Soft foods: Offer soft foods that are easy to swallow, such as yogurt, mashed potatoes, or soup.

Preventing the Spread of Hand, Foot, and Mouth Disease

The best way to prevent the spread of HFMD is to practice good hygiene:

  • Wash hands frequently with soap and water, especially after changing diapers, using the toilet, and before preparing food.
  • Disinfect surfaces and objects that may be contaminated with the virus, such as toys and doorknobs.
  • Teach children to cover their mouths and noses when coughing or sneezing.
  • Keep children with HFMD home from school or daycare until their fever is gone and the blisters have dried.

Complications of Hand, Foot, and Mouth Disease

Complications from HFMD are rare, but can include:

  • Dehydration: This is the most common complication. Mouth sores can make it painful to swallow, leading to decreased fluid intake.
  • Viral meningitis: In rare cases, the virus can infect the membranes and fluid surrounding the brain and spinal cord.
  • Encephalitis: Inflammation of the brain, which is a very rare complication.

Living with Hand, Foot, and Mouth Disease

Hand, foot, and mouth disease can be uncomfortable for children, but with proper care and attention to hygiene, the illness typically resolves without complications. Focus on keeping your child comfortable, hydrated, and preventing the spread of infection to others. Remember to consult with your doctor if you have any concerns.