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Hand Foot and Mouth Disease: A Complete Guide For Parents

Little ones under the age of 5 years are most vulnerable to Hand Foot and Mouth Disease (HFMD).

Although not usually a serious complication, HFMD deserves immediate attention. Why?

  • The health of innocent little children is at stake.

  • High ‘contagious’ factor of the disease.

  • Severe scenarios can lead to loss of life.

Hand Foot and Mouth Disease is often mistaken as Foot-and-Mouth Disease. Also, known as Hoof-and-Mouth Disease, the latter is actually an animal disease. It targets cows, sheep, and pigs. In contrast, HFMD is a viral infection affecting humans, primarily kids.

With more than 200,000 cases every year, the condition is a frequent occurrence in children in the USA. As for India, 2022 saw 80 cases in Kerala and many other states issuing alerts about HFMD. So, the once uncommon name has become a significant emerging infection in our country.

Here’s an in-depth insight into the issue to help all you parents keep your little munchkins safe.


What is Hand Foot and Mouth Disease?

Hand Foot and Mouth Disease is a very familiar childhood illness. A contagious viral infection that is characterized by sores in the mouth and rashes on the hand and feet. Summer and fall see a rise in the number of cases in the temperate climate like in most parts of the US. While India’s tropical climate may favor the virus to stay active all around the year.

The good news is, in the majority of cases, the condition is mild and self-treatable. The virus usually goes away within 10 days. So, the general recommended quarantine period is 7-10 days. The exact time frame you need to keep your kids at home however depends on individual health.

Hand Foot and Mouth Disease Causes

The infection is mainly caused by viruses from the Enterovirus family. For those unaware, it is a group of viruses responsible for many mild infectious diseases.


Here are some names highly instrumental in the development of the health issue.

  • Coxsackievirus A16 - This virus is the prime factor in most HFMD scenarios. But other strains of the Coxsackievirus can also be the culprits.

  • Coxsackievirus A6 - The problem can get slightly more severe with this virus in action.

  • Enterovirus 71 (EV-A71)- East and Southeast Asia are more prone to this outbreak. The situation often turns serious resulting in encephalitis (swelling of the brain). Thankfully, such complexities are rare.

Hand Foot and Mouth Disease Symptoms

Mouth sores and skin rashes are the most obvious signs. But, there are other symptoms of HFMD as well that you need to be aware of.

  • Fever

  • Loss of appetite

  • Throat pain

  • Mouth ulcers

  • Irritability

  • Fatigue

  • Malaise (a constant feeling of discomfort)

  • Dehydration

  • Headaches

  • Coughing

  • Blisters (fluid-filled bubbles in the skin)

  • Skin peeling

Stages of Hand Foot and Mouth Disease

The Hand Foot and Mouth Disease symptoms appear 2 to 6 days after your child is exposed to the virus. If it is the Coxsackievirus A16 causing the issue, then the disease usually progresses in the following pattern.


  • Fever- The first stage of Hand Foot and Mouth Disease starts with a fever. The patient may have a temperature of around 101-102 °F for the initial one or two days.

  • Mouth Sores- It is followed by sores in the back of the mouth, tongue, gums, and inner portion of the lips. During this time, your child may get fussy, refuse to eat, or complain of pain while swallowing.

  • Skin Rashes- The next few days may see spots in the skin mainly in the hands, feet, elbows, knees, and bottoms. The rashes are usually tiny and barely noticeable. But for some children, they may develop into blisters.

How Does Hand Foot and Mouth Disease Spread?

Hand Foot and Mouth Disease is highly infectious. It literally spreads like wildfire through contact with the infected individuals:

  • Nose secretions (nasal mucus)

  • Throat secretions (saliva, drool)

  • Fluid from the blisters

  • Feces

Note: The first week is considered to be a very contagious period. However, the virus may shed for 1 to 3 weeks in saliva, mucous, and respiratory secretions. In the case of stool, it may be 2 to 8 weeks post the main infection.


Hand Foot and Mouth Disease in Adults

Although HFMD primarily targets children, adults are not immune to it. The main issue about Hand Foot and Mouth Disease in adults is that in most situations, there are no signs. So, many of you won’t even be aware of your ongoing issue. And may end up transmitting it unknowingly to vulnerable infants and children.

Therefore, if your child is suffering from HFMD, it’s best to exercise caution to try not to get infected. Frankly speaking, it is easier said than done but here are some hacks that might work:

  • Use facial coverings.

  • Avoid sharing cups, utensils, and personal hygiene items with your kid

  • Resist the temptation to touch your eyes, nose, and mouth as much as possible.

  • Wash your hands immediately after attending to your little one.

  • Use gloves while changing diapers.

  • Clean their clothes thoroughly on a regular basis.

  • Disinfect the toys, doorknobs, and other potentially contaminated surfaces.

  • Teach your child basic cough and sneeze etiquette.


Hand Foot and Mouth Disease Treatment

There is no particular treatment for mild HFMD. Pain medications (not aspirin) like paracetamol can help with fever and throat pain. As for blisters, they are best left to dry naturally and should never be pricked. However, some pediatricians advise ointment aloe vera 10% lotion for eruptions.

In the meantime, follow simple home remedies to ease your kid’s discomfort.

  • Keep them hydrated with water.

  • Give ice pops, ice creams, or sherbets (in controlled amounts) to help soothe the throat and mouth.

  • Avoid acidic items. Sodas and citrus fruits for instance.

  • Hot drinks should be avoided. You may go for lukewarm tea instead.

  • Make soft easily-swallowed food that does not demand much chewing.

For severe illness and aged patients with weak immunity, Intravenous immune globulin (IVIG) is often used. It is a therapy in which a product of human antibodies is introduced to the body through the veins.


Final Thoughts

Hand Foot and Mouth Disease usually cures on its own. No fever for 24 hours and the disappearance of other symptoms is an indication that you can send your child back to their everyday life. But as stated earlier, things can take a serious turn.

Consult a doctor for immediate Hand Foot and Mouth Disease treatment if you notice:

  • Severe symptoms

  • Your kid is not drinking at all, thereby increasing the risk of dehydration.

  • Conditions are not improving even after 10 days.

  • Weak immune system.

  • Your little one is not even 6 months old.

 

The Author : Dr. Sunil Khattri

sunilkhattri@gmail.com

+91 9811618704

Dr Sunil Khattri MBBS, MS(General Surgery), LLB, is a Medical doctor and is a practicing Advocate in the Supreme Court of India and National Consumer Disputes Redressal Commission, New Delhi.

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