Dr. Tariq Jagnarine
Fam Med, Endocrinology
Hand, foot, and mouth disease are contagious infections that cause blisters and sores. It tends to occur most often in young children. It is a highly contagious infection. It’s caused by viruses from the Enterovirus genus, most commonly the coxsackievirus. These viruses can spread from person to person through direct contact with unwashed hands or surfaces contaminated with feces. It can also be transmitted through contact with a person’s saliva, stool, or respiratory secretions.
HFMD is characterized by blisters or sores in the mouth and a rash on the hands and feet. The infection can affect people of all ages, but it usually occurs in children under age 5. It’s generally a mild condition that goes away on its own within several days.
CAUSES
HFMD is often caused by a strain of coxsackievirus, most commonly coxsackievirus A16. Coxsackievirus is part of a group of viruses called enteroviruses. In some cases, other types of enteroviruses can cause HFMD. Viruses can be easily spread from person to person. A child may get HFMD through contact with a person’s: saliva, fluid from blisters, feces, or respiratory droplets that are sprayed into the air after coughing or sneezing.
HFMD can also be transmitted through direct contact with unwashed hands or a surface containing traces of the virus.
RISK GROUPS
Young children have the highest risk of getting HFMD. Risk increases if they attend day care or school, as viruses can spread quickly in these facilities. Children usually build up immunity to the disease after being exposed to the viruses that cause it. This is why the condition rarely affects people over age 10. However, it’s still possible for older children and adults to get the infection, especially if they have weakened immune systems.
SYMPTOMS
Symptoms begin to develop 3 to 6 days after first getting the infection. This period is known as the incubation period. When symptoms do appear, you or your child may experience:
• Fever
• Decreased appetite
• Sore throat
• Headache
• Irritability
• Malaise (feeling unwell)
• Painful red blisters in your mouth
• Drooling
• Red rash on the hands and the soles of feet
A fever and sore throat are usually the first symptoms of HFMD. The characteristic blisters and rashes show up later, usually 1 or 2 days after the fever begins. The rash usually looks like flat red spots. The spots can be harder to see on darker skin tones, so it’s easier to check the palms of hands and the bottom of feet where the condition may be more noticeable.
Lesions can appear on all surfaces of your hands and feet, but this is one of the few times a rash on your palms and soles occurs, which is why it’s easy to identify. Most children with HFMD will also have painful sores in the mouth. Check their tongue — including the sides — and throat.
DIAGNOSIS
A doctor can often diagnose HFMD by performing a physical exam. They’ll check the mouth and body for the appearance of blisters and rashes. The doctor will also ask about other symptoms. The doctor may take a throat swab or stool sample to test for the virus. This will allow them to confirm the diagnosis.
TREATMENT
In most cases, the infection will go away without treatment in 7 to 10 days. However, your doctor may recommend certain treatments to help ease symptoms until the disease has run its course. These can include:
• 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
Dont give aspirin to children for viral infections. Aspirin can lead to Reye’s syndrome in children.
HOME REMEDIES
Certain at-home treatments can also provide relief from HFMD symptoms. Try the following home remedies to help make blisters less bothersome:
• Sucking on ice chips or popsicles
• Eating ice cream or sherbet
• Drinking cold beverages
• Limiting citrus fruits, fruit drinks, and soda
• limiting spicy or salty foods
• Swishing warm salt water around in your mouth may also help relieve the pain associated with mouth blisters and throat sores. You can do this several times a day or as often as needed.
Infected people should feel completely better 7 to 10 days after the initial onset of symptoms. Getting the infection again is uncommon. The body usually builds up immunity to the viruses that cause the disease.
Call a doctor immediately if symptoms get worse or don’t clear up within 10 days. In rare cases, coxsackievirus can cause a medical emergency.
Potential complications of HFMD include:
• Dehydration
• Fingernail or toenail loss
• Viral meningitis
• Encephalitis
• Paralysis
• Myocarditis
PREVENTION
• Practicing good hygiene is the best defense against HFMD. Regular handwashing can greatly reduce the risk of getting this virus.
• Teach children how to wash their hands using hot water and soap. Washing hands after using the restroom, before eating, and after being out in public is important.
• Children should also not put their hands or other objects in or near their mouths.
• It’s important to disinfect any common areas in your home on a regular basis. Try cleaning shared surfaces first with soap and water, then with a diluted solution of bleach and water.
• Disinfect toys, pacifiers, and other objects that may be contaminated with the virus.
• If experiencing symptoms such as a fever or sore throat, stay home from school or work. It’s best to avoid contact with others once the blisters and rashes develop. This can help avoid spreading the disease to others.
