Hand Foot and Mouth Disease

Recently, a five year old girl saw me with complaints of "my mouth hurts" and "my tummy hurts." Her mother noticed sores in her mouth several days ago. Her medical history was unremarkable, she was a healthy active young girl. Upon examination, she had a temperature of 100.6 and a couple of small sores in her mouth. Interestingly, she also had a rash on her hands. Reassurance was given to both the mother and the girl and she recovered nicely in several days.

Hand Foot and Mouth Disease is a viral illness that affects young children, typically under ten years of age. It is most commonly caused by coxsackieviruses (Enterovirus genus), members of the Picornaviridae family. HFMD is contagious and spread by nasal secretions, saliva, fecal material, and aerosolized droplets. Daycares have a high incidence of HFMD. It is more common during the summer and autumn months. Children are contagious one week prior to the onset of symptoms and potentially several weeks after resolution.

The signs and symptoms include (but not limited to):
1. Fever
2. Fatigue
3. Cough
4. Abdominal pain
5. Sore throat
6. Poor appetite
The rash and sores develop 12 to 36 hours later. The oral sores are painful, red, blister-like lesions located on the tongue, inner cheeks, or gums. The rash on the palms, soles of feet, or buttocks are not itchy, red, and possibly blistery. The rash and sores can last for five to seven days.

HFMD is not usually serious and self-limiting (will resolve with time). Rare complications include viral meningitis, myocarditis, and encephalitis.

Treatment includes:
1. Fluids
2. Supportive care
3. Tylenol or ibuprofen for the pain
4. Popsicles/ice cream for the oral pain
5. Warm salt water rinses without swallowing (1/2 teaspoon of salt with one cup of warm water)
6. Time...HFMD will usually resolve in 7-10 days

Prevention includes:
1. Good hygiene
2. Hand washing (twenty seconds)
3. Do not rupture blisters
4. Avoid close contact with patients diagnosed with HFMD
5. Keeping toys and surfaces clean

Call the doctor immediately if the child develops any of the following symptoms:
1. Fever higher than 100.4° Fahrenheit (38° Celsius) for infants younger than 6 months and higher than 102° Fahrenheit (38.8° Celsius) for older kids
2. Poor appetite or trouble feeding
3. Difficulty breathing
4. Convulsions
5. Unusual sleepiness
6. Severe headache, especially with vomiting, confusion, unusual sleepiness, or convulsions
7. Neck stiffness

Please note Hand Foot and Mouth Disease is not Foot (Hoof) and Mouth Disease.

Call your primary physician for more information. Hope this was informative!