Hand-foot-and-mouth disease – Symptoms and causes

Overview A mild, contagious viral infection common in young children is known as hand-foot-and-mouth disease which is characterized by sores in the mouth and a rash on the hands and feet. Hand-foot-and-mouth disease is caused by a coxsackievirus most commonly. No specific treatment is present for hand-foot-and-mouth disease. Frequent hand-washing and close contact with people […]

Overview

A mild, contagious viral infection common in young children is known as hand-foot-and-mouth disease which is characterized by sores in the mouth and a rash on the hands and feet. Hand-foot-and-mouth disease is caused by a coxsackievirus most commonly.

No specific treatment is present for hand-foot-and-mouth disease. Frequent hand-washing and close contact with people should be avoided who are infected with hand-foot-and-mouth disease may help reduce the child’s risk of infection.

Symptoms

All of the following signs and symptoms or just some of them may be caused by hand-foot-and-mouth disease. They include:

  • Fever
  • Sore throat
  • Feeling of being unwell (malaise)
  • Painful, red, blister-like lesions on the tongue, gums and inside of the cheeks
  • A red rash, without itching but sometimes with blistering, on the palms, soles and sometimes the buttocks
  • Irritability in infants and toddlers
  • Loss of appetite

The usual period from starting of the infection to the onset of signs and symptoms is three to six days. The first sign of hand-foot-and-mouth disease is often fever, followed by a sore throat and sometimes a poor appetite and malaise.

One or two days after the fever begin, in the front of the mouth or throat painful sores may develop. Within one or two days a rash on the hands and feet and possibly on the buttocks can appear.

Sores developed in the back of the mouth and throat may suggest that the child is infected with a related viral illness known as herpangina. A sudden high fever and in some instances, seizure is included in other distinguishing features of herpangina. Rarely sores develop on the hands, feet or other parts of the body.

Hand-foot-and-mouth disease is generally a minor illness causing only a few days of fever and signs and symptoms which are relatively mild. Doctor should be contacted if mouth sores or a sore throat keeps the child from drinking fluids. And doctor should be consulted if after a few days, the child’s signs and symptoms worsen.

Causes

Infection with the coxsackievirus A16 is the most common cause of hand-foot-and-mouth disease. The coxsackievirus belongs to a group of viruses which are known as nonpolio enteroviruses. Hand-foot-and-mouth disease can sometimes be caused by other types of enteroviruses.

The main source of coxsackievirus infection and hand-foot-and-mouth disease is oral ingestion. By person-to-person contact with an infected persons can spared the illness:

  • Nasal secretions or throat discharge
  • Saliva
  • Fluid from blisters
  • Stool
  • Respiratory droplets sprayed into the air after a cough or sneeze

Common in child care setting

Hand-foot-and-mouth disease is most common in children in child care settings due to frequent diaper changes and potty training, and because little children often put their hands in their mouths.

Although the child during the first week of illness is most contagious with hand-foot-and-mouth disease, the virus can remain in the body for weeks after the signs and symptoms are gone. That means others can still be infected by your child.

Some people, particularly in adults, the virus can be passed without showing any signs or symptoms of the disease.

Outbreaks of the disease can be found more commonly in summer and autumn in the United States and other temperate climates. In tropical climates, outbreaks occur around a year.

Different from foot-and-mouth disease

Hand-foot-and-mouth disease isn’t connected to foot-and-mouth disease sometimes known as hoof-and-mouth disease, which is an infectious viral disease found in farm animals. Hand-foot-and-mouth disease cannot be contracted from pets or other animals, and you can’t transmit it to them.

Risk factors

Children younger than age 10 are affected primarily with hand-foot-and-mouth disease, often those under 5 years. Children in child care centers are especially vulnerable to outbreaks of hand-foot-and-mouth disease as the infection spreads by person-to-person contact, and young children are the most susceptible.

Immunity to hand-foot-and-mouth disease is developed by children usually as they get older by building antibodies after exposure to the virus that causes the disease. However, it’s possible that the disease can be affected to adolescents and adults.

Complications

Dehydration is the most common complication of hand-foot-and-mouth disease. Sores can be caused by illness in the mouth and throat, making swallowing painful and difficult.

A close watch should be kept to make sure the child frequently sips fluid during the course of the illness. If dehydration is severe, intravenous (IV) fluids may be essential.

Hand-foot-and-mouth disease is usually a minor illness causing only a few days of fever and signs and symptoms which are relatively mild. A rare and sometimes serious form of the coxsackievirus can involve the brain and other complications may be caused

  • Viral meningitis is a rare infection and inflammation of the membranes (meninges) and cerebrospinal fluid surrounding the brain and spinal cord.
  • Encephalitis is a severe and potentially life-threatening disease which involves brain inflammation caused by a virus. Encephalitis is rare.

Prevention

The risk of infection can be reduced with certain precautions with hand-foot-and-mouth disease:

  • Wash hands carefully. Hands should be washed frequently and thoroughly, especially after using the toilet or changing a diaper and before preparing food and eating. When soap and water aren’t available, hand wipes or gels treated with germ-killing alcohol should be used.
  • Disinfect common areas. The habit should be taken of cleaning high-traffic areas and surfaces first with soap and water, then with a diluted solution of chlorine bleach and water. A strict schedule of cleaning and disinfecting all common areas should be followed by child care centers, including shared items such as toys, as the virus can live on these objects for days. Baby’s pacifiers should be cleaned often.
  • Teach good hygiene. Children should be shown how to practice good hygiene and how to keep themselves clean. Explaining to them why it’s best not to put fingers, hands or any other objects in their mouths.
  • Isolate contagious people. As hand-foot-and-mouth disease is highly contagious, limiting exposure while having active signs and symptoms with people having the illness. Children with hand-foot-and-mouth disease should be kept out of child care or school until fever is gone and mouth sores have healed. If you have the illness, stay home from work.

Diagnosis

Distinguishing hand-foot-and-mouth disease from other types of viral infections is likely to be done by the doctor by evaluating:

  • The age of the affected person
  • The pattern of signs and symptoms
  • The appearance of the rash or sores

 

A throat swab or stool specimen may be taken by the doctor and sent to the laboratory to determine which virus caused the illness.

Treatment

No specific treatment for hand-foot-and-mouth disease is present. Signs and symptoms of hand-foot-and-mouth disease generally clear up in a period of seven to 10 days.

The pain of mouth sores can be relieved with the help of a topical oral anesthetic. General discomfort may be relieved by over-the-counter pain medications other than aspirin, such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin, others).

 

Lifestyle and home remedies

Blisters on the tongue or in the mouth or throat may be irritated by certain foods and beverages. Below these tips should be tried to help make blister soreness less bothersome and eating and drinking more tolerable:

  • Suck on ice pops or ice chips.
  • Eat ice cream or sherbet.
  • Drink cold beverages, such as milk or ice water.
  • Acidic foods and beverages should be avoided, such as citrus fruits, fruit drinks and soda.
  • Salty or spicy foods should be avoided.
  • Soft foods that don’t require much chewing should be eaten.
  • Rinsing mouth with warm water after meals.

If the child is able to rinse without swallowing then swishing with warm salt water may be soothing. Several times a day or as often as needed should be done by the child to help reduce the pain and inflammation of mouth and throat sores caused by hand-foot-and-mouth disease.

Preparing for appointment

If taking child to a doctor, by writing down information the doctor will need before you go will spare time to make most of it, including:

  • Any signs and symptoms the child is experiencing
  • Duration of child having signs and symptoms
  • Whether the child has been in child care or other environments where the disease might be spread
  • Any questions to be asked should be written down

What to expect from doctor

The doctor may ask some questions which may include:

  • Beginning of symptoms?
  • Severity of the symptoms?
  • Child being recently exposed to anyone who was sick?
  • Any illnesses heard at child’s school or child care?
  • Anything seem to improving the symptoms?
  • Anything appearing to worsen the symptoms?

What can be done in the meantime

To help reducing discomfort, doctors often recommend:

  • Getting rest.
  • Drinking fluids such as milk-based fluids may be easier to tolerate than acidic liquids, such as juice or soda.
  • If required, over-the-counter pain relievers should be taken other than aspirin, such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin, others) in an age- and weight-appropriate form and dosage. But they’re not required for low-grade fevers and will do nothing to hasten the resolution of the child’s condition.
  • Mouthwash or oral spray to numb pain should be used.

 

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