Dr. Mark Grier: Hand, Foot, and Mouth Disease in Children
Hand, foot, and mouth disease is an infection that causes sores to form in the mouth, and on the hands, feet, buttocks, and sometimes the genitals. A related infection, called “herpangina,” causes sores to form in the mouth. Both infections most often affect children, but adults can get them, too.
There are actually multiple different types of viruses that can cause HFM Dz. These viruses are in a family of viruses called enteroviruses. Coxsackievirus A16 and enterovirus A71 are the serotypes most frequently associated with HFM Dz and are responsible for the majority of large outbreaks.
The main symptom is sores that form in the mouth, and on the hands, feet, buttocks, and sometimes the genitals. They can look like small red spots, bumps, or blisters. The sores in the mouth can make swallowing painful. The sores on the hands and feet are not usually painful. It is possible to get the sores only in some areas. Not every person gets them on their hands, feet, and mouth.
The infection sometimes causes fever.
The virus that causes hand, foot, and mouth disease can travel in body fluids of an infected person. For example, the virus can be found in:
- Mucus from the nose
- Fluid from one of the sores
- Traces of bowel movements
People with hand, foot, and mouth disease are most likely to spread the infection during the first week of their illness. But the virus can live in their body for weeks or even months after the symptoms have gone away.
The diagnosis of HFM Dz is mainly made based on the typical history and clinical exam findings. The doctor should be able to tell if your child has it by learning about your child’s symptoms and doing an appropriate exam.
You should call your child’s doctor or nurse if your child is drinking less than usual and hasn’t had a wet diaper for 4 to 6 hours (for babies and young children) or hasn’t needed to urinate in the past 6 to 8 hours (for older children). You should also call your child’s doctor or nurse if your child seems to be getting worse or isn’t getting better after a few days.
As far as treatment for HFM Dz, it is mainly symptomatic care. HFM Dz usually goes away on its own within a few days. Children who are in pain can take nonprescription medicines such as acetaminophen (sample brand name: Tylenol) or ibuprofen (sample brand names: Advil, Motrin) to relieve pain. If your child has hand, foot, and mouth disease, keep him or her away from other people during the first week of the illness.
The sores in the mouth can make swallowing painful, so some children might not want to eat or drink. It is important to make sure that children get enough fluids so that they don’t get dehydrated. Cold foods, like popsicles and ice cream, can help to numb the pain. Soft foods, like pudding and gelatin, might be easier to swallow.
The most important thing you can do to prevent the spread of this infection is to wash your hands often with soap and water, even after your child is feeling better. You should teach your children to wash often, especially after using the bathroom. It’s also important to keep your home clean and to disinfect tabletops, toys, and other things that a child might touch.
About the Author: Dr. Mark Grier is one of the wonderful pediatricians at Urgent Care for Kids in Austin, Texas. He received his Bachelor of Science in Biology from the University of Illinois in Champaign, IL and shortly after, he attended the University of Illinois College of Medicine where he received his M.D. He then completed his pediatric residency at LSU in New Orleans. He is currently board certified in Pediatrics and is a fellow of the American Academy of Pediatrics. In his free time he enjoys reading, writing, and listening to all forms of music (anything from classical music to good old Austin rock and roll). College and professional football watching is a must, he says. But the majority of Dr. Grier’s free time is spent enjoying life here in beautiful Austin with his family and friends. He and his wife are proud parents to adorable twins.