acozyfuture.com – Have you ever heard of hand, foot, and mouth disease (HFMD)? This highly contagious viral illness has recently become more prevalent in various countries, including Singapore, prompting concerns among parents and caregivers.
In this blog, we’ll dive into everything parents need to know about HFMD, from understanding its causes and recognizing early symptoms to managing the illness at home and preventing its spread. So, grab a pen and take notes, parents—your child’s health is always worth the extra attention!
What is Hand, Foot, and Mouth Disease (HFMD)?
Hand, foot, and mouth disease (HFMD) is a common viral illness primarily affecting infants and children under the age of 5, though it can occasionally occur in older children and adults. This disease was initially described after an outbreak in Canada in the 1950s [1].
For many years, this disease was largely overlooked because it was considered a mild viral infection with standard symptoms that would resolve on their own within a few days without complications. However, over the past two decades, HFMD has garnered renewed attention due to emerging evidence that its clinical, epidemiological, and etiological features may differ significantly from earlier assumptions [1].
Hand, foot, and mouth disease is caused by picornaviruses, primarily human enteroviruses and coxsackieviruses. The most common viruses are enterovirus 71 and coxsackievirus A16 [2].
The Signs and Symptoms of HFMD
When it comes to the symptoms of hand, foot, and mouth disease, they can be divided into two distinct categories: common symptoms and atypical symptoms. Understanding these symptoms is crucial for early detection and proper care.
Here is a list of HFMD symptoms that every parent should be aware of:
Common Symptoms of Hand, Foot, and Mouth Disease
Fever:
The first symptom of HFMD is often a fever, which can range from mild to high. The fever typically appears 3-7 days after exposure to the virus.
Sore Throat:
Along with the fever, a sore throat is common, making it painful for the affected person to swallow.
Skin Rash:
Red spots, sometimes with blisters, commonly on the palms of the hands, soles of the feet, and buttocks.
Loss of Appetite:
Due to the painful sores in the mouth, children may refuse to eat or drink, leading to dehydration.
Irritability and General Malaise:
Children often become irritable and may feel generally unwell.
Atypical Symptoms of Hand, Foot, and Mouth Disease
Rash in Unusual Locations:
Rash may appear on the knees, elbows, and trunk instead of just the hands, feet, and mouth.
High Fever:
More severe than typically expected, sometimes lasting longer.
Neurological Symptoms:
In rare cases, complications like viral meningitis or encephalitis may occur, causing headaches, stiff neck, or confusion.
Severe Skin Peeling:
Extensive peeling of the skin, particularly on the hands and feet, which is less common.
Prolonged Illness Duration:
Symptoms lasting longer than the typical 7-10 days.
Respiratory Symptoms:
Such as cough or difficulty breathing, which are not typically associated with HFMD.
Gastrointestinal Issues:
Nausea, vomiting, or diarrhea, though rare, can also be seen in atypical cases.
These atypical symptoms may indicate a more severe or unusual presentation of HFMD, sometimes associated with different strains of the virus, such as Enterovirus 71 (EV71).
How to Treat Hand, Foot, and Mouth Disease
Medications are usually not needed as HFMD is a viral disease that typically gets better on its own. Currently, there is no specific treatment available for hand, foot, and mouth disease [3]. However, certain measures can be taken to relieve symptoms, such as:
1. Fever and Pain Relief
Over-the-counter pain relievers like acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) are commonly used to reduce fever and alleviate pain, especially from mouth sores. Aspirin should be avoided in children due to the risk of Reye’s syndrome.
2. Mouth Sore Relief
Topical Anesthetics:
Over-the-counter gels or sprays containing benzocaine or similar ingredients can be applied to mouth sores to numb the pain and make eating and drinking less painful.
Cold Foods and Drinks:
Offering cold or soft foods like ice cream, yogurt, or smoothies can help soothe mouth sores and encourage hydration. Avoid acidic or spicy foods that can irritate the sores.
Saltwater Rinses:
Older children and adults can gargle with warm salt water to help reduce mouth discomfort and keep the area clean.
3. Hydration
Importance of Fluids:
Keeping the patient hydrated is essential, especially if they are reluctant to eat or drink due to mouth pain. Dehydration is a common concern in children with HFMD, particularly if they have a high fever or are not consuming enough fluids.
Hydration Strategies:
- Encourage frequent sips of water or electrolyte solutions like Pedialyte.
- Offer popsicles or ice chips, which can provide hydration and soothe the mouth.
- Breastfeeding or formula feeding should continue as usual for infants.
4. Rest and Comfort
Adequate Rest:
Ensuring the child or patient gets plenty of rest is crucial to help the body fight off the infection. Resting in a quiet, comfortable environment can also alleviate irritability and discomfort.
Comfort Measures:
Keep the patient comfortable with soft bedding, and monitor for signs of worsening symptoms. Comforting activities, like reading or watching favorite shows, can help distract from discomfort.
5. Monitoring and Recognizing Complications
Observation for Atypical Symptoms:
While HFMD is usually mild, it's important to monitor for any signs of complications, especially if the child has a high fever for more than three days, shows signs of dehydration (such as reduced urination, dry mouth, or lethargy), or if the rash becomes unusually severe.
When to Seek Medical Attention:
Immediate medical attention is required if the child experiences difficulty breathing, severe headache, stiff neck, unusual drowsiness, or convulsions, as these could be signs of more serious complications like meningitis or encephalitis.
In summary, treatment for hand, foot, and mouth disease is supportive, focusing on relieving symptoms, maintaining hydration, and ensuring rest. While HFMD is generally mild, parents and caregivers should be vigilant for any signs of complications and seek medical advice when necessary.
Symptoms of hand, foot, and mouth disease typically resolve within 7-10 days. Once infected, the child usually develops immunity to the specific virus that caused the infection. However, since HFMD can be caused by different viruses, they may get it again from a different strain.
Complications of HFMD
Although complications from the viral infections that cause hand, foot, and mouth disease are rare, they require immediate medical attention if they occur. Infections caused by Enterovirus 71 are generally more severe and have a higher likelihood of leading to neurological or cardiac complications, including death, compared to those caused by Coxsackievirus A16 [4].
In rare instances, HFMD can lead to viral or aseptic meningitis, which presents with symptoms such as fever, headache, stiff neck, or back pain. While this condition is typically mild and resolves without treatment, short-term hospitalization may sometimes be necessary. Other serious complications of HFMD, though uncommon, include encephalitis (inflammation of the brain) and, in rare cases, flaccid paralysis [5].
How to Prevent Hand, Foot, and Mouth Disease
As of now, there is no vaccine to protect against the viruses that cause hand, foot, and mouth disease [3]. Preventing HFMD involves good hygiene practices:
1. Frequent Handwashing
Wash hands with soap and water, especially after diaper changes, using the toilet, and before eating.
2. Cleaning and Disinfecting
Regularly clean and disinfect frequently touched surfaces and toys.
3. Avoid Close Contact
Keep infected children home from daycare or school to prevent spreading the virus.
4. Cover Coughs and Sneezes
Teach children to cover their mouths with a tissue or their elbow when they cough or sneeze.
Conclusion
Hand, foot, and mouth disease (HFMD) is a common yet highly contagious viral illness that primarily affects young children. While the symptoms can be uncomfortable, they are usually mild and manageable with proper care.
The key to preventing HFMD lies in good hygiene practices, such as regular handwashing, disinfecting common surfaces, and avoiding close contact with infected individuals. If your child shows signs of HFMD, it’s essential to keep them home from school or daycare to prevent the spread of the virus.
Remember, while HFMD typically resolves on its own, it’s always wise to consult with a healthcare provider if symptoms worsen or if you have concerns. By staying informed and proactive, you can help protect your child and others from this common childhood illness.
References
[1] Nassef C, Ziemer C, Morrell DS. Hand-foot-and-mouth disease: a new look at a classic viral rash. Curr Opin Pediatr. 2015;27(4):486-491.
[2] Repass GL, Palmer WC, Stancampiano FF. Hand, foot, and mouth disease: identifying and managing an acute viral syndrome. Cleve Clin J Med. 2014;81(9):537-543.
[3] Sarkar PK, Sarker NK, Tayab A. Hand, Foot and Mouth Disease (HFMD): An Update. Bangladesh J Child Health. 2016;40(2):115-119.
[4] Sharma N. Hand, foot and mouth disease: current scenario and Indian perspective. Indian Journal of Dermatology, Venereology and Leprology. 2013;79:165-75.
[5] Huang CC, Liu CC, Chang YC, Chen CY, Wang ST. Neurologic complications in children with enterovirus 71 infection. The New England Journal of Medicine. 1999;341: 936-42.