It’s Friday afternoon, and you are looking forward to a wonderful weekend with your family. When you pick up your 2 year old from daycare, you notice two small red dots on her right foot. She does not seem to be bothered by it, and you go on your merry way. Over the next day, however, blisters pop up on her hands, feet, mouth, and even in her diaper area, and now she is refusing to eat. Sadly, you give up your weekend plans and wonder if your child has the infamous “hand foot mouth disease.”
Hand foot mouth disease, or HFMD, is a common illness among infants and toddlers, especially those under 5 years old. It is caused by a couple of viruses, broadly called coxsackie or enterovirus, which are most prevalent in the summer and fall. Children can contract the disease by coming in contact with an infected person’s nasal or oral secretions, blister fluid, or stool. As you can imagine, this can be spread easily in a daycare or other environments where children play in close quarters and constantly share toys and food.
As scary as it sounds, HFMD is usually not serious, and nearly everyone recovers in seven to 10 days without medical treatment. Most people have contracted this at some point in their lives. Typically, the illness manifests as a rash of red spots that may blister on the palms of the hands, soles of the feet, in the genital region, and sometimes can involve larger areas of the arms and legs. In fact, pediatricians nickname the disease “hand-food-mouth-butt disease” because the rash in the genital region can be such a prominent part of the presentation. Children also can have a sore throat and fever. The most frustrating symptom is the presence of painful mouth sores, which can lead to a reduced appetite. In rare cases, fingernail or toenail loss have been reported a few weeks after recovery, which is temporary and is not cause for alarm. They grow back.
Because it is a viral illness, the treatment is entirely supportive. If your child continues to be able to drink, he or she is likely safe to be observed at home with acetaminophen or ibuprofen to help relieve discomfort. As a parent, know that the time to seek medical care would be if your child is: 1) not drinking and therefore not able to hydrate him or herself; 2) no longer making four or more wet diapers in a day, has a dry mouth, or is not able to cry tears; 3) having a fever above 100.4 degrees that does not come down with acetaminophen or ibuprofen, or 3) overly lethargic and not alert. If you observe any of these symptoms, your child may need medical intervention such as IV fluids, additional oral pain medication, or further tests for another problem.
Although the likelihood of adults contracting HFMD is low, it is still possible, so be careful. To prevent spread of the virus, we recommend washing your hands frequently with soap and water for at least 20 seconds, especially after changing diapers.
Try to avoid touching your eyes, nose, or mouth with unwashed hands. Disinfect frequently touched surfaces and objects, and avoid sharing cups, utensils, food, or drinks with someone who is sick.
Parents can rest assured HFMD is very common and most children recover shortly without long-term effects. Talk with your healthcare provider if you have additional questions.
Dr. Grace Yu is a pediatric resident at Baylor Scott & White McLane Children’s Medical Center.