HAND-FOOT-MOUTH DISEASE
DEFINITION
- A viral infection that causes mouth ulcers and tiny blisters on the hands and feet
Main Symptoms
- Small painful ulcers in the mouth, especially on tongue and sides of mouth (in all children).
- Small, thick-walled water blisters (like chickenpox) or red spots located on the palms, soles, and webs between the fingers and toes (70%).
- 1 to 5 water blisters per hand or foot.
- Small blisters or red spots on the buttocks (30%).
- Low-grade fever 100° to 102°F (37.8° to 39°C).
- Mainly occurs in children age 6 months to 4 years.
Cause
- Coxsackie A-16 virus
- Not related to animal disease
See More Appropriate Topic (instead of this one) If
- Only has mouth ulcers, see MOUTH ULCERS. (Exception: exposed to HFM)
- Only has a rash, see RASHES, WIDESPREAD AND CAUSE UNKNOWN.
WHEN TO CALL YOUR DOCTOR
Call your doctor now (night or day) if:
- Your child looks or acts very sick.
- Signs of dehydration (e.g., very dry mouth, no tears, no urine in more than 8 hours).
- Stiff neck, severe headache or acting confused. (delirious)
Call your doctor within 24 hours (between 9am and 4pm) if:
- You think your child needs to be seen.
- Red, swollen and tender gums.
- Fever persists for more than 3 days.
Call your doctor during weekday office hours if:
- You have other questions or concerns.
Parent care at home if:
- Probable hand-foot-mouth disease and you don't think your child needs to be seen.
HOME CARE ADVICE
- Reassurance: Hand-foot-mouth disease is a harmless viral rash.
- Liquid Antacid for Mouth Pain:
- Use a liquid antacid 4 times per day.
- For younger children, put 1/2 teaspoon in the front of the mouth 4 times per day after meals.
- Children over age 4 can use 1 teaspoon as a mouthwash after meals.
- Soft Diet:
- Encourage favorite fluids to prevent dehydration.
- Cold drinks, milkshakes, popsicles, slushes, and sherbet are good choices.
- Avoid citrus, salty, or spicy foods.
- For infants, give fluids by cup, spoon or syringe rather than a bottle. (Reason: The nipple can cause pain.)
- Solid food intake is not important.
- Fever Medicine: Give acetaminophen (e.g., Tylenol) or ibuprofen for fever above 102 F (39 C) or severe mouth pain.
- Contagiousness: Quite contagious but a mild and harmless disease. Incubation period is 3-6 days. Can return to daycare or school after the fever is gone (usually 2 to 3 days). The rash is not contagious.
- Expected Course: The fever lasts 2 or 3 days. The mouth ulcers resolve by 7 days. The rash on the hands and feet lasts 10 days.
- Call Your Doctor If:
- Signs of dehydration develop
- Fever present over 3 days
- Your child becomes worse
And remember, contact your doctor if your child becomes worse or develops any of the "Call Your Doctor" symptoms.
REFERENCES
- Adler JL, et al. Epidemiologic investigation of hand-foot and mouth disease. Am J Dis Childhood. 1970;120:309.
- Slavin KA and Frieden IJ. Picture of the month: Hand-foot-and-mouth disease. Arch Pediatr Adolesc Med. 1998;152:505-506.
- Thomas I and Janniger CK. Hand, foot, and mouth disease. Cutis. 1993;52:265-266.
Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.
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