HAND, FOOT, AND MOUTH DISEASE
What is it? Hand, foot, and mouth disease (HFMD) is a common illness of infants and children. It is characterized by fever, sores in the mouth, and a rash with blisters. HFMD begins with a mild fever, poor appetite, malaise ("feeling sick"), and frequently a sore throat. One or 2 days after the fever begins, painful sores develop in the mouth. They begin as small red spots that blister and then often become ulcers. They are usually located on the tongue, gums, and inside of the cheeks. The skin rash develops over 1 to 2 days with flat or raised red spots, some with blisters. The rash does not itch, and it is usually located on the palms of the hands and soles of the feet. It may also appear on the buttocks. A person with HFMD may have only the rash or the mouth ulcers.
What causes HFMD? Viruses from the group called enteroviruses cause HFMD. The most common cause is a coxsackievirus.
Is HFMD serious? Usually not. HFMD caused by a coxsackievirus infection is a mild disease and nearly all patients recover without medical treatment in 7 to 10 days. Complications are uncommon. Rarely, the patient with a coxsackievirus infection may also develop "aseptic" or viral meningitis, in which the person has fever, headache, stiff neck, or back pain, and may need to be hospitalized for a few days. Another cause of HFMD may also cause viral meningitis and, rarely, more serious diseases, such as encephalitis.
Is HFMD contagious? Yes, HFMD is moderately contagious. Infection is spread from person to person by direct contact with nose and throat discharges, saliva, fluid from blisters, or the stool of infected persons. A person is most contagious during the first week of the illness. HFMD is not transmitted to or from pets or other animals.
Children are often excluded from group settings during the first few days of the illness, which may reduce the spread of infection, but will not completely interrupt it. Children who have fevers, blisters in their mouths and drool or who have weeping lesions on their hands will be excluded from school.
How soon will someone become ill after getting infected? The usual period from infection to onset of symptoms (“incubation period”) is 3 to 7 days, but may be up to a couple of weeks after infection. Fever is often the first symptom of HFMD.
Who is at risk for HFMD? HFMD occurs mainly in children under 10 years old, but adults may also be at risk. Everyone is susceptible to infection, but not everyone who is infected becomes ill. Infection results in immunity to the specific virus, but a second episode may occur following infection with a different member of the enterovirus group.
Can HFMD be prevented? Do not share food or eating/drinking utensils and encourage your children to follow these same precautions. Follow strict handwashing and personal hygiene procedures. Preventive measures include frequent handwashing, especially after diaper changes or assisting a child in the bathroom, and always before eating or handling food. Cleaning of contaminated surfaces and items by diluted solution of chlorine-containing bleach (made by mixing approximately º cup of bleach with 1 gallon of water), and washing soiled articles of clothing is also important. The risk of infections can most often be lowered by good hygienic practices. ** Please notify your physician and the school nurses if your child develops these symptoms.
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