It’s one of the most dreaded signs to see hanging on the door of your child’s daycare room door – “There has been a case of Hand, Foot, and Mouth Disease in the classroom.” Nooooo!
Hand, Foot, and Mouth (HFM) Disease is viral infection cause by a Coxsackie virus. It is a very common childhood viral infection. Typical symptoms include a rash on the palms and soles and around the mouth, ulcers in the throat, and often a fever. Unlike most of the viral rashes we see in kids that are often concentrated on the trunk of the body, HFM is typical red spot on the hands and feet. On the palms and soles, there will be flat red spots of varying sizes and blistering lesions as well. The tops of the hands and feet may have flat and raised red spots too, that may extend up the arms and legs as well. Frequently there is a red, blistering rash in the diaper area as well. Inside the mouth, the throat is typically red with some ulcers. Around the lips, there may be red bumps and blisters too.
The mouth sores can be painful so kids will often drool more and eat less as it is painful to swallow. If kids have a lot of sores on their feet, it may be a bit painful for them to walk. Fever frequently occurs with HFM, but not always. Symptoms typically last about 3-7 days. There is often peeling of the fingers and toes 1-2 weeks after the start of the infection.
This virus is very contagious. Kids can be contagious for a couple of days prior to any symptoms starting, so it can spread through a daycare classroom very quickly. There is a lot of virus present in the saliva when they have ulcers in their throat, so toddlers spread it very well with their drool and through sneezing and coughing. The virus is often shed in the stool as well. Kids are most contagious for the first week of the illness. However, some kids will continue to shed the virus in their saliva/snot for 1-3 weeks and in their stools for weeks to months! The best way to prevent the infection is frequent hand washing and disinfecting the surfaces/toys that are in contact with the child.
There are a few strains of the Coxsackie virus that cause HFM, so sadly you can get it more than once. Parents will sometimes get this as well. Since it is caused by a virus, antibiotics are not helpful, and we don’t have any medicine to make it go away any faster. We can keep kids more comfortable by using ibuprofen (Motrin, Advil) or acetaminophen (Tylenol) to control the fever and the pain. Encourage fluids and cool drinks (or popsicles) to help keep kids hydrated.
If you have any concern for dehydration or prolonged fever (more than 3-5 days), then we should evaluate your child in the office.