What is Hand, Foot and Mouth disease?

Hand, foot, and mouth disease (HFMD) is an infectious disease caused by a contagious virus (coxsackievirus 16) that mainly affects your hands, feet, and mouth and can cause a bumpy or blistery rash all over your body.

Hand, foot, and mouth disease (HFMD) causes painful red blisters on the hands, feet, and diaper region in addition to the mouth, throat, and sores. The coxsackievirus causes most HFM infections. HFMD is infectious and spreads fast when unclean hands, body fluids such as feces, saliva, nasal secretions, or blister fluids come into contact with another healthy person.

Children under the age of 7 who are in places like daycare facilities, preschools, schools, summer camps, and other environments are at risk. In addition to the blisters, children might get dehydrated since it is painful to swallow drinks and often have a fever for a few days. In most cases, symptoms disappear after ten days, and children fully recover. Although there is no cure and no vaccination to prevent it, the doctor may suggest home care to help the kid feel more comfortable while recovering.


Symptoms

HFMD symptoms can range from mild to severe. They are more likely to impact children under five years of age, and this disease usually goes off entirely within 7 to 10 days.

Here's what you probably didn't know: Despite its tendency to affect children, the hand, foot, and mouth diseases are also capable of affecting adults. A person can easily pass the infection to others even though they don't show signs or symptoms.

It usually begins with a fever, reduced appetite, sore throat, and feeling lethargic, after which the child develops rashes. Oral lesions are referred to as herpangina.

Basically the incubation period is 3 to 6 days from the time of infection to the onset of symptoms.

Hand-foot-and-mouth disease can cause the following symptoms:

  • Fever sometimes or no fever noted. Sore throat
  • Sore throat
  • Feeling sick
  • Telltale signs, also called herpangina, appear as spots — usually on the back of the mouth, tongue, gums, and inside of cheeks, hard palate. These spots can blister and become severely painful.
  • A rash on the palms, soles, and or sometimes on the buttocks. The rash may not be itchy, but it can cause blisters.
  • Fussiness in infants and toddlers
  • Loss of appetite

People often start to exhibit symptoms after 3 to 7 days after getting exposed to infection. The most typical signs and symptoms are:

  • Fever
  • Throat pain
  • Small, blister-like lesions can develop on the soles of the feet, the inside of the mouth, on the sides of the tongue, palms of the hands, the fingers, and the "nappy" area.
  • Children are frequently irritated, worn out, and maybe food-intolerant.

Rarely the virus may harm the brain or spinal cord lining, resulting in more severe symptoms, including seizures, disorientation, instability, and weakness.


Complications

Usually, it is a mild illness but can lead to serious consequences sometimes. It can lead to dehydration, renal failure, brain infections (viral meningitis, encephalitis)

Dehydration is the most common side effect of hand, foot, and mouth disease. During the illness, encourage children to drink fluids. Extremely dehydrated children may require intravenous (IV) fluids while undergoing medical care.

Hand, foot, and mouth disease cause slight temperature and mild discomfort. When the enterovirus enters the brain, it can have serious consequences such as meningitis or encephalitis.


Prevention

You can lower your child's risk of hand-foot-and-mouth disease in many ways:

  • Wash hands and use hand sanitizers if hand washing is not possible.
  • Teach good oral and general hygiene.
  • Disinfect common areas like door knobs, toys, tables, etc.
  • Clean napkins or towels with soap or water
  • Avoid close contact
  • Wear Masks in public places and while in contact with sick patients.

Tomato flu vs Hand Foot Mouth Disease

The tomato flu is also a variant of the HFMD, where there are cherry red rashes on the skin. While in HFMD, the child may or may not have fever, in cases of tomato flu, fever is always present.


When to see a doctor?

Hand-foot-and-mouth disease symptoms can range from mild to serious:

  • Meet your health care provider if your child is younger than 1 year of age,
  • High-grade fever not responding to oral medication.
  • Not accepting anything orally, looking dehydrated, has decreased urine output.
  • Very irritable, or dull and over sleepy.
  • Blisters/rash looking infected, draining pus or really painful.

Hand, foot, and mouth illnesses usually cause minor symptoms resulting in a few days of fever. Call your doctor if the kid is younger than six months old, has a weak immune system, or suffers from mouth sores or sore throat that makes it uncomfortable to take fluids. If the child's symptoms don't improve after ten days, contact your doctor immediately.


Causes

How Hand, Foot, and Mouth Disease Spreads:

HFMD is mainly caused due to a contagious virus that spreads from one person to another through nose and throat secretions, including saliva, blister fluid, mucus, or feces.

You can also be exposed to the HFMD virus by:

  • Close personal contact with an infected person.
  • Getting exposed to a sick person’s sneeze or cough.
  • Touching contaminated objects, such as toys or doorknobs.
  • Coming in contact with infected water, including swimming pools.

A person with HFMD can be very infectious in the first week. Unless the blisters scab does not vanish, a person can be contagious for several days.

A coxsackievirus strain, most commonly coxsackievirus A16, is responsible for HFMD. The coxsackievirus belongs to a class of viruses known as enteroviruses. Viruses may be quickly transferred from one person to another.

You or your kid might get HFMD by coming into contact with:

  • Close personal contact with an infected person.
  • Getting exposed to a sick person’s sneeze or cough.
  • Touching contaminated objects, such as toys or doorknobs.
  • Coming in contact with infected water, including swimming pools.

Risk Factors

Children under the age of 5 to 7 are mainly affected by this condition. Because the virus spreads via direct touch, children in childcare facilities are particularly at risk. Although small children are commonly affected, anybody can contract the hand-foot-mouth illness.

It is believed that adults and older children are immune to hand-foot-and-mouth illness. After being exposed to the disease-causing viruses, they produce antibodies. However, the disease can still affect teenagers and adults.


Diagnosis

The doctor will diagnose HFMD through a physical examination of blisters, and they will look for blisters and rashes around the mouth and body. The doctor may collect a stool sample or a swab from the patient's throat to test for the virus and to confirm the diagnosis.


Treatment

How to Treat Hand, Foot, and Mouth Disease and Prevent It From Spreading

There's no specific treatment for hand-foot-and-mouth disease. Outbreaks of the disease are more common between the months of July to November in India.

“It is very important to keep small childrens hydrated, also you should give them soft food that they can tolerate while they’re sick. It’s okay if you just give milk and ORSL(apple) for a couple of days,” said Dr. Parakh.

Acetaminophen (Paracetamol) is safe to use to decrease fever and pain; anti-itch over-the-counter creams and lotions can be used for application on the rash/blisters on the body.

We strongly recommend consulting your pediatrician and starting the right treatment plan for you or your child — or if you have any concerns about persistent symptoms.

The hand, foot, and mouth diseases have no known treatment or vaccination, and antibiotics treat bacterial infections, not viruses.

Meanwhile, parents may do the following to make the child feel better:

  • Ibuprofen, acetaminophen, or numbing mouth sprays are examples of over-the-counter painkillers and avoid taking aspirin unless prescribed by the doctor.
  • Avoid cold foods like smoothies, yogurt, or ice pops to relieve a sore throat. Avoid canned juice and soda since they contain acids that can irritate sores.
  • Anti-itch lotion, like calamine, for rashes.


Dos and Don’ts

Currently, no medication or vaccination is available to prevent the disease. Practicing good hygiene has always been a valuable and uncostly prevention method. Below are some things you can do to ensure your family and friends are safe from HFMD.

Do’s Don’ts
Use bleach or sanitizers to disinfect toys. Touch your eyes, nose, and mouth with unclean hands.
Wash your hands, especially after changing diapers. Skip taking fluids
Call the doctor if symptoms worsen and don’t improve within 2 weeks. Avoid taking precautions and medications prescribed by the doctor
Take complete rest until the fever is gone. Share drinking cups or eating utensils.
Clean contaminated surfaces Use medicines without consulting the doctor

Treatment includes medications, being hydrated and taking rest. However, if the problem persists consult a doctor for immediate therapy.


HFMD Care at Medicover Hospitals

At Medicover hospitals, we have the best team of pediatrician and other specialists who treat HFMD and its severe symptoms. Our highly trained doctors use the most up-to-date diagnostic tools and procedures to perform various medical tests, and treat patients. Our medical experts collaborate closely with patients to evaluate their health and treatment progress to achieve a faster and more lasting recovery.

Citations

https://www.ncbi.nlm.nih.gov/books/NBK431082/
https://www.rch.org.au/kidsinfo/fact_sheets/Hand_foot_and_mouth_disease/
https://www.who.int/westernpacific/emergencies/surveillance/archives/hand-foot-and-mouth-disease
https://www.nhs.uk/conditions/hand-foot-mouth-disease/
https://www.aad.org/public/diseases/a-z/hand-foot-mouth-overview
https://www.sciencedirect.com/topics/medicine-and-dentistry/hand-foot-and-mouth-disease
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