by Jumana Giragos, MD
Hand-foot-and-mouth (HFM) disease is a common childhood infection caused by a virus that results in a characteristic rash. The rash consists of small, blister-like bumps in the mouth (usually in the back near the tonsils) and a rash on the palms and soles. The rash also commonly appears on the legs, arms, around the mouth, and in the diaper area, especially the buttocks; in those areas, the rash can also appear as small red bumps rather than blisters.
As stated, HFM is caused by a virus, mostly commonly by specific strains of the enterovirus family. It is very common in children, especially those younger than 10. It is more common during warmer times of the year such as summer and fall. The virus is spread primarily through fecal-oral contact, although it may also be transmitted through other modes such as saliva. The rash itself is NOT considered contagious by contact. To prevent the spread, it is very important to have good hand washing.
The signs and symptoms of HFM consist of the rash (described above), and fever. The oral lesions can cause pain, so affected children may not eat or drink well. Overall, children do not feel well with this illness. Due to the distinctive rash, the diagnosis is made based on the rash and associated symptoms, and usually no further testing is needed.
Symptoms typically last 5-7 days. Because it is caused by a virus, antibiotics will not help. The main goals of treatment are to make the child as comfortable as possible due to the pain associated with the oral blisters and to encourage the child to stay hydrated with fluids. Acetaminophen and/or ibuprofen can be used to manage the fever and also help with pain control. It is very important to make sure your child is hydrated as dehydration is the biggest potential complication of this virus. Frequent sips of fluids, popsicles, etc are different ways to make sure your child does not get dehydrated.
To prevent the spread, hand washing is very important. Also contaminated surface can be cleaned with disinfectants. The virus can be shed for a few weeks even after the rash is gone. For that reason, we do not limit children from attending daycare while they have the rash unless they also have a fever at the time.