Does My Child Have Hand Foot And Mouth Disease?

Hand foot and mouth disease, or HFMD, is a common viral illness seen among young children that causes a rash that appears on the palms of the hands, soles of the feet, legs, arms and diaper area. Small blisters also occur in the mouth, usually at the back of the throat.

The Tippecanoe County Health Department said area schools recently have seen a spread of hand, foot and mouth disease in students, including teenagers.

"We honestly see it more in toddlers and preschoolers,” said Heather Rich, NP, a pediatric nurse practitioner with Franciscan Physician Network Pediatrics West Lafayette, in an interview with Star City News. “However, you can get it at any age."

What Causes Hand Foot And Mouth Disease In A Child?

Hand foot and mouth disease is contagious and is caused by an enterovirus spread through the feces-to-mouth route (which can happen when a child forgets to wash up after using the toilet; it can also spread by children mouthing toys that an infected child has mouthed or handled). Hand foot and mouth tends to run through play groups and day care centers, striking susceptible children.

The most common viruses that cause hand foot and mouth disease include:

• Coxsackievirus A16
• Enterovirus A71.

Hand foot and mouth disease is often spread because of not washing hands properly, particularly after changing diapers or using the bathroom. Proper handwashing is key to help prevent the spread of these viruses.

How Is HFMD Spread?

The viruses that cause HFMD spread through contact with nose, throat or blister fluids, bowel movements, touching contaminated surfaces or breathing air after a sick child coughs or sneezes.

When Is Hand Foot And Mouth Disease Most Contagious?

Your child will be the most contagious during the first week of illness.

"Hand, foot, mouth is most contagious, honestly, right before you start running that fever and during the fever,” Rich said. “Sometimes the rash doesn't even come until after the fever is getting better, or gone."

What Are The Symptoms Of Hand Foot And Mouth Disease In A Child?

Symptoms of hand foot and mouth disease can occur a bit differently in each child. They can include:

• Blisters in the mouth, usually near the throat and tonsils
• Small blisters on the palms of the hands or soles of the feet, or both
• Small blisters in the diaper area
• Rash on the arms and legs
• Fever
• Lack of appetite
• Generally not feeling well

Mouth sores can take up to a week to heal. Located on the tongue, the inside of the cheeks, and the back of the throat, they look like canker sores and are painful. As a result, some children refuse to drink and may become dehydrated.

Hand foot and mouth disease symptoms may last up to a week.

HFMD symptoms are usually unique. But they can be like other health conditions. Make sure your child sees his or her doctor or healthcare provider for a diagnosis.

Which Children Are At Risk For Hand Foot And Mouth Disease?

Hand foot and mouth disease is very common in young children, particularly those under 5 years of age. But older children, teens and adults also can get hand foot and mouth disease.

How Is Hand Foot And Mouth Disease Diagnosed In A Child?

Hand foot and mouth disease is diagnosed through a physical exam, including looking at the rash. The hand foot and mouth disease rash is unique and may be enough to diagnose your child.

Additionally, your child may have a throat culture or stool sample sent to a lab for testing.

How Is Hand Foot And Mouth Disease Treated?

Because hand foot and mouth disease is caused by a virus, antibiotics are not used to treat this illness.

Instead, the goal of treatment is to help manage symptoms. Treatment will depend on your symptoms, age, general health and severity of symptoms.

Home treatment may include:

• Giving your child plenty of fluids
• Giving fever reducers and pain relievers such as acetaminophen or ibuprofen. Don't give ibuprofen to a child younger than 6 months old, unless your healthcare provider tells you to. Don't give aspirin to children, as it can cause a serious health condition called Reye syndrome.

Dehydration is a big risk with hand foot and mouth disease. Help prevent dehydration by offering your child plenty of liquids. Some tips to encourage hydration in your child:

• Some children prefer ice-cold liquids and frozen juice bars. These can numb the mouth a bit, so the sores hurt less, and provide necessary fluids.
• Other kids may find warm liquids and broth soothing.
• Anything your child will drink is okay, except citrus drinks.
• Don't give your child orange juice, citrus fruit bars, or food that's spicy or salty, as they'll probably sting.

Keep your child at home until he or she is well. Most people should recover in 7 to 10 days and usually do not face serious complications.

When Should I Call The Pediatrician?

Call your child's pediatrician if your child shows signs of dehydration, including a dry, tacky mouth, tearless crying, or urinating less than usual. You should also call if the fever lasts more than three days or if your child appears to be getting worse. You should also call your pediatrician immediately if you see greyish-red blisters any place other than your child's buttocks, palms, the soles of his feet, or between his toes or fingers. A rash anywhere else means that hand foot and mouth disease is probably not the cause, although another virus could be.

Enteroviruses can cause other illnesses as well, including viral meningitis; it's not as serious as bacterial meningitis, but can make your child feel quite ill. Call for an emergency appointment if your child has a stiff neck, headache, or stays drowsy after sleep and seems foggy and confused. 

Rashes that look like bruises or broken blood vessels, or appear purple in any way, can be a sign of a more serious condition like meningitis. A simple way to tell the difference is to press on the spot. If it doesn't blanch or go away with pressure, it's not recognized as hand foot and mouth disease, and your child needs to be seen right away. Call for an emergency appointment if you detect a rash fitting this description.

How Can I Help Prevent Hand Foot And Mouth Disease In My Child?

Good handwashing - not just using hand sanitizer - is important to stop the disease from being spread to other children.

"Hand sanitizer is just not enough for disinfecting this virus,” said Seema Shankar Kengeri Srikantiah, MD, a primary care doctor at Franciscan Physician Network Family Medicine West Lafayette, who also serves as the Tippecanoe County Health Officer. “So we recommend washing with warm water if available, or just water and soap for at least 20 seconds."

To help prevent the spread of hand foot and mouth disease to others:

• Wash your hands before and after caring for your child. Use soap and warm water and scrub for at least 20 seconds. Rinse well and air dry or use a clean towel.
• Make sure your child washes his or her hands often.
• Make sure your childcare center encourages handwashing.
• Avoid touching your eyes, nose or mouth with unwashed hands.

Also make sure to:

• Clean contaminated surfaces, like toys, light switches and doorknobs, with a disinfectant.
• “Encourage your children not to share drinks and plates and cups with their friends," Rich said.
• Stay away from infected people. An infected person can still transmit viruses for 1 to 2 weeks after he or she no longer has symptoms.