Things Every Mama Needs to Know About Hand Foot and Mouth Disease

Hand Food and Mouth Disease (HFMD) seems to be an ever-present concern at preschools and swimming pools in Dubai, and it’s an awfully scary name for something that affects little ones. Fear not, the brilliant Dr Riham from The Palm’s Al Das Medical Clinic is here to arm you with info to fight this all-too-common problem. Knowledge is power mamas!

One day your child comes home with an illness – “Hand Foot and Mouth Disease”. It sounds scary, but is it really?

What is hand-foot-mouth disease?

Hand-foot-mouth disease is not a scary disease but a common childhood illness featuring mouth sores, fever, and a rash.

Hand-foot-mouth disease is usually caused by a virus called coxsackievirus A16 but there are also other less common viruses that can cause the disease. However, many children with coxsackievirus A16 infections do not have all of the features of hand-foot-mouth disease. Some have no rash, some have no mouth sores, and some even have no fever.

This disease is most common among young children but is seen with some frequency up until puberty. Adults can get it, but this is much less common. Once people have had coxsackievirus A16 they are generally immune, but they could get another case of hand-foot-mouth disease from one of the other, less common viruses. Most infections occur in the summer or early fall, with the peak between August and October in the northern hemisphere.

How does HFMD spread?

The viruses that cause hand-foot-mouth disease are present both in the stool and in the respiratory secretions. It can spread by fecal–oral transmission, droplet transmission, contact transmission, and by means of fomites (infected toys or other objects). Hand cleansing—especially after diapering/toileting and before eating—can help reduce its spread. Children are often kept out of school or daycare for the first several days of the illness until fever subsides for at least 24 hours though this will not prevent the spread of the virus as the virus stays in the saliva for up to 2 – 3 weeks and in stools for up to 3 – 8 weeks. This is why all children and adults should follow the proper hand washing techniques for the best way to prevent spread of infection.

What are the symptoms?

Children with hand-foot-mouth disease usually start to feel crummy 3 to 7 days after they have been exposed. Often, the first thing parents notice is their children’s decreased appetite for solids. Children may also have a fever and a sore throat. A day or two later, many children develop sores in the mouth. They begin as small red spots on the tongue, gums, or mucous membranes. They may blister or form ulcers.

A skin rash may also develop over a day or two, with flat or raised red spots. Unlike with many rashes, the spots are often found on the palms and soles. Also, it is common to have the rash on the buttocks. Often, the red spots will form tender blisters. Unlike with chickenpox, the rash does not itch.
Usually the rash disappears and the child feels better within about 1 week.

How can I treat my little one when they are suffering from HFMD?

The disease is generally self-limiting and symptoms usually stay from 3 up to 10 days maximum depending on the severity of infection.

Antibiotics do not help with hand-foot-mouth disease. The important issues are pain relief and plenty of fluids. Treatments (such as Paracetamol and or Ibuprofen) are given only to alleviate discomfort.
Oral analgesic gel can help reduce the pain of the mouth sores and help the child to eat easier.

Children often tolerate soft, cool treats like Jell-O or milkshakes and we should avoid giving them acidic citrus food, spicy, sour or hot food as this will increase the pain from mouth ulcers.
If your child has severe mouth ulcerations with inability to tolerate any oral intake, we might need to give him IV fluids for hydration and antiviral medicines called Acyclovir (Zovirax) that help in shortening the course of the disease and alleviate symptoms faster. 

Are there any long-term effects and complications mamas should be aware of?

Most of the time children’s immune systems rally to defeat the virus and the infection goes away without any serious complications. Thankfully, the overwhelming majority of coxsackie viral infections are mild. Complete recovery is the rule, and serious disease is rare.

Those with weakened immune symptoms are more likely to be the ones who have complications. Breastfeeding, beneficial bacteria, a healthy diet, avoiding the unnecessary use of antibiotics, and getting plenty of sleep are all ways to help the immune system to function at its best.

If the child’s immune system is low due to any chronic disease like heart diseases, neurological diseases, kidney disease, Diabetes… the virus can spread systemically and cause croup, bronchitis, pneumonia, hepatitis, pancreatitis, arthritis, meningitis, encephalitis, temporary or permanent paralysis, and viral myocarditis. But don’t get too worried, these effects are rare – the most important thing is that you seek medical assistance if you are in any way concerned.

So there you are mamas, all of the info necessary to knock Hand Foot and Mouth on the head!

Al Das Medical, Building No. 10, Shoreline Apartments, Shoreline Trunk Palm Jumeirah, Dubai, (+971)(0) 4 452 9998, www.aldasclinic.com