Download Hand Foot Mouth

P E DI A T
R I C A F F I L IA
TE S
OF HAMPTON ROADS
200 GRAYSON ROAD, SUITE 101
VIRGINIA BEACH, VIRGINIA 23462
(757) 473-3200
www.doc4kids.com
HAND - FOOT - MOUTH DISEASE
Hand-foot-mouth disease is a viral infection that usually begins in the throat. The Coxsackie virus
(a member of the Enterovirus family) causes this disease. The throat and tonsils develop small
ulcers while a rash with characteristic vesicles (very small blisters) affects the hands, feet, and
diaper area. This is usually a mild illness with the rash healing in 5 to 7 days. The actual incidence
is unknown, but hand-foot-and-mouth disease is a relatively common infection in children. Another
Coxsackie virus infection with a high incidence and related features is herpangina. This is
characterized by painful ulcers in the mouth and throat, but does not have a rash on the hands,
feet or buttocks. The most important risk factor is age. The infection typically affects young
children, but can be seen in adolescents and occasionally adults. The outbreaks occur most often in
the summer and fall.
Symptoms
• Fever
• Sore Throat
• Ulcers in the throat, mouth and tongue
• Headache
• A rash with vesicles (small blisters -- 3-7 mm) on hands, feet, and diaper area. The vesicles
are typically on the palm side of the hands, the sole side of the feet, and are very
characteristic in appearance. The vesicles are also tender or painful if pressed.
• Loss of appetite
Treatment
Since a virus causes this disease, there is no specific treatment for the infection other than
symptomatic relief of symptoms. Treatment with antibiotics is not effective, and is not indicated.
Acetaminophen or Ibuprofen may be used to treat any fever. Aspirin should not be used in viral
illnesses in any children since this may lead to Reye’s Syndrome. Salt water mouth rinses (1/2
teaspoon of salt to 1 glass of warm water) may be soothing if the child is able to rinse without
swallowing. Ensure that an adequate fluid intake occurs because swallowing may be painful and a
child could become dehydrated. Extra fluid is needed when a fever is present. The best fluids are
Pedialyte®, Jell-O®, cold drinks, popsicles, and cold milk products, especially ice cream or sherbet.
Many children refuse juices and sodas, for example, because their acidity causes burning pain in the
ulcers. You may offer a soft diet for a few days. Your child may benefit from a Maalox/Benedryl
Slurry for pain relief. Mix equal amounts of Maalox (coats and soothes the gums and mucosa) and
Benedryl (acts as a topical anesthetic). After mixing in a 1:1 proportion, paint the area that is
inflamed as often as needed but not before every 2 hours.
Expectations (prognosis):
Generally, complete recovery occurs in 5 to 7 days. Hand-Foot-Mouth Disease is quite contagious
and many of your child’s friends may get the illness. The incubation period after contact is 3 to 6
days. The spread of the disease is extremely hard to prevent. There is no need to isolate the
child. Most children are contagious from 2 days before the onset of the rash until 2 days after the
rash is through.
Complications:
• Dehydration can occur because the mouth lesions can cause pain with swallowing.
• Possible febrile seizure
Calling The Office:
Apply home treatment and call us if there are signs of complications, such as pain in neck or arms
and legs. Other times to call include: when a high fever is not reduced by medication, signs of
dehydration occur such as dry skin and mucus membranes, weight loss, irritability, lethargy, and
decreased amount of urine (no output for more than 8 hours) or dark urine. Emergency symptoms
include convulsions.
Prevention:
Avoid contact with people with known illness. Strict hand washing is important if in contact with
infected children.
Copyright 2005, A.D.A.M., Inc.
Hand-Foot-Mouth rev.: 11/12/09