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Hand-foot-and-mouth Disease

Definition

Hand-foot-and-mouth (HFM) disease is a viral infection with a characteristic rash. It usually occurs in young children.

What is going on in the body?

The viruses that cause HFM disease are easily spread from person to person. The viruses produce a characteristic rash. Most of the time, HFM disease is caused by the virus called Coxsackievirus A16. This is a member of a viral subgroup known as enteroviruses. It has no relation to foot-and-mouth disease, a viral infection often found in farm animals.

Risks

What are the causes and risks of the disease?

HFM disease is more common in the summer and fall months. The viruses infect humans only and are passed in feces. They can be spread when a person with contaminated hands touches food or objects that are put into the child's mouth. Less commonly, the viruses are passed through respiratory secretions or mouth-to-mouth contact.
Factors that put a person at risk for the disease include:
  • age less than 5 years
  • crowded living conditions
  • poor sanitation

Prevention

What can be done to prevent the disease?

HFM disease is a contagious infection. Careful hand washing after using the toilet or changing a diaper can decrease the spread of the infection. Hands should also be washed well before food preparation. Children and toddlers should be taught good hygiene. Children with HFM disease are contagious for about a week. They should be kept out of day care or school until the fever is gone and the mouth ulcers have healed.

Diagnosed

How is the disease diagnosed?

Diagnosis of HFM disease begins with a medical history and physical exam. HFM disease is diagnosed by observing the characteristic rash. There are no commonly used tests to identify the virus. In rare cases, a test may be ordered to look for the virus in fluid from the skin lesions.

Long Term Effects

What are the long-term effects of the disease?

HFM disease is almost always a mild illness without major long-term effects. If the brain is affected in the severe form of the disease, serious neurologic or developmental problems can result.

Other Risks

What are the risks to others?

HFM is a contagious disease that is easily passed from one person to another. The virus may be found in the person's respiratory secretions for up to 2 weeks. It may also be found in the stool for up to a month after the disease starts.

Treatments

What are the treatments for the disease?

Since HFM disease is caused by a virus, antibiotics are of no use. Since it is a mild illness, treating symptoms to make the child more comfortable is usually all that is necessary. Medicines such as ibuprofen (i.e., Advil, Motrin) or acetaminophen (i.e., Tylenol) may be given for fever. Occasionally, intravenous fluids are needed to prevent dehydration.
The mouth ulcers will be less painful if the child avoids:
  • citrus fruits and fruit drinks such as orange juice
  • foods that require a lot of chewing
  • salty foods or beverages such as sports drinks
  • spicy foods
Cold drinks and frozen desserts are often well liked and well tolerated by an individual with this condition. The person should drink plenty of fluids and rinse the mouth with warm water after meals.

Side Effects

What are the side effects of the treatments?

Acetaminophen or ibuprofen may cause stomach upset or allergic reactions.

After Treatment

What happens after treatment for the disease?

The individual can return to normal activities once he or she feels better.

Monitor

How is the disease monitored?

Any new or worsening symptoms should be reported to the healthcare professional.

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