Hand Foot and Mouth disease

Hand, Foot and Mouth disease – hard to avoid – simple to manage

 In this information article, we’ll look at exactly what this disease is, symptoms to look for so that you can recognise the condition and take early action. We’ll also look at ways in which you can help minimise the risk of spreading infection and tips on what you can do to help your child.

What is Hand, Foot and Mouth?

Hand, Foot and Mouth disease is caused by a viral infection from the enterovirus group, chiefly coxsackie A or B virus, although there are less common other strains. The infection derives its name from a rash which appears in these areas as the symptoms progress. It most commonly affects children under 10, with ages 1-4 being the most susceptible. In rare cases, adults too can be affected, however most carry immunity from their own childhood.

The disease is highly contagious and is easily spread through the air from mouth or nose via coughs and sneezes. The virus can then be contracted from contact with surfaces or objects that may have become contaminated from airborne droplets of saliva. Similarly, with very small children and babies, they can become infected when they put contaminated objects in their mouth.

The disease can also be spread through contact with infected faeces or from the fluid in the little rash blisters. In general, the infection runs its course in 7 – 10 days. In most cases, it’s not too painful, however it may make children very uncomfortable and sometimes distressed.

In all cases, once identified you should keep your little patient at home as much as possible and avoid public facilities like the pool or play parks, play centres etc… until it’s cleared up completely, more on that later in this piece.  Once your child has had this disease, it’s unlikely (not impossible) that they will catch it again. Just a quick note here; this disease is not in any way the same as the Foot and Mouth disease which relates to livestock.

Symptoms timeline

Initially, the virus may appear as feverish symptoms with your child running a temperature (maybe 38 - 38.8 C), which may last for a couple of days. Once these symptoms appear, the virus may have already been present for 4 or 5 days.

Concurrently during this phase, or within a day or so, swallowing may become painful and if you check inside the mouth, you will see small red lesions or spots on the gums, tongue, palate or inside the lips and / or cheeks and the high temperature may still be present.  Within a day or two, red spots may appear in various parts of the body. Generally, hands, soles of the feet are most common, however, spots may also appear on the bottom, looking a bit like nappy rash.

These spots can be flat or in some cases raised as blisters containing fluid and as a rule are not itchy. As mentioned earlier, the infection will clear up by itself with fever reducing and spots clearing up in around 7-10 days.

Treatment options

Whilst there is nothing that can be prescribed to cure this disease (it’s a viral infection so anti-biotics are of no use), there are some steps you can take to help alleviate the symptoms, help minimise the risk of spreading infection and let the immune system take care of fighting the infection.

Four most helpful tips

Tip 1

Most important thing is to ensure your child stays well hydrated. As it’s difficult to drink and swallow, combined with the effects of high temperature, dehydration is a real danger.  Encourage them to drink plenty of water. Weak diluted fruit drinks can be ideal or better still, making your own frozen fruit water ice lollies at home can both hydrate and help relieve oral discomfort and sore throat may also help distract your child from misery of symptoms for a while.

Tip 2

When temperature is high, you can give them children’s paracetamol (Calpol, Parapaed 6+) to help manage pain and reduce temperature.

Tip 3

If spots are itchy, a 1% Hydrocortisone cream (available over the counter) will help relieve itchiness. Speak to your pharmacist or doctor before using 1% Hydrocortisone cream on children, despite being the mildest type of steroid cream, children are a little more prone to side effects like thinning skin; it should only be used short term.  1% Hydrocortisone can be vital in helping prevent the spread of virus as the fluid from burst blisters is infectious. This will also minimise risk of scratched spots becoming infected too.

Tip 4

Instigating and maintaining a thorough handwashing routine, perhaps supported by an antibacterial handwash, is also key to preventing the spread of infection. It is important to note that this particularly important after changing nappies. The virus can be present in stools for up to four weeks after the infection appears to be gone so vital to remain vigilant with your routines for all the family for a few weeks following the infection.

How long does Hand, Foot and Mouth last?

Each case is different, but in general around 10 days, however the virus can be present in faeces for up to four weeks, so, care needs to be taken. Once your child has been fever-free for 24 hours they should be able to mix with other children. A caveat to this rule is that if they have fluid filled blisters, these need to have dried and scabbed before returning to regular activity or school, playschool etc as there is a continued risk of infection from fluid from burst blisters.

 

In conclusion, Hand, Foot and Mouth is a mild illness and is nothing to worry about. As children are inquisitive by nature and love nothing more than playing with other children, if the infection is around, it can be hard to avoid. Encouraging your children to maintain their good hygiene habits when they’re out and about, at camps, playdays etc can help minimise their risk of infection. If you see symptoms that appear to be worse or perhaps last longer than those described above, it is advisable to contact your GP

Disclaimer: This article has general information and is not meant as a substitute to medical assessment with your doctor or other health professional

 

For health advice and information call in to Whelehans Pharmacies, log on to www.whelehans.ie or dial 04493 34591 (Pearse St) or 04493 10266 (Clonmore).