Hand, Foot, and Mouth Disease (HFMD) is a common viral illness that frequently affects infants and young children, though it can occur in individuals of any age. This widespread infection is known for causing sores in the mouth and a rash on the hands and feet. Outbreaks are common in settings where young children gather, such as childcare centers and schools.
Understanding Hand, Foot, and Mouth Disease
Hand, Foot, and Mouth Disease is a mild viral infection that typically resolves on its own. It is rarely fatal. The illness is primarily caused by viruses belonging to the enterovirus family, mainly Coxsackievirus A16. Other strains, such as Enterovirus 71 (EV-A71) and Coxsackievirus A6, can also cause it. These viruses spread easily through close personal contact, respiratory droplets from coughing or sneezing, and contact with an infected person’s feces or fluid from blisters.
Typical Symptoms and Disease Progression
The onset of HFMD symptoms occurs three to six days after exposure to the virus, starting with a fever, sore throat, and reduced appetite.
One to two days later, painful, blister-like sores appear in the mouth, commonly on the tongue, gums, and inside of the cheeks. A rash then develops on the palms of the hands and soles of the feet, but it can also appear on the buttocks, arms, and legs. This rash consists of flat or slightly raised red spots that may blister, and it is not itchy.
The fluid within these blisters can contain the virus, making them a source of transmission. While the rash may vary in appearance depending on skin tone, it resolves without scarring. Most individuals experience mild symptoms that clear up within seven to ten days. The illness is self-limiting.
Rare but Serious Complications
While HFMD is mild, severe complications can arise in rare instances, particularly with certain viral strains like Enterovirus 71. Dehydration can occur if painful mouth sores make it difficult to swallow liquids, especially for young children. Some individuals may experience temporary fingernail or toenail loss weeks after the illness, though nails grow back.
More serious complications involve the nervous system or heart. Viral meningitis, inflammation of the membranes surrounding the brain and spinal cord, causes symptoms like fever, headache, and a stiff neck. Encephalitis, or swelling of the brain, may develop in rare cases. These neurological complications can also include acute flaccid paralysis, a condition affecting muscle weakness.
Myocarditis, inflammation of the heart muscle, is another rare but severe complication associated with HFMD. When these severe complications arise, HFMD can lead to fatality.
When to Seek Medical Attention
While most cases of HFMD are mild and resolve on their own, it is important to know when to seek medical attention. Contact a healthcare provider if symptoms do not improve after 7 to 10 days or if new symptoms appear.
Seek medical attention for a continuous high fever, especially if it persists for 72 hours or more. Dehydration signs like decreased urination, lethargy, or reduced fluid intake, warrant medical consultation.
Neurological symptoms like severe headache, stiff neck, confusion, unusual drowsiness, jerking movements, or seizures warrant immediate evaluation. Difficulty breathing, rapid heartbeat, or any signs of chest pain or abdominal pain should prompt urgent medical care.
Preventing and Managing Infection
Preventing the spread of Hand, Foot, and Mouth Disease involves good hygiene. Frequent and thorough handwashing with soap and water for at least 20 seconds, especially after using the toilet, changing diapers, or before eating.
Shared surfaces and objects, toys and doorknobs, should be regularly cleaned and disinfected. Avoiding close contact like hugging or sharing eating utensils with an infected person helps limit transmission.
Managing symptoms focuses on comfort and preventing dehydration. Over-the-counter pain relievers like acetaminophen or ibuprofen can help alleviate fever and mouth pain.
Encourage fluid intake to prevent dehydration, as painful mouth sores can make swallowing difficult. Offering cold liquids, ice chips, popsicles, or soft, non-acidic foods can help soothe sore mouths.