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Pharmamum’s Ultimate Guide: Hand, Foot, and Mouth Disease
When a doctor or other health professional diagnoses your child for the first time with hand, foot and mouth disease, it can be quite daunting and your first thought may be, ‘Is this disease serious? Did they catch it from an animal? Are there any long term complications? How contagious is it? How do we treat the disease?’ The following post will answer all the questions above, inform you about the disease and give you some practical advice which worked well in my household.
What is hand, foot and mouth disease?
Hand foot and mouth (HFM) disease is a childhood disease, which in comparison to many other childhood diseases causes a mild illness. It is caused by a number of enteroviruses (mainly the coxsackie group of enteroviruses) and not related to the foot and mouth disease in cattle. The virus harbours in the body for about 3-7 days before symptoms start appearing. It mainly occurs in children under 10 years of age, particularly in the creche/day care setting. It is very contagious and usually if one child presents with hand, foot and mouth disease, most likely the rest of the class will soon follow. Adults can catch the disease but symptoms are usually either mild or not present, but adults can transmit the disease to others without having the symptoms.
How do you catch hand, foot and mouth disease?
HFM disease is caught through air particles via secretions ie nasal mucus, saliva and usually passed on via close contact through coughing and sneezing. It can be contagious through the fluid in the blisters and the virus is also present in faeces (stools) for several weeks after contracting the illness. The spots start as small red dots and then become fluid filled turning into blisters, and then slowly drying out and disappearing.
What are the symptoms?
The typical presentation are blisters on the palms of the hands, soles of the feet, in and around the mouth and in the nappy area. The blisters on the hands, feet and nappy region are not itchy or painful however the blisters in the mouth are what causes the most pain and distress in babies/children. Sore throat, irritability and fever (either mild or very high) can be present before the rash appears and loss of appetite is very common until the baby/child has recovered. The spots can also be present around the knees and elbows.The blisters usually appear as red dots and then fill with fluid, people will describe them as small ulcers too. Sometimes the red spots will just remain red spots and will not fill up with fluid, this is usually the case for the nappy region.
The symptoms can go from being mild with the child hardly suffering at all, to being quite severe, causing the child to be miserable, in pain and distressed. Complete recovery takes approximately 7-10 days.
Both my children have suffered with HFM disease and when my eldest daughter contracted the virus, I thought, ‘Great, we got over that disease, one childhood illness down.’ That was until the following year, my daughter came down with a very high fever and spots on the hands and feet and it was diagnosed as HFM disease again. It turns out you can catch HFM disease more than once because, you develop immunity to the specific virus that causes the infection, but because HFM disease is caused by several different viruses, people can get the disease again. My eldest daughter has had it at least 3 times and each time really suffered with the virus, having very high fevers for at least 3-4 days, very tired and irritated by the condition. My youngest daughter recently contracted it with getting a high fever, spots in her nappy region and little ulcers in her mouth which caused her to be off her food for at least a week but had no spots on her hands and feet and did not seem to be in a lot of discomfort. So it’s important to realise that not everyone gets all the symptoms of HFM disease.
Is HFM a serious disease?
No, HFM disease is not a serious disease and although it can be quite unpleasant and distressing for the child (and parents), it very rarely causes complications. Complications include viral meningitis and signs of that would include, headache, back pain or neck pain. Obviously a baby cannot communicate a headache, back pain or neck pain, however if a baby under 3 months of age ever has a temperature (ie above 38 degrees celsius), it is considered a medical emergency, because without proper urine/blood analysis it is impossible to work out the cause of a fever and If your child is under 12 months of age with a fever, it is always recommended to get your child checked out by a gp as soon as possible to get a professional diagnosis.
If you are pregnant whilst your child is suffering with HFM disease, there is no known risk to pregnant mothers or their unborn child.
- Exclude your child from creche/kinder whilst they are suffering with the symptoms and until the blisters have dried up.
- Symptom relief- Give your child Paracetamol and/or Ibuprofen to help with pain, or if the child is irritated and bothered by the fever. There is no cure or vaccine for the disease, keeping your child comfortable is key.
- Applying medicated gels to the ulcers in the mouth can help relieve the pain ie SM33 gel contains a numbing agent and can be used every 3 hours.
- Your child may not want to put anything in their mouth and be off both fluids and solids. Ensure your child is drinking to avoid becoming dehydrated. If your child has a very high temperature, they are likely to become dehydrated fast. To prevent dehydration, keep offering water and what worked well in my household was making icypoles from diluted cordial and fruit juices. The ice not only helps prevent dehydration but when placed directly on the ulcers, will numb the pain, bring comfort and reduce the inflammation of the ulcers. Cold purees helped when offering food. You often hear of babies/toddlers refusing to drink their regular bottle and in that situation watching for dehydration is very important. Signs of dehydration: Not passing urine ie dry nappies, dry mouth,lack of tears, is pale, has sunken eyes, cold hands and feet, drowsiness and very irritable. When making a bottle or a meal, make sure the temperature is lower than normal because anything hot will feel like burning.
- Allow your child as much rest as possible, I know my eldest daughter needed a lot of sleep to help her recover.
- Ensure good hygiene especially when changing nappies as the virus can be present in the faeces. Be extra vigilant when wiping yours or childrens noses, eyes, mouths and when preparing food.
- See a GP/doctor if:
- i) your child is not drinking fluids due to painful mouth ulcers.
- ii)your child has stiff neck, headache, back pain
- Do not pop the blisters as the fluid that oozes out is highly contagious. The blisters are very unlikely to cause any scarring.
- Try not to give your child oranges or highly acidic fruits because the juice will sting and irritate the mouth ulcers.
- Antibiotics are not necessary and do not help, as the disease is caused by a virus and not bacteria.
Please feel free to leave comments on this blog and if there are any questions I am more than happy to answer them. Also if you tried a remedy that worked well for your children that was or wasn’t mentioned above, let me know. I hope this information does help.