Hand, Foot and Mouth Disease (HFMD) is an infection caused by a virus called enterovirus. It is characterised by fever, ulcers in the mouth, and rashes on the hands and feet.
The same virus may cause ulcers in the absence of rashes; in that case, the condition is called herpangina.
HFMD affects primarily infants and young children, although adults may also be at risk of infection. The virus can spread directly from person to person via saliva, stool and respiratory droplets. It can also spread indirectly via items contaminated with the secretions.
Signs and Symptoms of Hand, Foot and Mouth Disease
Symptoms include:
Fever
Sore throat
Painful mouth ulcers on the back of the throat, roof of the mouth or tongue
Rashes. They may look like vesicles, which are fluid-filled bubbles. They are most commonly found on the palms, soles and sometimes over the buttocks and around the mouth.
There may be diarrhoea and vomiting as well.
Due to the ulcers, children may have difficulties eating and drinking, and dehydration may occur. Complications affecting the heart or brain are otherwise rare.
Treatment Options
HFMD in children usually resolves on its own within 7 to 10 days. The mainstay of treatment is to ensure good hydration to prevent dehydration.
Parents may consider the following:
Pain relief with topical analgesic gels, e.g. MediGel, Bonjela or oral analgesia such as paracetamol
Give fluids at room temperature or chilled, and offer soft foods to help relieve discomfort.
The rashes will resolve by itself over time and generally do not require any treatment. The blisters should not be popped.
In addition, as HFMD/herpangina are very infectious conditions, it is advisable for your child to rest at home and avoid school and public places, for at least 1 week after onset of the rashes. They may usually return to school when they are recovered, which is after fever and ulcers resolve and blister rashes over the body dry up.
Your child’s school may require a doctor’s assessment and certification for fitness before returning to school. Please check with the school regarding that.
When Should Parents be Worried?
Bring your child to see a doctor if your child:
Is not eating and drinking well
Is vomiting
Has no urine output after 6-8 hours
Has a change in behaviour- cranky and inconsolable, or difficult to wake or get up to move
The doctor will check your child’s hydration status to determine if there are any complications from the HFMD infection. Some children may need hospitalisation for hydration, such as with an intravenous drip.
Summary
HFMD (or herpangina, in some cases without rashes) is a viral infection which can cause fever, painful mouth and throat ulcers, with rashes that may look like blisters. While the condition will resolve on its own, the risk is often of dehydration due to the painful ulcers which affects drinking and eating. Children who do not eat and drink well despite analgesic medications will need to be seen by a doctor.
As this is a high contagious virus that spreads through saliva droplets and stools, adequate hand hygiene and cleaning of contaminated surfaces, including toys and environment, will be essential to reduce the spread of this condition in the household.
