by Becky L. Spivey, M.Ed.
Hand, foot, and mouth (HFM) disease is a very contagious viral illness
named coxsackie virus a16 and/or enterovirus 71. In fact, you might hear
your child’s doctor refer to it as the coxsackie virus. The symptoms of HFM
disease are hard to miss: painful, blister-like sores in and around the mouth,
on the palms of the hands and bottoms of the feet, on the buttocks and
legs, and in the throat. The illness is most common in infants and children
and seems to cycle around our schools, daycare centers, and other places
children gather, but adults are susceptible as well. The virus usually doesn’t
last more than a week or so and appears mostly in summer and fall.
The most common complication of HFM disease is dehydration. The
sores in the mouth and throat make swallowing painful and difficult. If dehydration is severe,
intravenous (IV) fluids may be necessary.
This very contagious virus spreads through saliva, nasal mucus, and infected stools (i.e., changing
a diaper or when a young child gets stool on his hands and then touches objects that other
children put in their mouth). Often the disease breaks out within the local community or
neighborhood or wherever children are playing together. The virus gets in the saliva from the
sores and passes between different children. You can also catch the virus from someone coughing
in close proximity to you.
The first symptoms of HFM disease appear a few days before the breakout of lesions. You might
notice that the child has
- Pain or irritability; infants, toddlers, and older children just don’t seem like they feel well (just not acting like themselves).
- Been drinking less fluids. Drinking or eating is painful if the child is developing blisters in the mouth.
- Loss of energy and appetite.
Then you will see…
- Red, blister-like lesions on the tongue, gums, and inside the cheeks (some can be painful).
- Red rashes (without itching) and blisters on the palms, soles of the feet, and sometimes the buttocks and legs.
Since HFM is viral, there is no quick cure, but the symptoms are very manageable. Always consult
your physician for advice on treating HFM. Treatment usually includes:
Keeping children hydrated with lots of water and cool fluids to help with sore throat.
Cold foods such as flavored ice pops and ice cream may also help.
Treating high fevers with fever-reducing medications (under the instruction of a
physician). For pain and fever, give your child acetaminophen (such as Tylenol) or
ibuprofen (such as Advil). Do not give your child aspirin. Aspirin has an association to
Reye syndrome, a very serious illness.
Avoiding giving children acidic or spicy foods and drinks, such as salsa or orange juice.
These foods can make mouth sores more painful.
Children are more likely to spread the disease during the first week of the illness (even before
the blisters appear), but the virus can stay in the stool for several months and can spread quickly
to others. To help prevent the disease from spreading:
Insist that everyone in your home wash their hands frequently, especially after toileting. It
is especially important that adults wash their hands after touching a
blister or changing the diaper of an infected child.
Don’t allow infected children to play in close contact with others,
share toys, or give kisses.
Clean toys regularly with antibacterial wipes, and wash linens,
blankets, clothes, and pajamas frequently during and after the child’s
Talk to the day care or school staff about when your child can return.
Even though HFM disease is a minor illness causing only a few days of fever, mild signs, and
symptoms, a form of the coxsackie virus can involve the brain and cause very serious (though
Viral meningitis. This is an infection and inflammation of the membranes (meninges) and
cerebrospinal fluid surrounding the brain and spinal cord.
Encephalitis. This severe and potentially life-threatening disease involves brain
inflammation caused by a virus. Encephalitis is rare.
If you suspect your child has hand, foot, and mouth disease, please contact your physician.