All you need to know about Hand, Foot, and Mouth Disease

Hand, Foot, and Mouth Disease (HMFD) is a viral infection that produces sores at, as the name suggests, hands, feet and mouth. However, other areas such as buttocks and genitals may also be affected by sores.

This disease is known to commonly affect children, but adults may catch this disease too.

 

Who is the culprit?

HMFD may be caused by a range of viruses known as enterovirus but coxsackievirus A16 and enterovirus 71 are the most common culprits.

Infection usually occurs after oral ingestion of the virus which is shed through fluid from the sores or saliva and mucus from the nose. It can also be transmitted through faeces. This disease is highly contagious with a risk of nearly 100% to catch the disease when young children are exposed to another person with the active disease.

 

What are the symptoms?

After ingestion, the virus will incubate for about 4 to 6 days before causing symptoms in the affected person. Early symptoms include:

  • Fever (37.3oC to 38.3oC)
  • Tiredness
  • Loss of appetite

This is then followed by the appearance of painful sores in the hands, feet and mouth as shown below.

 

Image credit: MidgleyDJ at https://en.wikipedia.org/wiki/Hand,_foot,_and_mouth_disease (creative commons)

Image credit: Ngufra at https://en.wikipedia.org/wiki/Hand,_foot,_and_mouth_disease (creative commons)

Image credit: KlatschmohnAcker at https://en.wikipedia.org/wiki/Hand,_foot,_and_mouth_disease (creative commons)

An infected child may also refuse to eat due to the pain the sores cause inside the mouth. Although the hands, feet and mouth are common areas for the sores to appear, not everyone gets them in all three locations.

Although rare, the infection may also reach the brain and potentially be life-threatening.

 

Prevention starts with you

Due to the highly contagious nature of the disease, people with the disease should be isolated from the general public for at least a week from the start of the illness as this is when they are most infectious. This is especially important for children who attend school or day-care where they may spread the disease to other children they come into contact.

Since the disease is spread through ingesting infected bodily fluids or faeces, hand hygiene is extremely important. Wash your hands often using soap and water. Children should also be taught to maintain good hand hygiene, especially after visiting the toilet and before eating. Disinfect surfaces such as table-tops, toys and other items/surfaces a child may come in contact with.

 

How is it treated?

The disease itself is usually self-limiting. That is to say, it will resolve by itself without any active treatment. Therefore, the treatment of HFMD revolves around treating the symptoms such as taking pain and fever medicines. Examples are paracetamol (Panadol®, Tylenol®) or ibuprofen (Brufen®, Nurofen®). Do not give aspirin to children as it may cause severe side effects.

Due to the sores, swallowing can be painful, hence some children may refuse to eat and/or drink. As such, it is important to make sure that these children are getting sufficient fluids to prevent dehydration. Ice cream and popsicles can be useful to provide relief to the pain while replenishing fluids. Foods that are soft such as pudding or jelly may be easier to swallow.

 

When to see a doctor?

You should bring child to see a doctor when:

  • The child is drinking little or no fluids
  • The is no urination for the past 6 hours or more
  • The fever persists for more than 3 days
  • The fever is higher than 38.3OC
  • The child is acting strange

 

HFMD is a highly contagious but relatively benign (harmless) disease. The symptoms may cause discomfort but is not life-threatening. Therefore, it is important to observe good hand hygiene while isolating people with the disease away from the community. Preventing outbreaks of HMFD starts with you!

 

Image Gallery – Symptoms of HFMD:

References

Cdc.gov. (2017). Hand Foot and Mouth Disease | About HFMD | CDC. [online] Available at: https://www.cdc.gov/hand-foot-mouth/about/index.html [Accessed 12 Dec. 2017].

Uptodate.com. (2017). Patient education: Hand, foot, and mouth disease (The Basics). [online] Available at: https://www.uptodate.com/contents/hand-foot-and-mouth-disease-the-basics [Accessed 12 Dec. 2017].

Pou Wee Gan
Pou Wee Gan

M.Pharm, MBBS, BCPS, R.Ph

A pharmacist first, then a medical doctor. An avid tea drinker and an occasional poet.

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