Hand Foot and Mouth Disease: Symptoms & Treatment
Hand, foot and mouth disease is a contagious viral illness that mainly affects young children, causing blisters on the hands, feet and inside the mouth.
Things worth knowing about "Hand, foot and mouth disease"
Hand, foot and mouth disease is a contagious viral illness that mainly affects young children, causing blisters on the hands, feet and inside the mouth.
What is Hand, Foot and Mouth Disease?
Hand, foot and mouth disease (HFMD) is a common, highly contagious viral infection that primarily affects infants and children under the age of 10. It is caused by enteroviruses, most commonly Coxsackievirus A16 or Enterovirus 71. In the vast majority of cases, the illness is mild and resolves on its own within 7 to 10 days.
Causes and Transmission
The viruses responsible for HFMD belong to the Picornaviridae family. Transmission occurs mainly through:
- Fecal-oral route: Contact with contaminated hands, objects or surfaces
- Respiratory droplets: Spread through coughing, sneezing or saliva
- Direct contact with blister fluid: Touching open blisters on an infected person
The disease spreads rapidly in childcare settings, nurseries and kindergartens. The incubation period is typically 3 to 7 days.
Symptoms
The illness usually begins with general flu-like symptoms, followed by the characteristic rash:
- Fever (usually mild to moderate)
- Sore throat and difficulty swallowing
- Fatigue and general feeling of being unwell
- Painful blisters and sores inside the mouth (gums, tongue, palate)
- Red spots and blisters on the palms of the hands, fingers and soles of the feet
- Occasionally also on the buttocks or genital area
Because of the painful mouth sores, affected children often eat and drink less, which can lead to dehydration.
Diagnosis
The diagnosis is usually made clinically based on the characteristic appearance of the rash and sores. Laboratory testing is generally not required. In severe or atypical cases, viral identification can be carried out using throat swabs, stool samples or blister fluid via PCR testing.
Treatment
There is no specific antiviral treatment available. Management is supportive and symptomatic:
- Pain relief and fever reduction using ibuprofen or paracetamol (in age-appropriate doses)
- Adequate fluid intake: Cool, soft foods and drinks can help soothe mouth pain
- Mouth rinses or gels may help relieve discomfort in the oral cavity
- In cases of severe dehydration, hospital admission with intravenous fluids may be necessary
Complications
HFMD is usually a harmless illness. However, rare complications can occur, particularly with Enterovirus 71 infections:
- Aseptic meningitis (inflammation of the membranes surrounding the brain)
- Encephalitis (inflammation of the brain)
- Nail shedding (onychomadesis) as a late complication
Prevention and Hygiene
As there is no widely available vaccine against the strains circulating in Europe, the most important preventive measure is consistent hand hygiene. Recommendations include:
- Frequent and thorough handwashing with soap and water
- Avoiding close contact with infected individuals
- Regular cleaning and disinfection of toys and frequently touched surfaces
- Keeping sick children at home until they are fever-free and no longer have open blisters
References
- Centers for Disease Control and Prevention (CDC): Hand, Foot, and Mouth Disease (HFMD). Available at: https://www.cdc.gov, 2023.
- World Health Organization (WHO): A Guide to Clinical Management and Public Health Response for Hand, Foot and Mouth Disease. WHO Regional Office for the Western Pacific, 2011.
- Longo DL et al. (eds.): Harrison's Principles of Internal Medicine, 21st edition. McGraw-Hill, 2022.
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