It often starts with a high fever and an overall feeling of being unwell, but from one day to the next can quickly turn into, as one Yorktown mother describes, “a nasty, evil virus.”
Carrie Chi knows all too well how miserable hand, foot and mouth disease can be for the whole family. Her nearly 2-year-old daughter experienced the virus not once, but twice, in the span of a year and to make a bad situation worse, she and her husband got it, too.
It’s “worse than the flu, in my opinion,” Chi says.
It’s Not Just a Childhood Illness
Caused by the coxsackievirus, most commonly the A16 strain, the virus better known as hand, foot and mouth disease (HFMD) is notoriously miserable for those affected. Just referencing the virus conjured unpleasant memories for Chi and her weeks-long ordeal.
While the virus itself is relatively mild in terms of impact to health, the notoriety stems from its highly contagious nature. It can spread rapidly through communal facilities such as daycares, schools and underchlorinated pools if proper precautions are not taken.
The virus mostly affects children under the age of 5; however, as was the case with the Chi family, anyone is susceptible. In some cases, parents may actually experience more severe symptoms than their children.
“The virus typically presents the same in adults and children with a high fever, change in demeanor or behavior and overall feeling unwell,” says Dr. Joseph Baust, Jr., a pediatrician at TPMG (Tidewater Physicians Multispecialty Group) James River Pediatrics in Newport News, Va.
A key identifier of HFMD is the trademark rash of bright-red bumps and blisters on the hands, feet and inside the mouth, which follows a day or so after the fever. The rash can be so distinctive a pediatrician or family doctor may need only view it to diagnose, Baust says.
Depending on the severity of the symptoms and the health of the individual, the rash can range from flat bumps to blistering sores on the hands, feet and inside the mouth, which when localized is known as herpangina. In some cases of HFMD, the blisters can be so severe that fingernails and toenails fall off.
Unfortunately, since it is a virus, there is no specific treatment for hand, foot and mouth disease. The focus is typically on symptom management and controlling the spread to others.
Over-the-counter pain medications such as Tylenol and Ibuprofen can be given to help alleviate some of the pain or discomfort caused by the sores. (Children under 18 should not be given aspirin as it may cause a rare but serious illness called Reye’s syndrome.) Baust also suggests soothing beverages such as slushy drinks or popsicles to help ease the discomfort caused by the blisters and to keep the patient hydrated. Particularly for young children, fluid intake should be monitored to avoid dehydration. If you believe your child has become dehydrated, seek medical attention.
“Keeping the patient comfortable and hydrated are the top priorities as the virus runs its course,” which lasts about a week, says Baust.
Since HFMD is spread through direct contact and bodily fluids such as saliva, avoid kissing and hugging a child with the virus to help limit potential spread amongst other children and family members. While not everyone who comes in contact with the virus experiences symptoms, they can still pass it to others.
Proper hand washing — especially after changing diapers — and disinfecting practices are encouraged to help limit the virus’ spread.
Children should be kept home from school and daycare facilities to limit exposure to others. These facilities often have notification procedures to inform parents of an incidence of illnesses such as HFMD, as well as protocol for disinfecting shared toys or everyday objects such as cups and utensils.
Back to Health
Children are typically cleared to return to schools, daycare and regular contact with others once they have been fever-free for 24 hours, are tolerating fluids well and the rash begins to subside.
Similar to other viral illnesses such as chickenpox, if you have had hand, foot and mouth disease, chances are you built up some level of immunity to avoid another incidence. However, “if you encounter a similar, yet dissimilar enough, strain of the virus you may experience a recurrence,” Baust says. In some cases, a child may experience the virus on the hands, feet and in the mouth, but with the next incidence, may experience herpangina with the sores only inside the mouth.
The best advice is to avoid hand, foot and mouth disease all together, and as always, good hand-washing practices can help you stay healthy and well.