Hand-foot-mouth disease

Hand-foot-mouth disease is an infection of young children in which characteristic fluid-filled blisters appear on the hands, feet, and inside the mouth.

Coxsackie viruses belong to a family of viruses called Enteroviruses.These viruses live in the gastrointestinal tract, and are therefore present in feces. They can be spread easily from one person to another when poor hygiene allows the virus within the feces to be passed from person to person. After exposure to the virus, development of symptoms takes only four to six days.Hand-foot-mouth disease can occur year-round, although the largest number ofcases are in summer and fall months.

Hand-foot-mouth disease is very common among young children, and often occursin clusters of children who are in daycare together. It is spread when poorhand-washing after a diaper change or contact with saliva (drool) allows thevirus to be passed from one child to another.

Within about four to six days of acquiring the virus, an infected child may develop a relatively low-grade fever, ranging from 99-102°F (37.2-38.9°C). Other symptoms include fatigue, loss of energy, decreased appetite, anda sore sensation in the mouth, which may interfere with feeding. After one totwo days, fluid-filled bumps (vesicles) appear on the inside of the mouth, along the surface of the tongue, on the roof of the mouth, and on the insidesof the cheeks. These are tiny blisters, about 3-7 mm in diameter. Eventually,they may appear on the palms of the hands and on the soles of the feet. Occasionally, these vesicles may occur in the diaper region.

The vesicles in the mouth cause the majority of discomfort, and the child mayrefuse to eat or drink due to pain. This phase usually lasts for an averageof a week. As long as the bumps have clear fluid within them, the disease isat its most contagious. The fluid within the vesicles contains large quantities of the causative viruses. Extra care should be taken to avoid contact withthis fluid.

Diagnosis is made by most practitioners solely on the basis of the unique appearance of blisters of the mouth, hands, and feet, in a child not appearing very ill.

There are no treatments available to cure or decrease the duration of the disease. Medications like acetaminophen or ibuprofen may be helpful for decreasing pain, and allowing the child to eat and drink. It is important to try to encourage the child to take in adequate amounts of fluids, in the form of icechips or popsicles if other foods or liquids are too uncomfortable.

The prognosis for a child with hand-foot-mouth disease is excellent. The child is usually completely better within about a week of the start of the illness.

Prevention involves careful attention to hygiene. Thorough, consistent hand-washing practices, and discouraging the sharing of clothes, towels, and stuffed toys are all helpful. Virus continues to be passed in the feces for severalwee