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Hand Foot and Mouth Disease

Hand, foot and mouth disease (HFMD) is a common, and very contagious, viral infection.  It can be caused by several different viruses, but the most common is the Coxsackie virus.  

HFMD mostly affects children under the age of 5, but it can occur at any age.  Interestingly enough, it was first described in an outbreak that occurred in Toronto in 1957.  It is now one of the most common and recognizable causes of viral rashes in children and adults.   It most often occurs in the summer and fall. 

What Are The Symptoms of HFMD?

It takes about 3-6 days for symptoms to appear after you are exposed to HFMD.  It usually starts out with a fever, runny nose and sore throat.  Then a rash with tiny blisters will appear.  The most common body sites for the rash and blisters to appear are:

  • Mouth (inner cheeks, gums, sides of the tongue, top of the mouth
  • Palms of the hands and fingers
  • Soles of the feet
  • Buttocks

Other symptoms may include headache, loss of appetite, lack of energy, vomiting, and diarrhea.  

Symptoms are the worst in the first few days and are typically gone within about a week. 

HFMD Is Very Contagious

It spreads from person to person usually from saliva – talking, coughing, sneezing can spread droplets onto surfaces and then transferred to someone else’s eyes, nose or mouth.  

It can also spread through an infected persons stool.  If a child goes to the bathroom and does not wash their hands afterwards, they may contaminate surfaces and spread it to the hands of other children.  

HFMD is the most contagious within the first week of illness.  It can stay in someone’s stool for up to 4 weeks after the initial infection. 

Handwashing is the best way to prevent the spread of HFMD.

Other things parents can do to prevent the spread of infection:

  • Everyone should wash their hands with soap and water after blowing their nose, using the bathroom, and before eating.  Parents should wash their hands after diaper changes. 
  • Keep toys cleaned and sanitized after they have been used by a child with HFMD.
  • Teach your children to cover their mouths and noses when they cough or sneeze. 
  • Children should stay at home if they have symptoms.

Treatment of HFMD

Treatment is aimed at symptom management.  HFMD is self-limiting, which means it will go away on its own, usually within 7-10 days. 

Treat any fever or discomfort with acetaminophen or ibuprofen.  Avoid dehydration.  Offer your child plenty of fluids.  Sores in their mouth may make eating and drinking uncomfortable so it is important to make sure they stay hydrated.  Offer cold bland liquids like milk or water.  Juice may irritate sores in the mouth.  

Do not pop blisters.  They will heal on their own.  

Call your doctor if your child’s fever does not go away after 3 days, or if they cannot take in any fluids.  

This post was co-authored by Erin Manchuk, BScPharm, BCGP and Stephanie Liu, MD, MSc, CCFP, BHSc.

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