Children and the outbreak of hand foot and mouth disease

We are seeing a nationwide outbreak of hand foot and mouth disease (HFMD) this summer, with more cases than in recent years. HFMD is a common infection in children. It usually causes sores in the mouth and a rash on the hands, feet or buttocks, sometimes spreading to other areas and lasts about 7-10 days.

Symptoms of HFMD

Common symptoms of HFMD include:

• Sores in the mouth that are often painful
  
  
• Rash on the hands, feet or buttocks (or occasionally other areas) which are small red bumps or blisters
  
  
• Sore throat
  
  
• Pain with swallowing, drooling
  
  
• Fever

Recently, there have been cases of children shedding their fingernails or toenails a few weeks or months after having HFMD. This is not dangerous, and the nails will grow back normally in several months.

1

What causes HFMD, and is it dangerous?

HFMD is caused by a virus. It is easily spread from person to person and is most contagious while the child has a fever and shortly after. It can be spread by breathing infected air (such as when someone coughs or sneezes), or contact with infected saliva or stool.

Though HFMD can cause some discomfort, it is rarely serious and most cases can be easily managed at home.

What can I do about HFMD?

There is no specific treatment for HFMD. It will go away with time. However, you can reduce discomfort by the following home measures:

• Have your child get plenty of rest.
  
  
• Offer your child plenty of fluids, especially cold liquids, ice or frozen juice bars.
  
  
• Avoid giving your child spicy or acidic foods.
  
  
• Give medicine for discomfort caused by the sores or fever such as ibuprofen or acetaminophen (Tylenol) as recommended by your doctor. (Do NOT give aspirin to a child with a fever, as this can put your child at risk for a serious illness called Reye’s syndrome.)
  
  
• For children over 4 with pain in their mouth, have your child rinse his mouth with saltwater or with baking soda and warm water, and then spit. You can also ask your doctor about “magic mouthwash,” which you can make at home.
  
  
• Put a thick moisture cream or ointment (such as Vaseline or zinc oxide) on skin bumps or sores that seem painful or irritated, especially in the diaper area.

2

Does my child need to be seen for HFMD?

Most of the time, HFMD can be managed at home. You should seek medical care if your child has any of the following:

• Mouth sores that do not go away within two weeks
  
  
• Difficulty drinking or swallowing
  
  
• Severe or increasing mouth pain
  
  
• Signs of dehydration such as crying less tears, dry mouth, decreased activity, or very dark or little urine
  
  
• Signs of infection around the rash or mouth sores such as pus, drainage, redness or swelling
  
  
• Fever for more than three days

If your child is seen by a doctor, she will determine if your child does indeed have HFMD and check for other illnesses such as an ear infection or strep throat. She will make sure that your child is not seriously ill or dehydrated and may offer further pain management or other medications (if needed). In addition, she can give further advice on how care for your child’s symptoms at home.

With proper care, most children will be fine

HFMD can look quite scary and make your child feel miserable at times, but with a little time and care at home, most children do just fine.

You can help prevent illnesses like this by teaching your child to wash his or her hands frequently and discouraging sharing of cups, utensils or personal items. Parents should also keep children out of daycare, out of school or from playing with others, until they are free of fever for 24 hours.

Laura Marusinec, MD Urgent Care Physician Children’s Wisconsin

Children’s Wisconsin has more than 20 primary care offices conveniently located throughout the Milwaukee area and southeast Wisconsin. Find a pediatrician near you.