11129 Hand Foot And Mouth Disease

Overview

Hand, foot, and mouth disease is a common viral illness that causes sores in the mouth and a rash on the hands and feet. It is usually mild and most people get better within a week or so.

Yes, it is very common, especially in summer and early fall. Outbreaks often happen in nurseries, schools, and childcare settings.

Most often affects infants and children under 5 years old, but it can occur in older children and adults too.

Symptoms

Common symptoms

• Fever
• Sore throat
• Tiredness and feeling unwell
• Poor appetite
• Rash with small blisters on the palms of the hands, soles of the feet, and sometimes on the buttocks
• Painful mouth sores on the tongue, gums, or inside the cheeks

Symptoms in children

• The same symptoms as above are common, but children may also be fussy, drool, or refuse to eat or drink because mouth sores hurt.
• The rash may appear first on the lips or inside the mouth before spreading to the hands and feet.

Causes

Main causes

• A group of viruses called enteroviruses, most often coxsackievirus A16.
• Spread through tiny droplets when an infected person coughs or sneezes.
• Spread through contact with infected saliva, blister fluid, or poo.
• Spread by touching toys, doorknobs, or other surfaces that have the virus on them, then touching your face, mouth, or eyes.

Risk factors

• Being in close contact with many people, such as in a nursery, school, or playgroup
• Not washing hands after using the toilet, changing nappies, or caring for someone who is infected
• Sharing cups, cutlery, towels, or toothbrushes with someone who has the virus
• Being under 5 years old

When to see a doctor

See a doctor urgently if:

• Seek same-day care if you or your child has signs of dehydration, a high fever that won't settle, severe mouth pain that prevents drinking, or symptoms that do not improve after a week.

Book a routine appointment if:

• Make a routine appointment if you are worried and want to check that it is really hand, foot, and mouth disease.
• If you are pregnant and think you have been exposed to the virus, talk to your midwife or doctor for advice.
• If you or your child have a weakened immune system, ask a doctor for guidance.

Diagnosis

A doctor can usually diagnose hand, foot, and mouth disease by looking at the rash and mouth sores and asking about symptoms. The doctor may also ask whether you have been around someone who has the same illness.

Tests that may be done

• Usually no tests are needed.
• In rare cases, a doctor might use a swab from the throat, a stool sample, or a blood test to confirm the virus. This is uncommon.

What to expect at your appointment

The doctor will examine the mouth, hands, feet, and other skin areas. They will ask about fever, eating and drinking, and any recent contact with others who are unwell. It is usually a quick and simple assessment.

Treatment

There is no medicine that cures the virus. Treatment focuses on making you or your child comfortable, lowering fever, relieving pain, and preventing dehydration.

Self-care at home

• Drink small amounts of fluid often. Water, milk, or an oral rehydration drink from the pharmacy can help.
• Eat soft, cool, and bland foods such as yogurt, ice cream, smoothies, or mashed potatoes.
• Avoid salty, spicy, or acidic foods that can make mouth sores sting.
• Rest as much as you need until the fever goes away and energy returns.
• Use plain over-the-counter pain relief and fever medicine as advised by your pharmacist or doctor – do not give aspirin to children.
• For older children and adults, rinsing the mouth with warm salt water may be soothing.
• Keep blisters clean and dry. Do not pop them.

Medical treatments

For more severe discomfort, a doctor may recommend special mouth rinses or gels to numb the mouth, or a prescription cream or rinse to help with pain. There is no antiviral medication for this illness. Always ask your doctor or pharmacist before using any treatment, especially for young children.

Living with this condition

Most people recover at home. Keep the person comfortable, encourage plenty of fluids, and watch for signs of dehydration or other warning symptoms. You can treat fever and pain with over-the-counter medicines if needed.

Lifestyle tips

• Wash hands carefully with soap and water after touching the person, using the toilet, changing nappies, or wiping a runny nose.
• Trim fingernails and discourage scratching of blisters to reduce the risk of skin infection.
• Keep the person away from nursery, school, or work until the blisters have dried and they feel better – usually about 7 days.
• Clean toys, cutlery, cups, and surfaces with soapy water, and then a disinfectant, especially in shared spaces.
• Do not share towels, cups, or eating utensils while someone is ill.

Diet and exercise

During the illness, focus on staying hydrated and eating soft, easy-to-swallow foods. Rest is more important than exercise. Once symptoms have gone, gradually return to normal activity as energy allows.

Mental health and emotional wellbeing

Being unwell with hand, foot, and mouth disease can be stressful for parents and carers, and older children may feel frustrated or uncomfortable. It is normal to feel anxious. Talk to your pharmacist, doctor, or a trusted friend if you need support.

Prevention

You can reduce the risk of catching and spreading the virus by washing hands often with soap and water, especially after toilet visits, nappy changes, and before eating. Clean shared toys and surfaces regularly, and avoid close contact with people who are infected.

Vaccines

There is currently no vaccine available to prevent hand, foot, and mouth disease.

Complications

If left untreated

• Most cases do not have complications, and the illness gets better on its own.
• Dehydration can happen if mouth sores make it too painful to drink enough fluids.
• In very rare cases, the virus can cause viral meningitis (an infection of the lining around the brain and spinal cord), which needs urgent medical care.
• Pregnant women who catch it near the time of birth can pass it to their baby, but most babies recover fully with supportive care.

Long-term outlook

The outlook is very good. Almost everyone recovers fully within 7 to 10 days. Some people notice a fingernail or toenail coming off a few weeks later, but it grows back without damage. Serious complications are extremely rare.

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