Narayana Health Care

Over the last couple of months, there has been an increase in cases of virus-borne hand, foot, and mouth disease (HFMD). This disease is very contagious. HFMD can infect people of all ages but usually occurs in children under five. The blisters of HFMD disease are similar to chickenpox, which makes diagnosis difficult. 

According to experts, the cases of hand, foot, and mouth disease rise every summer and fall season. Before the COVID-19 pandemic, children frequently got exposed to viral infections and developed immunity against them, causing fewer HFMD cases. But, in the last two years, children were staying home, leading to a lack of exposure to pathogens, which causes low immunity in children. Hence the cases and transmission are higher this year.

What is a hand, foot, and mouth disease (HFMD)?

Hand, foot, and mouth disease is a virus-borne infection and highly transmissible. In this disease, patients may have skin rashes, sore throat, and painful ulcers in the mouth. It is a self-limiting disease, so the symptoms usually disappear within a few days. 

According to numerous experts, the hand, foot, and mouth disease are more common in younger children under five years, but teenagers and adults can also get the infection if they come in contact with the virus. 

What are the cause of hand, foot, and mouth disease?

The virus responsible for the hand, foot, and mouth disease is coxsackievirus (mainly the A16 strain). This virus is a member of the enterovirus family. HFMD transmits from person to person when someone comes in close contact with the body fluid of an infected individual. The disease transmission is possible in the following ways:

• Touching the things or surfaces contaminated by sneezing, drooling on, or coughed by infected people
• Contact with fluid seeping from a draining sore
• Contact with the stool of infected people while changing diapers or helping children to wash after defecation
• Inhaling the air droplets from an infected person while talking

A child in the daycare facility is more likely to contract hand, foot, and mouth disease because of the frequent necessity of diaper changes, toilet training, and touching the mouth frequently. The children are most contagious during the first week of HFMD, but the virus shedding can happen from the body after the resolution of the symptoms, which means the child can still infect other children. While handling children in daycare, the adults can also get the virus, and despite not showing symptoms, they become a carrier and further transmit the disease.

What are the most common symptoms of hand, foot, and mouth disease?

The early symptoms usually appear 3-5 days after infection. This period is known as the incubation period of the virus. Initial symptoms of HFMD are much similar to the common cold, including:

• Fever
• Headache and malaise
• Sore throat
• Runny nose

After a day or two of the appearance of fever, a patient may experience the following symptoms:

• Red spots or a rash or small blisters on the diaper area, the palms of the hands, and the soles of the feet
• Small painful ulcers on the back of the throat and tonsils
• Increased salivation
• Irritability
• Decreased appetite

How can we diagnose hand, foot, and mouth disease?

A doctor starts with a physical examination of the child’s body and mouth to check the appearance of ulcers, rashes, and blisters. To confirm the HFMD, the doctors can suggest the following test:

• Throat swab: To know the causative pathogen
• Stool test: To test for the virus

How can we manage hand, foot, and mouth disease?

HFMD is a mildly infectious condition and will resolve within 7-10 days without any treatment. As it is a viral disease, antibiotics are not effective. The doctors may prescribe the following medicines for symptomatic relief:

• A doctor can give acetaminophen or ibuprofen to help with fever, sore throat, and headache for children older than six months
• A doctor can prescribe topical ointments to soothe rashes and blisters
• Medicated lozenges or syrups for sore throat

Do not give your child aspirin or aspirin-containing products, as aspirin can cause a fatal condition called Reye’s syndrome in children.

Numerous home remedies are beneficial to soothe throat ulcers and painful blisters, such as:

• Give plenty of liquids to your children, such as milk, water, apple juice, or popsicles.
• Avoid giving citrus fruits or their juices and carbonated drinks, as they can irritate the mouth and throat sores.
• If your child is younger than one year, give plenty of breast milk, milk formula, or both.
• Give your child soft foods that are easy to swallow
• Avoid salty or spicy foods
• Give your child warm broth or soups to soothe a sore throat
• For children who can gargle without swallowing, you can give salt in warm water to swish and gargle 2-3 times a day to relieve sore throat.

There is no vaccine available to prevent HFMD. The virus is more contagious during the first week of an infected child. And a child is still able to spread the disease after a few days of complete healing. Therefore, to avoid transmission, do not send your child to school or daycare, and teach them the importance of hygiene maintenance.