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WHAT IS HAND, FOOT AND  MOUTH  DISEASE?

 

Hand, foot and mouth disease is a common, contagious viral infection that generally affects children under the age of four. The illness is seen most often during the summer months and in early autumn.

 

Hand, foot and mouth disease (entirely different from the animal foot and mouth disease) is caused by a particular virus - the Coxsackie virus - and it usually takes about four days after infection for the child to start to feel unwell. At this stage a distinctive rash usually appears.

 

Hand, foot and mouth is not a serious condition. Its effects last from only a few days, up to a maximum of a week. While it is advisable with any rash to consult your doctor, many cases of hand, foot and mouth are so mild as to pass undetected

 

The Coxsackie virus is responsible for a number of diseases, including hand, foot and mouth and, in a different variation, the common cold. It is highly contagious.

 

How the virus is spread

 

The virus that causes hand, foot and mouth disease is passed from child to child in tiny airborne droplets of mucus. Transmission can occur in different ways.

 

Children playing in close proximity can facilitate the spread of a virus such as hand, foot and mouth.

 

• An infected child may cough or sneeze in close proximity to others, who then inhale the droplets. 
• Close personal contact, for example by kissing, can spread infection. 
• It is common for the brothers and sisters of toddlers infected with hand, foot and mouth to become infected as well. The virus is prevalent in children only, so adults in the family are usually immune. 

Recognizing the symptoms

 

As implied by its name, hand, foot and mouth disease affects those specific parts of the body. The symptoms include:

 

• A  fever, poor appetite, sore throat. 
• Small red spots that appear on the tongue, gums and inside the cheeks one or two days later. These turn into blisters, ending up as white ulcers about 3mm (1/8 in) in diameter. 
• Raised, red spots that become noticeable on the hands and feet, which sometimes turn into blisters that resemble those found in chickenpox. 
• Sometimes a child may also have a rash on the buttocks. 

Home nursing

 

There is no specific treatment for hand, foot and mouth disease and viral infections do not respond to antibiotics. Once the condition has been diagnosed, the doctor will probably want to monitor the child's progress, but there is generally no cause for concern. There are, however, several steps that parents can take to ensure that their child is as comfortable as possible.

 

• If a fever is present, remove most of the child's clothing and cover her with a cotton sheet. 
• Make sure that the room is well ventilated and use an electric fan if you have one. 
• Liquid paracetamol is particularly effective at reducing a temperature, and it has the added advantage of helping to relieve any discomfort from the rash or mouth ulcers. 
• If none of these measures seem to help, gentle sponging of the skin with tepid water (never ice-cold) can be effective in reducing the child's temperature. 
• Making sure that a child drinks plenty of fluids is important in any infection. Mouth and throat ulcers may be painful; ensuring that liquids are not too hot or ice-cold, and are as bland as possible, may help. A child may eat very little during the acute stage of the illness but it is more important to maintain a high level of fluid intake than trying to 'force' food down her. A short period of time without food will do no harm. 

Although the symptoms of hand, foot and mouth may be mild and of short duration, it is important to take steps to lower the temperature of a feverish child as quickly as possible.

 

How to treat the rash

 

The mouth ulcers and skin rash usually disappear within a week, but during this time a child may complain of discomfort (especially in the mouth) and itching. Mouth ulcers, if severe, can be particularly worrying for a parent as they can make a child reluctant to eat or drink.

 

• Several over-the-Counter products can help soothe inflammation inside the mouth. Gels containing local anaesthetic can be effective but it is important to check that the product is suitable for a young child. Some medicated mouthwashes claim to help heal ulcers, and, if they are antiseptic, may prevent a secondary infection developing. 
• The itchiness of the skin rash may be relieved by calamine lotion, which is also available over the counter. 
• Hot baths will make the rash on the skin feel even more uncomfortable. Ensure that the child's bath is run with warm water only, and avoid the use of bubble baths. 
• Use lightweight cotton rather than man-made fabrics for your child's bedding to reduce skin irritation. 

Lesions on the tongue and around the mouth can be extremely sore and distressing to a pre-school child. Consult your GP for advice if the symptoms worsen.

 

Nutrition.

 

If a child is suffering from the painful mouth ulcers that are symptomatic of hand, foot and mouth, it may be necessary to adapt her diet for a few days.

 

• Serve food that is soft and relatively bland, taking special care to avoid salty or spicy flavours. Salt should never be added to children's food either during cooking or serving. 
• Offer frequent drinks, but take care to avoid acidic fruit juices. Water and milk are the best options; citrus flavours may irritate the mouth ulcers. 
• Feverishness diminishes the appetite, so allow your child to eat at her own pace. Her appetite will revert to normal. 

For  More  Information:  Please  consult  your  physician  on  your  next  visit.