Hand, Foot and Mouth Disease

Many people associate this disease with the foot and mouth disease that farm animals can contract although please be assured thatthere is no link whatsoever between the two diseases.

What is Hand, foot and mouth disease?
Hand, foot and mouth disease in young children, especially those still wearing nappies, is surprisingly common but the disease can affect people of all ages. It is normally a mild illness which is caused by a number of different viruses, most commonly the coxsackie virus. It has been named Hand, foot and mouth disease because a rash usually appears on the hands and feet and blisters may appear in the mouth.

How can you get it?
Hand, foot and mouth disease is very contagious and outbreaks in places where children meet such as nurseries and playgroups are very common. Unfortunately, people are most contagious before any symptoms appear and therefore it is very difficult to prevent your child from catching the virus. Hand, foot and mouth disease can be spread by:

  • People with the disease coughing or sneezing.
  • People not washing their hands properly after going to the toilet. The disease can survive for up to four weeks inside poo.
  • Coming into contact with an infected blister or saliva

It is possible for a person to get Hand, foot and mouth disease more than once although most people develop an immunity to most of the viruses which can cause the disease as they get older.

What are the symptoms?
The symptoms of Hand, foot and mouth disease often begin to show within 5 days after infection. The early symptoms include:

  • A loss of appetite
  • A high temperature ( a fever of higher than 38 degrees)
  • A cough
  • Abdominal pain
  • A sore throat

The main symptoms of Hand, foot and mouth are

  • Mouth Ulcers
  • A skin rash

In some cases, sickness may also occur.

Mouth Ulcers
You may notice red spots inside the mouth, these may appear on the tongue, the gums and the inside of the cheeks.  It is normal to
get between 5 and 10 inside the mouth. They usually begin quite small but may then develop into yellow-grey ulcers. The mouth ulcers can sometimes be very painful and can make all mouth actions such as eating, drinking and swallowing very difficult and often cause young children or babies to dribble often. Normally the mouth ulcers should clear within a week.

HFMA skin rash
Small red spots are likely to appear on the skin. The spots normally appear on the sides of the fingers, on the back of the hands and around the heels of the feet first. Some people may develop spots on the palms of the hands and the soles of their feet too. The spots can also appear up the legs and around the bottom and groin area.

The spots are usually between 2 and 5mm in size, red in colour but with a greyish middle. The spots do not normally cause any pain or irritation and are not normal itchy. However, for some people the spots can turn into small blisters which can be very tender and cause pain.

The rash and blisters normally clear within a week.

When should I worry and get help?
Most infections of Hand, foot and mouth disease pass within 7 days and mild and do not require medical intervention. Hand, foot and mouth can be a very scary disease if a young child has it and you may want a diagnosis and advice from your doctors although there is no medication or intervention that they can provide.

However, you should contact your doctor or go to A+E if:

  • Your child cannot drink any fluids
  • Your child is dehydrated – extremely tired, not weeing, dry skin
  • The symptoms do not improve after a week
  • The symptoms get worse as the time goes by
  • You child experiences a change in personality
  • Your child experiences fits or seizures
  • Your child seems different mentally

How do I deal with Hand, foot and mouth disease?
This disease is a virus and therefore antibiotics will not help your child if they are suffering. You will need to let the body recover from the disease naturally and usually within 7 days. However, you could try the following to help ease your child’s symptoms:

  • Use a paracetemol based medication to bring down the fever and ease the pain
  • Ensure your child drinks plenty and try to avoid acidic drinks such as orange juice or cola. Cold drinks or frozen lollies can help to relieve pain in the mouth.
  • Offer food regularly – you may need to suggest soft foods such as soup and mashed foods
  • You may wish to speak to a pharmacist about using a mouth wash if your child is suffering badly with mouth ulcer.
  • You could try a baby teething gel in your baby’s mouth on the ulcers
  • Do not burst any blisters as this is likely to spread the infection.

In order to reduce the risk of infecting others you will need to:

  • Practise good hygiene and hand washing
  • Use separate utensils for those infected
  • Do not share toys while infected
  • Ensure all work areas are clean
  • Keep your child of school, nursery or playgroups until any blisters have dried over and no longer have fluid in them. You do not need to wait until the blisters have completely disappeared.

If you are worried about your child or Hand, foot and mouth disease, you should speak to you doctor for advice.

What do I do if I am pregnant and have come into contact with the disease?
Most adults are already immune to Hand, foot and mouth disease although it is possible for adults to get the virus. However, for adults, the symptoms are often very mild. Unfortunately, if you do catch the virus, there is a very small risk of miscarriage. If you contract the disease towards the end of your pregnancy, there is a chance that your baby can also be infected.

If you are pregnant, you must make sure that you regularly wash your hands properly. You may also wish to wear latex gloves when doing nappy changes or preparing food.

If you are worried or have any concerns you must speak to your midwife or doctor for advice.

by Jenny, mum to William and James

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