Friday, June 21, 2013



We have started to get calls about hand foot mouth lately,so I thought I would do a little review.

Hand foot mouth is a very common illness that most kids get during childhood. It is easily spread through body secretions such as saliva and stool. Although the virus most commonly associated with it is called coxsackievirus there are other strains that sometimes circulate.

Most folks may only get it once, but I have seen some patients who don't seem to hold the immunity and have gotten it multiple times. As with most childhood illnesses, most of us got this out of the way when we were young. Adults who are unfortunate enough to come down with this tend to be quite miserable.

I actually like to call it Hand Foot Mouth and Butt, because in my experience kids often get blisters on their butts as well as on the hands and feet.

Some people have mild congestion, sore throat and fever as part of the package.

It is a very variable illness, meaning that one child will not look very sick and another can feel wretched. The lucky ones might simply have a mystery blister on the hand and that is the extent of it! Most of the time the worst symptoms resolve in a week or so.
Last fall when it was going around it seemed like it was a rougher strain Many of the kids had mouth involvement and some of the blisters on the hands seemed to last a bit longer.

There is no treatment for this virus. You simply support your child through it and of course call the doctor if something is causing you alarm.

Your goal is to keep your little one hydrated.
I have found that the kids with more mouth involvement are the most miserable. In extreme cases the mouth sores are so awful that they don't want to eat or drink and can have a risk of dehydration.

Keeping them comfortable is the best way to get them drinking. Even if they have no fever, it is appropriate to dose them up with Tylenol or Ibuprofen (Motrin/Advil).
Tylenol comes in a suppository form if they are resistant to taking medicine by mouth.   
Offer cool creamy and soft foods ( hooray if you have breast milk).
Avoid anything acidic or sharp, like orange juice or tortilla chips.
Smoothies are a great choice. 
I like an over the counter medication called Glyoxide that can be applied by Q-tip to affected areas ( if your child lets you anywhere near them!)
For older kids with mouth sores try this:
1/2 teaspoon of Benedryl mixed with
1/2 teaspoon of Maalox
Squirt this mixture around the mouth every 4-6 hours
Many kids get quite a bit of relief from this.

If you are worried about hydration it is worth having your child seen.
A dehydrated child will have very low energy, decreased urine output and not a lot of tears or drool. They seem dry and droopy. As with any case of dehydration, if the oral route is failing, they may need some IV fluids. This is usually done in the emergency room.

If your child is running around, has normal activity level, and reasonably wet diapers, then they are "managing" and I wouldn't be too concerned.

The exposure period for this illness is usually from three days to a week. In other words, if your child was exposed on a Monday...they may start to show symptoms as early as Thursday but if a week goes by without anything happening you are probably out of the woods.

On the other hand, If you child has the illness, they are contagious as long as they still have blisters or a fever and perhaps can shed the virus for a week or two afterwards.

If your child is happy and eating and has no fever but has a few blisters I would try to keep them away from a newborn or someone with a compromised immune system, but it seems excessive to expect you to keep your kids out of daycare if that is the only symptom.

Good hand washing is key to avoiding this.

Make sure the shared toys are cleaned frequently.
If your child gets this (I should say when..not if) don't freak out. Time will fix it.
Think about it as a rite of passage.

Give them something cool and creamy along with a big hug.
As always, if you look at them and you are WORRIED ( not just feeling sorry for them) call for an evaluation.

1 comment:

  1. Yes, you are right young children have the higher risk of getting hand, foot and mouth disease. Risk increases if they attend daycare or school, as viruses can spread quickly in these facilities. Using home remedies to cure hand, foot and mouth disease is one of the best ways. I think this is very effective way by which we can easily manage this condition. I have also found a website disease related this condition 2 days ago. They have mentioned some easy and homemade remedies to cure this disease and I think if your child is also suffering from this condition, you should visit this website to get more and unique ways to tackle this condition.