Advisory on Hand, Foot, and Mouth Disease (HFMD)
- Dr. Anuradha Shah
- Jul 9, 2024
- 4 min read
What is Hand, Foot, and Mouth Disease (HFMD)?
Hand, Foot, and Mouth Disease (HFMD) is a common viral illness that primarily affects infants and children under the age of 5, although older children and adults can also be affected. It is caused by enteroviruses, most commonly the coxsackievirus A16 and enterovirus 71. HFMD is typically characterized by fever, sores in the mouth, and a rash on the hands and feet.
What are the symptoms of HFMD?
Fever: Often the first sign, usually mild.
Sores in the Mouth: Painful red spots that can develop into ulcers, usually on the tongue, gums, and inside of the cheeks.
Skin Rash: Red spots, sometimes with blisters, on the palms of the hands, soles of the feet, and sometimes the buttocks and genital area.
General Discomfort: Fatigue, irritability, loss of appetite, and sore throat.
How does HFMD spread?
HFMD is highly contagious and spreads through:
Person-to-Person Contact: Touching, hugging, or sharing cups and utensils.
Respiratory Droplets: Coughing and sneezing.
Contact with Contaminated Surfaces: Toys, doorknobs, or other objects.
Fecal-Oral Route: Particularly in settings like daycares where diaper changes occur.
When is HFMD most common?
HFMD can occur at any time of the year, but it is more common in summer and early autumn.
Who is most at risk for HFMD?
Children under the age of 5 are most susceptible, especially those in daycare or preschool settings due to close contact with other children. However, adults can also contract HFMD.
How much is the Incubation Period
The incubation period (time between exposure and onset of symptoms) for HFMD is typically 3-6 days.
How is HFMD Diagnosed?
HFMD is usually diagnosed based on clinical signs and symptoms. Laboratory tests, such as throat swabs, stool samples, or vesicle fluid, can confirm the diagnosis if needed.
Is there a treatment for HFMD?
There is no specific treatment for HFMD. The illness usually resolves on its own within 7-10 days. Supportive care focuses on relieving symptoms such as:
Over-the-counter pain relievers (like acetaminophen or ibuprofen) for fever and discomfort (consult your doctor for appropriate dosage)
Topical anaesthetic liquids or ointments for mouth sores (consult your doctor)
Cool mist humidifier for a sore throat
Plenty of fluids to prevent dehydration
Bland, soft foods that are easy to swallow if mouth sores are present (avoid acidic or spicy foods)
How can I prevent the spread of HFMD?
Frequent handwashing with soap and water, especially after diaper changes, using the toilet, coughing, sneezing, or before preparing food.
Avoid close contact with people who are sick.
Keeping infected children at home until fever and mouth sores have resolved.(typically 7-10 days)
Disinfect frequently touched surfaces and toys with a disinfectant solution.
Encourage children not to suck their thumbs or fingers.
Avoid sharing utensils, cups, or towels with someone who is sick.
Are there any home Remedies for HFMD Discomfort?
While HFMD resolves on its own within a week or two, some home remedies can ease the child's discomfort. These remedies aim to manage symptoms, not cure the infection.
For Mouth Sores:
Offer cool liquids like water , chilled coconut water, buttermilk ( छाछ - chhaach ), or diluted fresh fruit juices to keep your child hydrated and soothe a sore throat.
Popsicles and ice chips can numb mouth sores and provide some hydration.
A teaspoon of honey can coat the throat and offer mild pain relief. (Important Note: Honey is not safe for infants under 1 year old due to the risk of infant botulism.)
For Blisters :
Apply a cool compress made with a clean washcloth soaked in cool water to the blisters for temporary relief.
Calamine lotion can help relieve itching associated with the rash. Double-check with your doctor before using calamine lotion, especially on young children or those with sensitive skin.
Sandalwood Paste (Chandan) and Neem Oil may be used. (Limited research) Important Note: Consult your doctor before using neem oil on very young children or those with sensitive skin.
General Comfort Measures:
Encourage your child to get plenty of sleep to aid their recovery.
Opt for bland, cool foods like cooked and mashed vegetables (dal), khichdi, or curd rice (dahi chawal) that are easy to swallow if mouth sores are present. Avoid spicy or fried foods that can irritate the sores.
Lukewarm Turmeric Milk (Haldi Doodh): Turmeric has natural anti-inflammatory properties. Mix a half teaspoon of turmeric powder in a glass of lukewarm milk and offer it to your child for pain relief (if tolerated).
Special Note for Daycares/Schools :
Daycare centres and schools should implement strict hygiene protocols, including regular cleaning and disinfection of toys and common areas.
Ensure strict hygiene practices among staff and children.
Staff should be vigilant in monitoring children for symptoms and promptly isolate any suspected cases.
Inform parents about any cases of HFMD and advise them on monitoring for symptoms.
Open communication with parents about HFMD cases and preventative measures is crucial.
Special Note for Parents:
Keep an eye on your child for symptoms if there is an outbreak.
If your child has HFMD, keep them home from daycare or school until the fever is gone and all the blisters have crusted over.
(typically 7-10 days)
FAQs
Q: How long is a child with HFMD contagious?
A: Children are most contagious during the first week of illness but can still spread the virus for weeks after symptoms disappear.
Q: Can you get HFMD more than once?
A: Yes, but it's uncommon. Once infected, you typically develop immunity to the specific virus that caused your illness. Several different viruses that can cause HFMD.
Q: When should I see a doctor?
A: Consult your doctor if your child experiences:
High fever (over 102°F)
Difficulty swallowing/ severe pain
Unable to drink fluids/ Dehydration symptoms (decreased urination, dry mouth)
Worsening rash or blisters,
Signs of meningitis (severe headache, neck stiffness, confusion)
Q: Can adults get HFMD?
A: Yes, adults can get HFMD, but it is less common and usually less severe.
Q: Can HFMD be prevented with a vaccine?
A: Currently, there is no vaccine for HFMD.
Q: Does Chicken pox vaccine (Varicella) protect against HFMD or the severity of illness?
A: No. They are caused by different viruses and there is no cross immunity.
HFMD is generally mild and resolves on its own, but maintaining good hygiene and taking preventive measures can help control its spread. If you have further questions, consult your healthcare provider for advice tailored to your specific situation.
Authored by Dr. Anuradha Shah, MBBS MD (Preventive Medicine).
(Note : This advisory may be used only with due credits to the author.)
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