Hand, Foot and Mouth Disease/Herpangina

 What is this illness?

 A viral disease characterized by yellow based red vesicles appearing in the throat, tongue and sides of mouth, and sometimes on the palms of the hands and the soles of the feet. If present only in the mouth, it is called Herpangina. These vesicles in the throat erode rapidly producing very painful ulcers. Sometimes the rash only causes blanching red spots on the palms and soles, this rash may be mildly tender when touched. High fever is usually present along with malaise, decreased appetite and diminished fluid intake.

This viral disease occurs most often in the summer months, often in mini-epidemics. This virus is not the same disease that causes hoof and mouth disease in sheep, cattle and horses.

 What causes this infection?

Typically, viruses called coxsackie A16 and sometimes A5 and A10 and other enteroviruses are the offending germs.

 What symptoms can I expect?

Fever is usually present. Your child may complain of a sore throat or in difficulty swallowing. Mild drooling may be a symptom. Your child may vomit because he is unable to swallow saliva or other liquids. You may be able to see some of the vesicles on the tongue or throat. There may be a rash on his/her hands and feet. 30% of infections produce rash or small blisters or red spots on the buttocks.

 At what age is my child more likely to contract this illness?

 6 months to 4 years

 Can my child get this illness again?

Yes, there are multiple strains of these viruses.

 How is this illness spread?Is it contagious?

 This illness is very contagious. It is spread by fecal-oral or by respiratory droplet/mucus. These germs can survive on surfaces for long periods and may be transmitted on toys, shopping carts, park equipment, and other surfaces.

 What is the course of the illness?

 The usual incubation period is 3-6 days and symptoms may continue for 3-7 days. Fever is usually only present for 1-3 days.

 When can my child return to school/day care?

 When your child is free of fever for 24 hours. Some mild communicability can exist after this time, sometimes as long as a week in your child’s saliva. If your child has vesicles on hand and feet, these should be crusted over.

 How should I treat my child?

 -Because this is a virus, antibiotics will not help.

-Plenty of your child’s favorite fluids (including milk/formula) should be given to prevent dehydration. Cold drinks, milk shakes, popsicles, slushes, sherbets, jellos are good choices. Pedialyte is okay too!

- Solids are not as important as liquids, but if your child seems interested they are fine. Avoid citrus, salty or spicy foods as they may irritate your child’s throat.

-Give fever/pain medicine like acetaminophen/ibuprofen (if baby is >6mos) according to directions-see dosage tables for acetaminophen/ibuprofen.

When should I call the office?

-Signs of dehydration- no urine in 8 hours, lethargy, decreased saliva in mouth

-Your child refuses to drink liquids

-If fever >3 days.

-Your child has been exposed to strep throat or has frequent strep infections

-The sores on the hands or feet become more red or are looking infected, swollen or are weeping fluids

-Your child becomes worse