Hand, Foot And Mouth Disease

By Wendy Innes. May 7th 2016

While outbreaks of hand, foot And mouth disease are more prevalent in Asian countries like Vietnam, there is a slight possibility that they may occur within the United States. Not to be confused with foot-and-mouth disease, hand, foot and mouth disease can be quite serious, and even fatal for some people, especially young children.

What Is It?

Hand, foot and mouth disease is a viral infection that usually affects infants and children under the age of 5, although it can certainly affect adults as well. The infection causes a rash on the skin as well as lesions in the mouth, which can be very uncomfortable to small children. This type of viral infection is not the same as the viral infection that causes foot and mouth disease in animals. Animals are not affected by the human virus and humans are not affected by the animal virus.


Hand, foot and mouth disease is a febrile condition, meaning it causes a fever, and is usually caused by coxsackievirus A16, enterovirus 71, or other enteroviruses. These are very common viruses contracted during childhood. Enterovirus 71 can cause severe neurologic complications such as meningitis, encephalitis, or polio-like paralysis. There is a significant mortality rate with this type of virus as well.

Symptoms And Complications

The most noticeable symptom associated with hand, foot and mouth disease is the skin rash due to its high visibility. However, there are other symptoms that occur immediately before the skin rash presents itsef, although some people are only inflicted with rash and lesions.

  • Sudden onset of fever (Hand, foot and mouth disease is a febrile condition)
  • Sore throat
  • Headache
  • Decreased appetite
  • Vomiting (in infants)
  • Skin rash
  • Lesions in the mouth

The skin rash typically appears on the palms of the hands and soles of the feet, but it can also appear on the knees, elbows, genitals and buttocks.

Lasting immunity to the infecting virus strain follows, which means that a child won’t be able to be infected by the same viral strain, although infection from another coxsackievirus or enterovirus strain is possible.

The most common complication associated with hand, foot and mouth disease is dehydration. Often, children will refuse to eat or drink because the lesions that occur in the mouth are too painful.  The good news is that hand, foot and mouth disease usually clears up quickly, although parents should monitor children closely and seek medical attention if dehydration presents itself. It’s also important for parents to remember that children can dehydrate very quickly; much faster than an adult.

Serious complications are rare and only associated with enterovirus 71 as mentioned above. Enterovirus 71 can cause viral (also known as aseptic) meningitis, characterized by a fever, headache, and a stiff neck and back. This is due to the inflammation of the membranes surrounding the brain and spinal cord.

Even more rare is encephalitis (inflammation of the brain), which is quite serious. It is characterized by a fever, severe headache, dizziness, mood and behavioral changes, seizures and vomiting among other symptoms. This is a medical emergency and if someone experiences these symptoms they should seek medical attention immediately.

Another possible complication of hand, foot and mouth disease is fingernail and toenail loss. There is evidence that suggests that the virus can cause fingernails and toenails to fall off within four weeks of having hand, foot and mouth disease, although further research is still necessary. The good news is that fingernails and toenails that are lost grow back without treatment.

Treatment And Prevention

The treatment for hand, foot and mouth disease is symptomatic, meaning that since the infection is viral it is not treated with medication as a bacterial infection would be, but instead the symptoms are treated to provide relief to those affected.

If a child has problems eating or drinking because of the pain in his or her mouth, acetaminophen or ibuprofen can be given to help relieve the pain. This will also help reduce the fever associated with the infection.

 If the child is old enough, he or she can use an aromatherapy mouth rinse to help heal the sores, but the child should not swallow the rinse. Oils such as tea tree, myrrh, bergamot and basil can be mixed with a teaspoon of vodka and added to half a cup of warm water, swished around the mouth and then spit out. Over-the-counter oral pain relieving sprays can also be used. This is particularly helpful when trying to get the child to eat or drink.

The very best way to treat hand, foot and mouth disease is to prevent it from spreading. Frequent hand washing and disinfection of surfaces can go a long way toward preventing the spread of this disease. Toys and feeding surfaces can be disinfected with a tablespoon of chlorine bleach mixed with four cups of water after washing with soap and water. Bottles, pacifiers and feeding utensils can be boiled or put in a microwave steam sterilizer as well.

Any time a child is sick can feel like the end of the world, both for the child and for the parents. But with this information parents can ease their child’s symptoms and take heart knowing that this condition will pass quickly.


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