Dear Doctor: We thought our 4-year-old son had caught a cold at daycare because he had a slight fever, but then he got these weird red spots on his feet. Our doctor said it’s foot and mouth disease. Is it dangerous?
Dear Reader: Your son is among the many children who contract hand, foot and mouth disease every year. Often referred to as HFMD, it’s a contagious viral infection that’s common in children under the age of 5, particularly during the warmer summer months.
Symptoms include fever and those red spots (which are a rash) that appeared on the soles of his feet. Additional symptoms of HFMD often include a sore throat; painful blisters or lesions on the tongue, gums and on the insides of the cheeks; loss of appetite; and a general feeling of discomfort or malaise. The red rash may also appear on the palms of the hands, and sometimes on the buttocks. Although the rash doesn’t itch, it can develop into fluid-filled blisters.
The disease is caused by a variety of enteroviruses, most commonly by one known as coxsackievirus A16. It’s spread through contact with certain bodily secretions from an infected person. These include the aerosolized spray from a cough or a sneeze, saliva, nasal secretions, throat discharge or stool. The fluid contained in the blisters is also infectious.
Considering how babies and toddlers explore the world around them with their mouths and their hands, it’s not surprising that HFMD is common among the younger set. It’s often seen in daycare settings, where it’s easily passed among the group. Since several different strains of enteroviruses cause the infection, it’s possible to get HFMD more than once. However, the good news is that, over time, kids can develop an immunity. Although HFMD is most common in children, adolescents and adults can contract the virus as well.
In the majority of cases, HFMD is not dangerous. The fever lasts a few days, and the sore throat may last a day or two longer. Most patients recover within seven to 10 days without any specialized treatment. In addition to feeling crummy as their immune systems mount a defense against the virus, the tongue and mouth sores can make it painful for patients to swallow. That makes hydration a priority. Offer frequent sips of water and other beverages throughout the day, but steer clear of citrus juices, which can irritate the mouth sores.
It’s rare but possible for a certain form of coxsackievirus to cause someone with HFMD to develop viral meningitis, an infection of the brain and spinal cord. Another rare complication is encephalitis, a life-threatening inflammation of the brain. That’s alarming, so let’s re-emphasize that those complications are rare.
Parents of kids with HFMD should alert their daycare provider so they can do a thorough cleaning of the facilities. Meanwhile, be vigilant about family hand hygiene, disinfect all common areas and keep sick children at home until fever and all sores have completely resolved.
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