A mild, contagious viral infection common in young children — is characterized by sores in the mouth and a rash on the hands and feet. Hand-foot-and-mouth disease is most commonly caused by a coxsackievirus.
There's no specific treatment for hand-foot-and-mouth disease. Frequent hand-washing and avoiding close contact with people who are infected with hand-foot-and-mouth disease may help reduce your child's risk of infection.
Hand, Foot, and Mouth Disease, or HFMD, is a contagious illness caused by different viruses. It is common in infants and children younger than 5 years old, because they do not yet have immunity also known as (protection) to the viruses that cause HFMD. However, older children and adults can also get HFMD. In the United States it is more common for people to get HFMD during spring, summer, and fall.
HFMD is usually not serious, and nearly all people recover in 7 to 10 days without medical treatment. Rarely, an infected person can develop viral meningitis and may need to be hospitalized for a few days. Other even more rare complications can include polio-like paralysis, or encephalitis, other wise known as (brain inflammation) which can be fatal.
Hand-foot-and-mouth disease may cause all of the following signs and symptoms or just some of them. They include:
· Sore throat.
· Feeling of being unwell. also known as, malaise.
· Painful, red, blister-like lesions on the tongue, gums and inside of the cheeks.
· A red rash, without itching but sometimes with blistering, on the palms, sole of the feet and sometimes the buttocks.
· Irritability in infants and toddlers.
· Loss of appetite.
The usual period from initial infection to the onset of signs and symptoms (incubation period) is three to six days. A fever is often the first sign of hand-foot-and-mouth disease, followed by a sore throat and sometimes a poor appetite and malaise.
One or two days after the fever begins, painful sores may develop in the front of the mouth, tongue or throat. A rash on the hands and feet and possibly on the buttocks can follow within one or two days.
Sores that develop in the back of the mouth and throat may suggest that your child is infected with a related viral illness called herpangina. Other distinguishing features of herpangina include a sudden high fever and in some instances, seizure. Sores that develop on the hands, feet or other parts of the body are very rare.
The child might get a rash on the palms of his hands or the souls of his feet a day or two after the first symptoms appear. This rash may turn into blisters. Flat spots or sores may pop up on the knees, elbows, or buttocks. He could have all of these symptoms, or only one or two.
Mouth sores can make it hurt to swallow, so be sure your child gets enough water and calories.
These symptoms usually appear in stages, not all at once. Not everyone will have all of these symptoms. Some people may show no symptoms at all, but they can still pass the virus to others.
When to seek Medical advice.
Hand-foot-and-mouth disease is usually a minor illness causing only a few days of fever and relatively mild signs and symptoms. Contact your doctor if mouth sores or a sore throat keep your child from drinking fluids. And contact your doctor if after a few days, your child's signs and symptoms worsen.
The most common cause of hand-foot-and-mouth disease is infection with the coxsackievirus A16. The coxsackievirus belongs to a group of viruses called nonpolio enteroviruses. Other types of enteroviruses (enterovirus 71) sometimes cause hand-foot-and-mouth disease.
Oral ingestion is the main source of coxsackievirus infection and hand-foot-and-mouth disease. The illness spreads by person-to-person contact with an infected person's:
· Nasal secretions or throat discharge
· Fluid from blisters
· Respiratory droplets sprayed into the air after a cough or sneeze
Common in child care setting
Hand-foot-and-mouth disease is most common in children in child care settings because of frequent diaper changes and potty training, and because little children often put their hands in their mouths.
Your child can catch hand-foot-and-mouth through contact with someone who has it, or from something that's been in contact with the virus, like a toy, tabletop, or doorknob.
Although your child is most contagious with hand-foot-and-mouth disease during the first week of the illness, the virus can remain in his or her body for weeks after the signs and symptoms are gone. That means your child still can infect others.
Some people, particularly adults, can pass the virus without showing any signs or symptoms of the disease.
Outbreaks of the disease are more common in summer and autumn in the United States and other temperate climates. In tropical climates, outbreaks occur year-round.
Different from foot-and-mouth disease
Hand-foot-and-mouth disease isn't related to foot-and-mouth disease (sometimes called hoof-and-mouth disease), which is an infectious viral disease found in farm animals. You can't contract hand-foot-and-mouth disease from pets or other animals, and you can't transmit it to them.
Hand-foot-and-mouth disease primarily affects children younger than age 10, often those under 5. Children in child care centers are especially susceptible to outbreaks of hand-foot-and-mouth disease because the infection spreads by person-to-person contact, and young children are the most susceptible.
Children usually develop immunity to hand-foot-and-mouth disease as they get older by building antibodies after exposure to the virus that causes the disease. However, it's possible for adolescents and adults to get the disease.
The most common complication of hand-foot-and-mouth disease is dehydration. The illness can cause sores in the mouth and throat, making swallowing painful and difficult.
Watch closely to make sure your child frequently sips fluid during the course of the illness. If dehydration is severe, intravenous or I V fluids may be necessary.
Hand-foot-and-mouth disease is usually a minor illness causing only a few days of fever and relatively mild signs and symptoms. A rare and sometimes serious form of the coxsackievirus can involve the brain and cause other complications:
· Viral meningitis. This is a rare infection and inflammation of the membranes (meninges) and cerebrospinal fluid surrounding the brain and spinal cord.
· Encephalitis. This severe and potentially life-threatening disease involves brain inflammation caused by a virus. Encephalitis is rare.
Certain precautions can help to reduce the risk of infection with hand-foot-and-mouth disease:
· Wash hands carefully. Be sure to wash your hands frequently and thoroughly, especially after using the toilet or changing a diaper and before preparing food and eating. When soap and water aren't available, use hand wipes or gels treated with germ-killing alcohol.
· Disinfect common areas. Get in the habit of cleaning high-traffic areas and surfaces first with soap and water, then with a diluted solution of chlorine bleach and water. Child care centers should follow a strict schedule of cleaning and disinfecting all common areas, including shared items such as toys, as the virus can live on these objects for days. Clean your baby's pacifiers often.
· Teach good hygiene. Show your children how to practice good hygiene and how to keep themselves clean. Explain to them why it's best not to put their fingers, hands or any other objects in their mouths.
· Isolate contagious people. Because hand-foot-and-mouth disease is highly contagious, people with the illness should limit their exposure to others while they have active signs and symptoms. Keep children with hand-foot-and-mouth disease out of child care or school until fever is gone and mouth sores have healed. If you have the illness, stay home from work.
Your child is most contagious in the first 7 days. But the virus can stay in their body for days or weeks after symptoms go away and it could spread through their spit or feces. The best way to prevent that is to wash hands thoroughly. That applies to you too, after you change a diaper or wipe a runny nose.
Your child should be fever- and symptom-free before they go back to school or daycare. Check with your doctor if you aren’t sure whether they are still contagious. Ask their school or daycare about their policy on when a child can return after illness.
Hand-foot-and-mouth disease is not the same as foot-and-mouth disease, which comes from a different virus and only affects animals.
Your doctor will likely be able to distinguish hand-foot-and-mouth disease from other types of viral infections by evaluating:
· The age of the affected person
· The pattern of signs and symptoms
· The appearance of the rash or sores
Your doctor may take a throat swab or stool specimen and send it to the laboratory to determine which virus caused the illness.
There's no specific treatment for hand-foot-and-mouth disease. Signs and symptoms of hand-foot-and-mouth disease usually clear up in seven to 10 days.
A topical oral anesthetic may help relieve the pain of mouth sores. Over-the-counter pain medications other than aspirin, such as Tylenol or Advil may help relieve general discomfort.
Hand-foot-and-mouth disease should go away on its own after 7 to10 days. There is no treatment for the illness and no vaccine. You can ease your child’s symptoms with:
• Over-the-counter pain relievers like Advil or Tylenol or numbing mouth sprays. Don’t use aspirin for pain -- it can cause serious illness in children.
• Cold treats, like Popsicles, yogurt, or smoothies, help soothe a sore throat.
• Anti-itch lotion, like calamine, can help against rashes.
Lifestyle and home remedies
Certain foods and beverages may irritate blisters on the tongue or in the mouth or throat. Try these tips to help make blister soreness less bothersome and eating and drinking more tolerable:
· Suck on ice pops or ice chips.
· Eat ice cream or sherbet.
· Drink cold beverages, such as milk or ice water.
· Avoid acidic foods and beverages, such as citrus fruits, fruit drinks and soda.
· Avoid salty or spicy foods.
· Eat soft foods that don't require much chewing.
· Rinse your mouth with warm water after meals.
If your child is able to rinse without swallowing, swishing with warm salt water may be soothing. Have your child do this several times a day or as often as needed to help reduce the pain and inflammation of mouth and throat sores caused by hand-foot-and-mouth disease.
Other home Remedies that you might want to try:
Tender Coconut Water
Coconut water cools the body and is gentle on the stomach. It contains a wide range of vitamins, minerals, electrolytes and anti-oxidants. It also contains lauric acid which fights viruses. Consuming coconut water when you have HFMD can alleviate pain in the mouth and help keep the body hydrated. You can also freeze coconut water and have your child chew on the ice cubes to reduce the pain of the mouth sores.
This is an old Ayurvedic method for keeping good oral hygiene. It also helps soothe the mouth-sores caused by HFMD. Take a tablespoon of any oil such as peanut, sesame or coconut, swish it around in your mouth for 5 to 10 minutes and then spit it out. Make sure you do not swallow the oil after swishing it around in your mouth.
Cod-liver oil contains Vitamins A, D and E. It boosts body immunity and has anti-microbial properties. It is a good remedy for HFMD. You can consume it as capsules or mix the oil in, juice or yoghurt, and consume it.
Echinacea is a herb that belongs to the daisy family. It has antimicrobial properties. This herb boosts the immune system and reduces symptoms of fever, colds and other infections like HFMD. You can consume it as capsules or boil its leaves in water to make a tea and drink it with honey.
Lavender oil is a very good disinfectant and fights viruses. It also helps in making you feel calm and relaxed and help you get a good night’s sleep. You can add a few drops in bath water or diffuse it into the room with an essential oil diffuser.
Lemon Essential Oil
Lemon essential oil is another disinfectant. You can add a few drops to your body wash to fight the virus and nourish the skin. You can also mix a few drops in a carrier oil like, coconut or olive oil and apply it on the rashes.
Licorice root has anti-viral properties and has been used as a home remedy for treating various viral infections. It contains a chemical called triterpenoid, that boosts immunity. It also forms a thin layer of mucous on the insides of the throat and esophagus, thus helping to soothe the blisters. Boil some liquorice roots in water, strain it to make a tea and have it with honey. An overdose of liquorice can have harmful effects, so use it with caution.
Salt Water Rinse and Baths
Rinsing your mouth several times a day with warm salt water can give relief from the painful blisters and mouth sores. You can use common table salt for this or, Himalayan pink salt. The pink salt is more effective because it balances the pH level inside the mouth. Also, adding Epsom salts to the bath water can help soothe the rashes on the body and makes you heal faster from the HFMD symptoms. You can also add a few drops of lavender or lemon essential oil to the Epsom salt bath to give you immense relief.
Garlic has strong antimicrobial properties because it contains high levels of sulphur compounds. You can include more garlic in the food, have it as capsules, or make a herbal tea by boiling 3 cloves of garlic in water and drinking it when cooled.
Elderberry is well known for its antioxidant properties that boost immunity and improve resistance to diseases. It helps the body produce mucous to fight viruses. It slightly increases body temperature, thus making it difficult for viruses to multiply and grow. Make an elderberry and honey syrup and have it frequently to heal faster from HFMD.
Ginger contains several anti-viral chemicals . It also has sedative and pain-relieving effects. Make ginger root tea by simmering crushed, chopped ginger in water until the water is concentrated with ginger juice. Cool this and have with honey.
Astralagus is a plant of the legume family and has been used as traditional Chinese medicine for hundreds of years. It is known for its immune-system-boosting properties. It stops viruses from multiplying in the body. You can buy astralagus ointments for topical application. You can also buy astralagus tea-bags or make your own by simmering a teaspoon of grated astralagus root in water. Strain this and drink it with honey to soothe the symptoms of HFMD.
Coconut oil has antiviral properties. You can apply coconut oil to the areas with rashes or blisters to soothe them. You can also use a tablespoon of coconut oil to swish around the mouth and spit out to soothe the blisters in the mouth.
Indian Lilac or Neem
Neem or Indian Lilac has several antimicrobial properties and has been used to treat viral diseases for hundreds of years. You can apply neem oil to the rashes on your body. You can also powder dried neem leaves and make a paste of it with water. Apply this paste to the rashes and blisters for quick healing. You can use neem oil combined with coconut oil and a few drops of lavender oil for topical application.
The Indian gooseberry (scientific name Emblica Officinalis) is rich in vitamin C, an important vitamin necessary for immunity. It also helps in purifying the blood and aids in digestion. You can consume it as gooseberry juice or make a powder from dried gooseberries and consume it with water.
Pomegranate contains antioxidants and anti-inflammatory compounds which help soothe the symptoms of HFMD. Drink pomegranate juice or just eat the fleshy seeds for quicker healing.
Apple Cider Vinegar
Apple cider vinegar contains vitamins B and C. It also contains a chemical called inulin which increases our white blood cell (WBC) count. WBCs, help fight viruses in our body. Mix 2 teaspoons of the apple cider vinegar in warm water and gargle with this to soothe the throat.
Calendula is a herb belonging to the marigold family. These plants have antibacterial and antiviral properties. They also lower inflammation, quicken healing and help maintain oral health. You can make a tea from calendula petals and consume it with honey. You can also use calendula cream to apply over the rashes to soothe them.
Holy Basil or Tulsi
Tulsi is a herb that has several medicinal properties. It fights harmful microbes, reduces inflammation, and has pain-relieving effects. You can chew Tulsi leaves or make a juice of the leaves, dilute it with water and drink it a few times a day for faster relief from HFMD.
Aloe Vera has antimicrobial properties. It also increases immunity. Aloe Vera contains minerals, vitamins and several other compounds that are beneficial for the skin. Apply Aloe Vera gel to the rashes and blisters for soothing relief. You can also drink Aloe Vera juice for faster healing from HFMD.
This remedy will help the child get relief from fever.
· Take 1/2 cup of boiling water
· Add 1/2 tsp of Saffron
· Allow it to rest for 2-3 mins
· Mix well
· Let the child sip this mixture hot
BGH Remedy (Basil, Ginger and Honey)
· Crush a handful of basil leaves and a 1 inch piece of ginger
· Place this paste on a sieve
· Press the paste to extract the juice
· Take 1 tsp of this juice
· Add 1 tsp of honey
· Mix well
· Give to child 4 times during the day
This remedy will get some relief from sore throat
· Take 1 tsp of lemon juice
· Add 1/2 tsp of black pepper powder
· Add 1/2 tsp of salt
· Mix well
· Heat the mixture till it turns lukewarm
· Give to child once per day
The symptoms of hand, foot and mouth disease can make children very uncomfortable and irritable. The rashes and blisters can be very painful for the little ones. Try these home remedies to soothe the symptoms and make your child as comfortable as possible.
Seeking Medical Advice
If you take your child to a doctor, make the most of your time by writing down information the doctor will need before you go, including:
· Any signs and symptoms your child is experiencing
· How long your child has been having signs and symptoms
· Whether your child has been in child care or other environments where the disease might be spread
· Any questions you have
Some questions you might want to ask your doctor include:
· What's the likely cause of the symptoms?
· Are there other possible causes?
· Will my child need to undergo any tests?
· What's the best treatment approach?
· Is there a need to take medicine?
· What can I do at home to make my child more comfortable?
What to expect from your doctor
Some questions the doctor may ask include:
· When did symptoms first begin?
· How severe are the symptoms?
· Has your child recently been exposed to anyone who was sick?
· Have you heard of any illnesses at your child's school or child care?
· Does anything seem to improve the symptoms?
· Does anything appear to worsen the symptoms?
What you can do in the meantime
To help lessen discomfort, doctors often recommend:
· Getting rest.
· Drinking fluids. milk-based fluids may be easier to tolerate than acidic liquids, such as juice or soda.
· Using mouthwash or oral spray to numb pain.