On the Lookout for Hand, Foot, and Mouth Disease

     Sunburn season and the perils of the pool are just about behind us, but as any parent knows, the antenna can never go completely down. Hand, foot, and mouth disease (HFMD)—a common viral illness that occurs in the summer and fall—typically affects infants and children younger than five years old. This year, Tania Crussiah, MD, of Williamsport Family Practice, has seen an increase in HFMD cases. Half of the cases she has seen have occurred in the parents or caregivers of young children.

     Hand, foot, and mouth disease should not be confused with foot-and-mouth disease (also called hoof-and-mouth disease), a condition limited to cattle, sheep, and swine. The HFMD virus travels through saliva, nasal mucus, stool, and fluid in blisters. Ground zero for HFMD is typically young children in daycare settings, but Dr. Crussiah explains that youngsters on play dates can spread the virus too. Infected adults may have little or no symptoms and can pass the disease unknowingly. “I tell the parents that usually the child is contagious even before the diagnosis is recognized,” says Dr. Crussiah. “And it’s often the child that brings the virus to the parent.”

Warning signs
The first sign of HFMD is a low-grade fever or general fatigue. “The fever comes first, then the sores,” says Dr. Crussiah. Adults complain that they just don’t feel right or feel tired—often their symptoms are mild compared to children’s signs. “The contagious period is when you’re feverish or feeling run down,” explains Dr. Crussiah. Other signs include:

• Blister-like sores (raised or flat) in the mouth, particularly on the tongue, palette, and throat. Young children may thrust their fingers into their mouths and refuse to eat or drink. 
• A skin rash that appears on the palms of the hands and soles of the feet. According to the Centers for Disease Control and Prevention, the rash can appear in other areas, such as the knees, elbows, buttocks, or genital area. 

How to avoid HFMD
“Preventing the disease is much more advantageous than having the disease,” warns Dr. Crussiah. “The best defense is hand washing and cleaning commonly used surfaces with a disinfectant.” In addition to vigilant hand washing, here are other useful tips:

• Avoid touching or kissing a family member who is sick. 
• Never share the same cups, plates, or utensils. 
• Regularly wash, rinse, and air-dry children’s toys using a solution of bleach and water. 
• Wear latex or rubber gloves when you apply any lotion, cream, or ointment to your child's blisters. It’s a good idea to wear gloves while changing the diaper of an infected child. 
• Ask your daycare provider or school about any recent viral outbreaks. 

Watchful waiting
HFMD is a virus and cannot be treated with antibiotics. With “watchful waiting,” the disease typically clears up in seven to ten days says Dr. Crussiah. Use children’s ibuprofen (Motrin) or acetaminophen (Tylenol) for pain and fever relief, and be aware of dehydration. Because of mouth sores, children can shy away from fluids so offer ice cubes, popsicles, or an electrolyte drink like Pedialyte on a regular basis.

By: Anne Gill