Lewis First, MD, is chief of Pediatrics at The University of Vermont Children’s Hospital and chair of the Department of Pediatrics at the Larner College of Medicine at UVM.

Lewis First, MD, is chief of Pediatrics at The University of Vermont Children’s Hospital and chair of the Department of Pediatrics at the Larner College of Medicine at UVM.

Parents have been asking me a mouthful of questions about an illness called hand, foot and mouth disease and whether their child might have it. Let me lend a hand and provide some information on this topic.

Hand, foot, and mouth disease (HFMD) is another name for an infection caused by a virus named coxsackie A16.  The virus infects the body’s digestive tract and spreads in infants and children usually less than 10 years of age due to poor handwashing.  HFMD is most often seen in the summer.

So what are the symptoms of this viral illness?  Fever is almost always present at some point, but the name comes from small painful sores on the throat, gums, tongue and inside the cheeks, combined with a rash of tiny blisters on the hands and soles of the feet.  In older children there may also be complaints of headache or a decreased appetite.  Since this is a virus that likes to frolic in the intestines, it can cause diarrhea as well.  

So how do we treat HFMD?  Sadly, there is no medicine we can prescribe to kill the virus other than our own immune systems, which do destroy the virus over time.  For treatment, we can only treat the symptoms: good hydration and acetaminophen for fever and mouth pain.  Your child’s health care professional may recommend a prescription mouthwash that can ease the mouth pain by numbing the sores.  Cold foods like ice cream and popsicles may be more welcome with children to cool and numb those sores. 

The good news is that even without treatment, children usually recover within seven to 10 days without problems.  The most common complication is dehydration.  Sometimes children’s mouths hurt so much that they don’t drink fluids, but treatments including intravenous fluid therapy to rehydrate them are rare. 

Even rarer would be if the virus got into the fluid surrounding the brain, causing a type of viral meningitis, or into heart muscle causing a type of heart disease called viral myocarditis.  Your child’s health care professional can diagnose these very rare complications if you are worried or find that your child’s HMFD is accompanied by changes in your child’s level of alertness or if they appear short of breath.

Let’s talk about prevention.  As with most viruses, the secret to prevention is good handwashing.  If a child becomes ill with this type of infection, they should stay out of school, summer camps and swimming pools so as not to increase the chance that the virus will spread to other children.

Hopefully tips like this will have you hand over foot ahead of the game when it comes to knowing more about hand, foot and mouth disease in children.

Lewis First, MD, is chief of Pediatrics at The University of Vermont Children’s Hospital and chair of the Department of Pediatrics at the Larner College of Medicine at UVM.  You can also catch “First with Kids” weekly on WOKO 98.9FM and WPTZ Channel 5, or visit the First with Kids video archives at www.UVMHealth.org/MedCenterFirstWithKids.

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