Hand, foot and mouth disease (HFMD) is a typically mild but highly contagious viral infection most common in children under seven years of age. The illness is characterized by mouth or throat pain (due to sores), fever and a rash (typically involving the hands, feet, buttocks, arms and legs). The infection is caused by enteroviruses—most often coxsackie virus A16—which are transmitted from person-to-person by oral contact with stool, saliva, fluid from skin lesions or respiratory fluids via coughs or sneezes. Herpangina, also caused by enteroviruses, is a cluster of symptoms characterized by fever and mouth lesions (but no rash). These illnesses are particularly common in child-care settings because of the frequency of contact and germ sharing between children and inadequate handwashing—especially after diaper changes or toilet use. The viruses can also be transmitted by contact with contaminated surfaces or objects, like toys.

Outbreaks occur most often in summer and fall but can happen anytime, especially if your child is in daycare. As recent reports of the disease have occured, Shilpa Shankar, MD, Pediatrician at NorthShore, shares symptoms parents should watch for and outlines ways you can make your child more comfortable while the virus runs its course: 

Symptoms of Hand, Foot and Mouth Disease:

• Small, painful sores in the throat or mouth, including cheeks, tongue and gums 
• These lesions cause pain and difficulty swallowing
• Small blisters or red spots classically located on hands, soles of the feet and between fingers and toes 
• Fever
• Decreased energy and appetite
• Diarrhea and vomiting
• Respiratory symptoms like congestion, cough and “pink eye” (conjunctivitis)

Symptoms of Herpangina:

• Fever
• Painful red sores in mouth/throat (as above)
• Vomiting
• Abdominal pain
• Headache
• Refusal to eat or drink

Fever and mouth/throat pain usually last three to five days. Other symptoms, like mouth sores and rash (with HFMD) can last up to seven to ten days. The virus is shed orally for one to three weeks and in stool for two to three months after infection. While there are no cures for HFMD or herpangina, there are things you can do to make your child more comfortable during those first few days, as well as reduce the risk for dehydration which can occur because of pain and difficulty swallowing. 

What can parents do?

Keep little ones hydrated. Try Pedialyte to keep their electrolytes up. Also popsicles, ice chips and other frozen treats can replenish fluids while also helping with pain. 

Reduce pain or fever. Use Acetaminophen or Ibuprofen but check age-appropriate dosages before administering. 

Make swallowing easier. Eliminate salty, spicy or acidic foods to avoid further irritating mouth sores. Consider providing a variety of soft foods, like yogurt, pudding and rice. And always rinse mouth after meals. 

While it is not always possible to prevent your child from contracting hand, foot and mouth disease, you can reduce his or her risk, and your own. Here are some ways to keep your kids healthy and prevent the spread of HFMD in your home:

• Wash hands with soap and water for 15-30 seconds and dry with disposable towel after using the toilet, changing diapers; after touching another child, the floor or contaminated surfaces; before eating meals or snacks; after coming in from outdoor play; after sneezing, coughing or wiping nose or eyes 
• Clean and disinfect contaminated surfaces and toys more than once a day
• Avoid or prevent close contact like kissing, hugging, sharing utensils or cups 

If your child does get hand, foot and mouth disease, watch for these signs of complications:

• Dehydration (dry mouth, pale skin and nails, no tears or urine, lethargy)
• Breathing difficulty
• Chest pain
• Stiff neck
• Mental status changes (inconsolable crying, confusion, poor balance, difficulty walking)