Hand foot and mouth disease (HFMD) is a well known and common illness. Let’s review.
Curiously, when I was a resident, this was mostly a summertime/early fall illness, but now I diagnose it almost year round. I do not have a good explanation for that development.
HFMD was first identified in 1957 in New Zealand and Canada. Initially, due to the mouth blisters, HFMD was assumed to be caused by herpes virus, which explains one of its common names–“herpangina.” However, we now know that it is caused by a different virus, called “coxsackie.” This is a member of the “enterovirus” family, which means that its a GI virus and spread via hand/mouth contact from body fluids–not from “droplet” contact like from coughing and sneezing. Therefore lets note that best preventive measure is careful hand washing, as well as cleaning home surfaces and toys. Many different strains of coxsackie can cause HFMD which explains why we keep seeing kids getting it year after year, and why your child can get it multiple times. HFMD incubates for 3-5 days after exposure, then may cause symptoms like fever, white or red spots in the mouth, throat, or lips as well as blister like lesions on the palms and soles and red spots on the rest of the body. Any combination of the above is possible–a child does not have to have all of the above to have an HFMD coxsackie infection. Spread in public or nursery schools, day care/babysitting centers is universal.
HFMD can be sporadic, but I very typically see it in epidemics: when one case comes in I expect to be inundated. Epidemics as large as 1.5 million cases are not uncommon. Most infections occur in children < 10 years old. Symptoms may last 7-10 days but generally resolve in < 1 week. There is no specific treatment to shorten its course. Use acetaminophen or ibuprofen for pain or fever. Cold compresses like ice pops are very helpful. Honey or topical treatments like Abreva or Blistex can relieve the sore throat pain. The only common complication is dehydration due to poor fluid intake caused by pain from numerous mouth lesions. Those children may require ER or admission for IV fluids, but again, they almost always recover nicely. There are numerous more severe but rare complications which have been reported. In 33 years of practice I have never seen one personally, so there’s no reason to list them here just to make you folks nervous.
One last point. HFMD affects children. “Hoof and Mouth” disease infects cattle and is a completely different problem. They have nothing whatsoever to do with each other.
Please send along questions or comments, and thanks for following.