Hand-foot-and-mouth disease (HFMD) is especially worrying for parents when they see their child feeling feverish and unwell. A day or two after that the disease sets in, strange spots and bumps appear on the hands, feet, and mouth of the child. While the rash will usually dissipate within a few days, some children end up losing all their fingernails and toenails in the process.
This chilling side effect of HFMD can seem scary, but the missing hand and toenails usually grow back after the condition has run its course. HFMD is spread through close contact with other people as well as through the air from coughing. Many people will even unwittingly be carriers for the virus but never feel any symptoms of their own.
Around the World
While HFMD is prevalent throughout the world, it usually occurs in smaller outbreaks within nursery schools or kindergartens. Outbreaks of the virus have been reported in Asia dating back to 1997, with the outbreaks usually taking place during the spring, summer, and fall. Perhaps the worst thing about HFMD is that it mainly affects children younger than five years old.
The symptoms of this virus are no fun at all and are characterized by fever, nausea, vomiting, feeling tired, generalized discomfort, loss of appetite, and irritability. The skin lesions which usually develop as a result of the rash can be followed by nasty vesicular sores with blisters on palms of the hands and soles of the feet. The good news for kids is that the rash is usually not itchy, but conditions such as encephalitis, meningitis, and paralysis can be a serious issue in the most extreme cases.
While this viral infection is classed as mild in medical terms, there is to date no specific treatment for it. Frequently washing the hands and avoiding close contact with people as much as possible is one way to stay safe and virus-free, but that’s not even remotely practical in a setting such as a kindergarten. While everyone wants to stay safe and disease-free, that’s not always an option.
One of the issues with the virus is that the mouth sores can get so severe that the child is unable to drink liquids, posing a serious threat. In such a case, one should contact their pediatrician as soon as possible to set up an appointment. Furthermore, if the symptoms get worse after the first three days, medical assistance needs to be sought.
It’s important to note that HFMD isn’t related to foot-and-mouth disease, also known as hoof-and-mouth disease. The latter is far more serious and is found in farm animals who can then, in turn, infect humans. This condition usually affects adults more than children and can be extremely dangerous, even fatal.
By far one of the most serious side effects of HFMD is dehydration. It’s vital to ensure that a child is getting enough fluids and nutrition as they try to fight the virus. Keeping the home as disinfected as possible is also a good idea, as this prevents the spread of the virus in a majority of cases.
Nothing is better than thoroughly washing the hands on a regular basis, especially after using the bathroom or changing a diaper. If soap and water aren’t available, hand wipes or germ-killing alcohol gels are also a good alternative. Make sure to disinfect common areas like the bathroom and kitchen, and use a diluted solution of chlorine bleach and water for best results.
According to a recent Fox report, doctors in several states have reported that they have seen an upsurge in cases of HFMD in children, but also in adults. Just a few weeks ago two Major League Baseball players were sidelined after contracting the virus. Dr. Scott Norton, chief of dermatology at Children’s National Medical Center in Washington D.C., explained that the common disease which affects children is relatively mild, although highly contagious.
“Because it will sweep through a community, I think it’s important for families, schools, and community leaders to realize we have this right now, particularly at the beginning of the school year,” said Norton. “We don’t want to have any outbreaks as these kids all get together once again, so I would like to get the word out that this is something we are seeing a lot of here in mid-August.”
According to Dr. Norton, the viral infection is most common at that time of year, although he reportedly sees more cases than ever before. Norton explained that he sees two to three cases per day on average at his clinic, while the more serious cases see 10 to 20 visits to the emergency room each day. And as the disease can be transmitted in three different ways, it makes it even more of a common occurrence.
Dr. Norton went on to explain the symptoms which usually show when it comes to the virus. “It’s both on the palms, soles and the backs of the hands and feet, and we see these very characteristic mini-blisters on the hands in particular,” he said. “They will look like scattered dots – maybe three or four millimeters in diameter and they usually have a very bright red rim, but they are totally painless.”
According to many like Dr. Norton, the real issue with the virus is that it’s so easily transmitted between people and especially between children. Others have said that HFMD is transmitted through oral and nasal secretions. Also that is a child coughs or sneezes near someone, it can be transmitted to them.
“The virus is easily spread to hard surfaces like toys and tabletops,” explained Dr. Heather Hawthorne, family practice physician at Doctor On Demand. “An infected person can pass the virus through fluid from the blisters of their rash, mucus in their nose, saliva, and even contact with their feces. It’s important for parents to teach children to wash their hands often and properly to help prevent infections. Effective hand washing means wetting hands with water, applying soap, and scrubbing for at least 20 seconds.”
Perhaps the silver lining to this, if one can call it that, is the fact that the virus seldom affects adults negatively, leaving them to care for their children who will be irritable for days. “Although it’s more common in children, adults can become infected too,” said Hawthorne. “However, their illness is usually milder. Sometimes they have no symptoms at all, but they can still spread the infection to others.”
One of the things that make HFMD even more tricky is the fact that even after the symptoms have completely healed, the child could still pass the virus to others through the stool. If you have many young children at home or work in a kindergarten, it’s worth keeping everything as clean as possible to keep things germ-free and avoid more children getting sick.
Many parents only give their children painkillers and sedatives from time to time, and only in an emergency. If your child is sick with HFMD, they will likely need something to get them through the tougher days. Ice-cold drinks and ice pops are also a great idea to keep children hydrated, ignoring the sugar content in favor of the bigger issue. Once the sores have healed the child should begin drinking water as usual.
Another unfortunate side effect of the virus is that your child will most likely need to miss up to two weeks of school to let the disease run its course. That not only adds to the child’s frustration of being sick for all those days but also means they could fall behind in their studies, leading to even more frustration. Even for parents who home-school, most kids will be unable to focus on anything other than the discomfort for at least a week.
While the whole ordeal will be over within a couple of weeks in most cases, there have been more extreme cases of HFMD over the years. As with other viruses, different parts of the body can become infected, and that includes the spinal column and brain. If that eventuality comes to pass, you could be looking at something even more serious such as meningitis or encephalitis.
More than Once
Unlike chickenpox, HFMD is a recurring virus which can infect the same child numerous times. As children slowly build up the right antibodies to fight the disease, they will reduce their chances of contracting the disease again, but there are no guarantees. The fact that brothers and sisters will usually infect each other at home is good for some parents and not so good for others, depending on their circumstances.
Many parents have learned their lesson when it comes to caring for a child with HFMD. While the one-to-two week ordeal is usually a grueling affair for all, when the symptoms do finally clear up, and the virus leaves the system, life goes on as normal.