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Hand, Foot & Mouth Disease (Child)

Hand, foot, and mouth disease (HFMD) is an illness caused by a virus. It is usually seen in infant and children younger than 10 years of age, but can occur in adults. This virus causes small ulcers in the mouth (throat, lips, cheeks, gums, and tongue) and small blisters or red spots may appear on the palms (hands), diaper area, and soles of the feet. There is usually a low-grade fever and poor appetite. HFMD is not a serious illness and usually go away in 1 to 2 weeks. The painful sores in the mouth may prevent your child from taking oral fluids well and result in dehydration.

It takes 3 to 5 days for the illness to appear in an exposed child. Generally, the HFMD is the most contagious during the first week of the illness. Sometimes, people can be contagious for days or weeks after the symptoms have disappeared. Adults who get infected with the HFMD may not have symptoms and may still be contagious.

HFMD can be transmitted from person to person by:

  • Touching your nose, mouth, eye after touching the stool of an infected person (has the virus)

  • Touching your nose, mouth, eye after touching fluid from the blisters/sores of an infected person

  • Respiratory secretions (sneezing, coughing, blowing your nose)

  • Touching contaminated objects (toys, doorknobs)

  • Oral secretions (kissing)

Home care

Mouth pain

Unless your doctor has prescribed another medicine for mouth pain:

  • Acetaminophen or ibuprofen may be used for pain or discomfort. Please consult your child's doctor before giving your child acetaminophen or ibuprofen for dosing instructions and when to give the medicine (schedule).  Do not give ibuprofen to an infant 6 months of age or younger. Talk to your child's doctor before giving him or her over-the counter medicines.

  • Liquid antacid can be used 4 times per day to coat the mouth sores for pain relief.  Follow these instructions or do as directed by your child's doctor.

    • Children over age 4 can use 1 teaspoon (5 ml)  as a mouth rinse after meals.

    • For children under age 4, a parent can place 1/2 teaspoon (2.5 ml)  in the front of the mouth after meals.  Avoid regular mouth rinses because they may sting.

Feeding

Follow a soft diet with plenty of fluids to prevent dehydration. If your child doesn't want to eat solid foods, it's OK for a few days, as long as he or she drinks lots of fluid. Cool drinks and frozen treats (sherbet) are soothing and easier to take. Avoid citrus juices (orange juice, lemonade, etc.) and salty or spicy foods. These may cause more pain in the mouth sores.

Fever

You may use acetaminophen or ibuprofen for fever, as directed by your child's doctor. Talk to your child's doctor for dosing instructions and schedule. Do not give ibuprofen to an infant 6 months of age or younger. If your child has chronic liver or kidney disease or ever had a stomach ulcer or GI bleeding, talk with your doctor before using these medicines.

Aspirin should never be used in anyone under 18 years of age who is ill with a fever. It may cause severe disease (Reye Syndrome) or death.

Isolation

Children may return to day care or school once the fever is gone and they are eating and drinking well. Contact your healthcare provider and ask when your child (or you) is able to return to school (or work).

Follow up

Follow up with your doctor as directed by our staff.

When to seek medical care

Call your child's healthcare provider right away if any of these occur:

  • Your child complains of neck or chest pain

  • Your child is having trouble breathing and lethargic

  • Your child is having trouble swallowing

  • Mouth ulcers are present after 2 weeks

  • Your child's condition is worse

  • Your child appear to be dehydrated (dry mouth, no tears, haven' t urinated is 8 or more hours)

  • Fever of 100.4°F (38°C) or higher, not better with fever medicine

  • Your child has repeated fevers above 104°F (40°C)

  • Your child is younger than 2 years old and their fever continues for more than 24 hours

  • Your child is 2 years old and older and their fever continues for more than 3 days

When to call 911

When to call 911 or seek medical care immediately :

  • Unusual fussiness, drowsiness or confusion

  • Dark purple rash

  • Trouble breathing

  • Seizure

 

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