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Hand, Foot and Mouth Disease

Updated on August 12, 2014

What is Hand, Foot and Mouth Disease

Hand, Foot and Mouth Disease or (HMFD) is a human illness that is caused by intestinal viruses. It is caused by different viral strains including coxsackievirus or enterovirus.. The most common offending virus is .Coxsackievirus A16 and Enterovirus 71

The illness is very common in infants and toddlers in the summer and fall months. It is passed through oral or nasal secretions or feces. Good hand washing is of utmost importance to slow down the spread of this virus. The illness is highly contagious even before symptoms even appear.

This is one of the many reasons parents and childcare workers need to be judicious hand washers.

maculopapular" rash with papules or small blisters
maculopapular" rash with papules or small blisters | Source


HMFD is highly contagious and spreads rapidly throughout a daycare or school situation. Infants may be lethargic, run a fever as high as 101degree F and have a loss of appetite. They may also have vomiting and diarrhea. It is often confused with Strep infection because of the sore mouth and throat that go with it. One to two days after the fever mouth sores or herpangina begin in the mouth.

After that the patient may develop vesicles on the hand , foot , buttocks. These are flat red pumps with iiny blisters underneath. Similar skin conditions include heat rash. Often a skin rash may develop prior to the blisters. Sometimes they will scab over The rash is not limited to the hand, foot and mouth but may be generalized especially around the ears and neck area. Anywhere that the child experience heat may be more susceptible.

Mouth of a young child with hand,food and mouth disease.
Mouth of a young child with hand,food and mouth disease. | Source

Hand , Foot and Mouth Disease Treatment

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Images of skin just at the beginning of the Illness

Notice the number of bumps around the mouth
Notice the number of bumps around the mouth | Source
This child had a severe outbreak with bumps on most of her skin. This is her knee in early stages
This child had a severe outbreak with bumps on most of her skin. This is her knee in early stages | Source
Broken blisters also on the knee.
Broken blisters also on the knee. | Source


HMFD is usually not acquired a second time although it has been known to happen.

The best treatment is acetaminophen or ibuprofen for fever and malaise, hydration and oral hygiene and rest. Some doctors may prescribe alternating doses of acetaminophen and ibuprofen to keep the child more comfortable. Benadryl may help with some of the itching and nausea and aid in sleep.

Keeping the child cool is important with a high fever.

Keep your child well hydrated during this time. Don't be too concerned about the content of the drink as you would when he is not ill.

A soft diet is recommended. The mouth sores make it difficult for the child to swallow so cool juices, frozen popsicles, jello, pudding, applesauce and non-acidic foods.Once the toddler or infant stops running a fever and all vesicles are scabbed over she is no longer considered contagious.

The vesicles and rash can be painful and itch. Oatmeal baths can be soothing. Also try to keep your child cool during this time and limit clothing to cool cotton clothes that are easy to slip on and off. Bedsheets may need to be changed often as the sores are open.

Keeping your child happy and entertained can be difficult during this time. If you have other children in your family that have had the illness they can play quietly together. Coloring, videos and reading books are often calming..

Treatment for mouth sores.

Active disease can be difficult for a toddler or older child and oral hygiene is important.

Oral sores are sometimes treated with a special soothing mouthwash made by a pharmacist consisting of an antacid to treat pain, an antihistamine and possibly an antibiotic and/or anti-inflammatory steroid medication as prescribed by a physician. This is often called "Magic Mouthwash " and is used for many oral conditions.

Treating Oral Sores

Your child will probably feel the worst during the febrile stage. The sores can also cause some irritation. Once these start to dry up your child will probably bounce back to his old self. Depending on the amount of exposure your child may have a mild case.

Some physicians believe a child can remain contagious after the last pustule dries up but as long as good hand washing is used and children do not share eating utensils the chance of another child becoming infected at this stage is rare.

As the pustule dry up the child will be left with some signs of the breakout and this make days to weeks totally go away. Some dead skin may peel away but this is no cause for concern.

Calling your doctor

Even if you know what your child is dealing with and how to treat it you may want to notify your doctor so he or she is aware of outbreaks in your area and can reassure other parents that are not familiar with the illness.


This illness actually looks worse than it really is as the skin breaks out. The child usually recovers with little to no complications. Other parents may be wary of having their own children around yours even after the eruptions have stopped and it is important to try to understand and not be offended by this fear.

Prevention is the same as with most childhood illnesses. Keep toys our to other children's mouths. Wash dishes carefully and don't allow children to share pacifiers of drink cups. Handwashing especially after diaper changes is very important.

Reference, Mayo Clinic,



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