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What is Hand-Food-Mouth Disease?

Hand-Foot-and-Mouth (HFM) disease is on the rise in the recent years. This condition occurs mainly in children under ten years. While it can affect older children and adults, we are only mildly discomforted or asymptomatic owing to better immune status. However we are still capable of transmitting the viruses that cause this condition.

HFM disease got its name from the painful blisters in the throat, and on the tongue, gums, palate, or inside the cheeks, which are a hallmark of this condition. They appear red with a small bubble of fluid on top. They go on to peel, leaving sore raw areas, with a reddish base. The soles of the feet and the palms of the hands may also have a rash that can look like flat red spots. It is an infection caused by coxsackievirus which belongs to a group of viruses called nonpolio enteroviruses.

A child with HFM also might have a fever, muscle aches, or other flu-like symptoms, all of which can be resolved with efficient home care. In rare cases, the child might become irritable or sleep more than usual or begin drooling (due to painful swallowing). This is a warning sign of the infection affecting the brain and spine and the child must be admitted in the hospital. Your child also may need to see the doctor if he or she looks dehydrated, with signs like a dry tongue, sunken eyes, or decreased urine output.

While there is no medical cure for HFM and the illness needs to run its course, there is much that can be done to prevent the infection from spreading and to make children more comfortable during recovery.

  •  A child who has trouble swallowing might be prescribed “magic mouthwash” (an anti-allergic, antiseptic and antiulcer formulation) that can be dabbed onto sores to ease pain. Cold foods like ice cream and popsicles also help by numbing the area, and will be a welcome treat for kids who have trouble swallowing (and even those who don’t!).
  • Avoid sharing items of personal hygiene (e.g. towels, washers and toothbrushes) and clothing (particularly shoes and socks).
  • Use separate eating and drinking utensils.
  • Thoroughly wash and clean any soiled clothing and surfaces or toys that may have been contaminated.
  • Teach children about cough and sneeze etiquette, immediate disposal of tissues, and to wash hands afterwards.
  • Acetaminophen(Paracetamol) or ibuprofen can be given to help a child who is achy or irritable, or to ease painful mouth sores or discomfort from fever. We do not give aspirin to children or teens, as it may cause a rare but serious illness called Reye syndrome.
  • Kids with blisters on their hands or feet should keep the areas clean and uncovered. Wash the skin with lukewarm soap and water, and pat dry. If a blister pops, dab on a bit of antibiotic ointment to help prevent infection.
  • Hand washing is the best protection. Remind everyone in your family to wash their hands often, especially after using the toilet or changing a diaper, and before preparing or eating food.
  • Shared toys in childcare centres should be cleaned often with a disinfectant during outbreaks because many viruses can live on objects for a few days.

HFM disease clears up within several days to a week and kids recover completely. Even after recovery, they can pass the virus in their stool for several weeks, so the infection can still spread to others. Children with HFM should be kept back from school and childcare centres until all of the blisters have dried.


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Dr. Krishna Mahathi holds diplomas in Pediatrics and in the management of allergies and asthma. Years of working and interacting with children and parents have given her insight into developmental disabilities. She wishes that there was more awareness and acceptance of the issues that differently-abled children face and hopes that through this blog, she can enable thse children and their families to make sensible and informed choices.

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