While many parents are surprised about an obscure diagnosis of their children of Hand-Foot-Mouth Disease, one local pediatrician says its always been pretty common.
Pediatrician Dr. Michael Fontenot said he’s seen cases of Hand-Foot-Mouth Disease here over past years, and said it’s not new.
He said the symptoms that parents and others can look for are mainly fevers, and sores that appear in a child’s mouth, sometimes in the throat, and on the palms of the hands and soles of the feet.
“Those are the hallmarks of this condition,” Fontenot said. “It can be caused by a virus or two, and usually lasts about a week. The first three to four days of it are usually the worst.”
Because it’s caused by a virus, there’s no treatment to kill the germs, he said.
“If the child’s mouth is painful, parents have used Benadryl liquid; and some have had good results with the Benadryl liquid mixed with Maalox liquid to rinse the child’s mouth.”
But, he said, the sores in a child’s mouth are the hardest to get to, to treat; and sometimes the best the parents can do is give the child Tylenol or Motrin.
Fontenot said the same virus also causes other syndromes, so it’s sometimes difficult to sort out the symptoms and define the disease.
“If a child has the mouth sores and won’t drink enough liquids, the parents have to keep saying, ‘I know it hurts, but you have to drink more water’.”
Dehydration is one of the most serious side effects, he said, but in the last five years, he hasn’t seen a single case that included dehydration, in his pediatric office.
“It’s spread through saliva and stool, but not through the air, and mainly affects children age five and under,” he said, which makes day cares and preschools the places where its victims are most often found.
“The preschool and day care staffs know to look for any remarkable symptoms and they all have regulations about washing their hands thoroughly after each diaper change,” Fontenot said. “But the Hand-Foot-Mouth Disease has no more life span than the average cold. Good hand-washing is key.”
The doctor said every germ has “seasonality” and Hand-Foot-Mouth Disease generally happens in the summer, though over the years he has seen cases of it all year round.
Mayo Clinic - information
Hand-Foot-Mouth Disease is most commonly caused by a coxsackievirus.
There's no specific treatment for Hand-Foot-Mouth Disease. Frequent hand-washing and avoiding close contact with people who are infected with Hand-Foot-Mouth Disease may help reduce the child's risk of infection.
The usual period from initial infection to the onset of signs and symptoms (incubation period) is three to six days.
A fever is often the first sign of Hand-Foot-Mouth Disease, followed by a sore throat and sometimes a poor appetite and malaise.
One or two days after the fever begins, painful sores may develop in the front of the mouth or throat.
A rash on the hands and feet and possibly on the buttocks can follow within one or two days.
When to see a doctor
Hand-Foot-Mouth Disease is usually a minor illness causing only a few days of fever and relatively mild signs and symptoms. Contact your doctor if mouth sores or a sore throat keep your child from drinking fluids. And contact your doctor if after a few days, your child's signs and symptoms worsen.
Common in child care setting
Hand-Foot-Mouth Disease is most common in children in child care settings because of frequent diaper changes and potty training, and because little children often put their hands in their mouths, according to Mayo Clinic research.
A child is most contagious with Hand-Foot-Mouth Disease during the first week of the illness, but the virus can remain in his or her body for weeks after the signs and symptoms are gone, meaning a sick child still can infect others.
Hand-Foot-Mouth Disease primarily affects children younger than age 10, often those under 5 years. Children in child care centers are especially susceptible to outbreaks of Hand-Foot-Mouth Disease. Children usually develop immunity to Hand-Foot-Mouth Disease as they get older by building antibodies after exposure to the virus that causes the disease.
Certain precautions can help to reduce the risk of Hand-Foot-Mouth Disease.
Wash your hands frequently and thoroughly, especially after using the toilet or changing a diaper and before preparing food and eating. When soap and water aren't available, use hand wipes or gels treated with germ-killing alcohol.
Get in the habit of cleaning high-traffic areas and surfaces first with soap and water, then with a diluted solution of chlorine bleach and water. Child care centers should follow a strict schedule of cleaning and disinfecting all common areas, including shared items such as toys, as the virus can live on these objects for days. Clean a baby's pacifiers often.
Show your children how to practice good hygiene and how to keep themselves clean. Explain to them why it's best not to put their fingers, hands or any other objects in their mouths.
Because Hand-Foot-Mouth Disease is highly contagious, people with the illness should limit their exposure to others while they have active symptoms. Keep children with Hand-Foot-Mouth Disease out of child care or school until fever is gone and mouth sores have healed. If you have the illness, stay home from work.
Fontenot said this one’s hard on parents when arrangements have to be made for a parent to stay home or get alternative child care.
There's no specific treatment for Hand-Foot-Mouth Disease. A topical oral anesthetic may help relieve the pain of mouth sores. Over-the-counter pain medications other than aspirin, such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin, others) may help relieve general discomfort.
Lifestyle and home remedies
Certain foods and beverages may irritate blisters on the tongue or in the mouth or throat. Mayo Clinic suggests parents try these tips to help make blister soreness less bothersome and eating and drinking more tolerable.
Suck on ice pops or ice chips; or eat ice cream or sherbet; or drink cold beverages, such as milk or ice water; and avoid acidic foods and beverages, such as citrus fruits, fruit drinks and soda; and avoid salty or spicy foods. Also, eat soft foods that don't require much chewing; and rinse your mouth with warm water after meals.
If your child is able to rinse without swallowing, swishing with warm salt water may be soothing. Have your child do this several times a day or as often as needed to help reduce the pain and inflammation of mouth and throat sores.
No antiviral medication or vaccine is available, but development efforts are underway, according to Mayo Clinic officials.
Fontenot partners with Dr. Chris Meriweather at Kerrville Pediatrics; and they treat patients from newborn to age 21. Fontenot said he’s been a pediatrician since 1988; and came to Kerrville in 2000.