WHAT IS IT?
Hand, foot and mouth disease is a common illness caused by a virus, usually the coxsackie A virus. However, in some cases, it can also be caused by the coxsackie B or the enterovirus 71. These viruses all belong to one group, known as enteroviruses.
Hand, foot and mouth disease gets its name from the rash which develops on the palms of your hands and soles of your feet. It can also cause sores in your mouth.
Hand, foot and mouth disease is very contagious (easily spread) and it is common in children under 10 years of age. However, sometimes adolescents and adults can also be affected. Most adults are immune to the coxsackie A virus as they have been previously exposed to it during their childhood. When adults develop the disease, they tend to experience milder symptoms compared with children.
Hand, foot and mouth disease is not the same thing as foot and mouth disease, which affects cattle, sheep and pigs. The two infections are completely unrelated, and you cannot contract hand, foot and mouth disease from animals.
SYMPTOMS
Symptoms of hand, foot and mouth disease usually start to appear 3-7 days after being infected with the virus.
The early symptoms of hand, foot and mouth disease include:
fever,
loss of appetite,
sore throat,
small flat or raised red spots in the mouth, throat, and skin.
generally feeling unwell.
After 12-36 hours, any red spots will develop into yellowy-red ulcers (lesions) in your mouth, around the roof of your mouth, tongue and inside of your cheeks. These ulcers may be sore and uncomfortable, making it difficult to eat, drink and swallow.
After 1-2 days, sores may develop on the palms of your hands, the soles of your feet, and between your fingers and toes. In some cases, they also develop on the buttocks and genitals. The sores last for about 3-6 days and may be itchy and uncomfortable. They are smaller than chicken pox sores.
If an adult develops hand, foot and mouth disease, their symptoms will usually be much milder compared with those of a child.
CAUSES
Hand, foot and mouth disease is usually caused by the coxsackie A virus, but it is sometimes caused by the coxsackie B or the enterovirus 71. These viruses are often spread through the air in the tiny droplets from coughs and sneezes of infected people.
You can develop hand, foot and mouth disease if you have contact with fluid from the sores, saliva or faeces of someone who is infected.
The virus stays in the faeces for about four weeks after the person has recovered. It is therefore vital that adults and children wash their hands thoroughly after going to the toilet, or handling nappies.
DIAGNOSIS
There are several different viruses that can cause sores and ulcers in the mouth. However, a GP will normally be able to distinguish hand, foot and mouth disease from other viruses by:
The age of the affected person - hand, foot and mouth disease is most common in children under the age of 10.
The pattern of symptoms - symptoms begin with fever and a sore throat, spots then develop in your mouth, before also developing on the palms of your hands and soles of your feet.
The appearance of sores - the sores are smaller and more yellow than chicken pox sores.
A throat swab, or stool sample, may be taken to determine which enterovirus has caused hand, foot and mouth disease. However, as it normally takes several weeks to get the results back from the laboratory, the infected person has often recovered. Therefore, such tests are rarely carried out.
TREATMENT
There is no specific treatment for hand, foot and mouth disease. The condition usually clears up by itself after about 10 days. As it is caused by a viral infection, the disease cannot be treated with antibiotics.
You can help to ease the symptoms of hand, foot and mouth disease by:
resting,
taking plenty of fluids - water, or weak squash, is ideal, or
taking paracetamol.
If you, or your child, has a fever, or sore throat, paractemol should help to relieve pain, and bring down a temperature. Children's paracetamol can be used for treating your child. However, aspirin must not be given to children who are under 16 years of age.
In some cases of hand, foot and mouth disease, the sores can become infected if your child scratches them. If this happens, the infection will need to be treated with antibiotics. Your GP will advise you about this.
PREGNANCY AND HAND, FOOT AND MOUTH DISEASE
If you are pregnant, the risk of hand, foot and mouth disease affecting you, or your baby is very low. However, if you develop the disease just before giving birth, there is a 65% chance you may pass it to your baby Babies born with hand, foot and mouth disease will usually only experience mild symptoms. However, in severe cases it can cause infection of the liver and heart. Infection of the major organs is potentially fatal. The risk of this type of infection is much higher in newborns who are two weeks old, or less.
There is also some evidence to suggest that, in very rare cases, catching hand, foot and mouth disease during your pregnancy may result in miscarriage. The risk of this happening is extremely small, but it is always best for you to contact your GP if you suspect you may have developed the condition during your pregnancy.
Although the risk of getting hand, foot and mouth disease while pregnant is low, it is best to avoid direct contact with anyone who has the condition in order to reduce the risk further.
COMPLICATIONS
Dehydration: If you have hand, foot and mouth disease, the sores that develop in your throat and mouth may make it difficult for you to drink and swallow. As a result of this, dehydration can occur. Therefore, if you have the condition, it is important to drink plenty of fluids and, if your child is affected, you should make sure that they drink plenty. If dehydration becomes severe, you may have to go to hospital so that fluid can be given through a drip in your arm (intravenously).
Infection: Another common complication of hand, foot and mouth disease is infection of the sores. If the sores are scratched, they may become infected. If this happens, your GP may prescribe antibiotics to treat the infection.
Viral meningitis: In rare cases, hand, foot and mouth disease can lead to viral meningitis. Viral meningitis is an infection of the meninges which are membranes that cover the brain and spinal cord. Viral meningitis is less severe than bacterial meningitis and most people will make a full recovery within two weeks. However, in severe cases it can cause weakness of the muscles, paralysis, speech disturbances, double vision or partial loss of the field of vision, and epileptic fits.
The symptoms of viral meningitis include:
fever,
drowsiness,
headache,
neck stiffness,
vomiting,
dislike of bright lights.
There is no specific treatment for viral meningitis. Rest and plenty of fluids are advised. Paracetamol can also be given to help lower a temperature and to ease pain and discomfort.
Encephalitis: In very rare cases, hand, foot and mouth disease can lead to encephalitis. Encephalitis is an infection that causes the brain tissue to swell and become inflamed. It can cause brain damage and is potentially life threatening. Early signs of encephalitis can develop in a few hours or over a few days. The infection can affect almost any brain function, but the most common symptoms include:
severe headache,
fever,
vomiting,
drowsiness or confusion,
dislike of bright lights,
memory loss,
unable to speak,
unable to control movement properly,
weakness of one or more parts of the body,
behaviour that is out of character,
a change to any of the senses - touch, taste, smell, sight, and hearing,
stiff neck and back,
muscle weakness, and
seizures (fits).
If you develop encephalitis you will have to be admitted to hospital. However, even when the condition has caused critical illness, many people make a full recovery.
PREVENTION
As hand, foot and mouth disease is very contagious, the best way to prevent it is to practice good hygiene. Always wash your hands after going to the toilet, handling nappies, and before preparing food. If your child has hand, foot and mouth disease, encourage them to wash their hands regularly as well.
Avoid sharing utensils with people who are infected with hand, foot and mouth disease. Also, always make sure that shared work surfaces are clean.
To prevent spreading hand, foot and mouth disease, close contact with those who have the condition, such as hugging and kissing, should be avoided.
If you child has hand, foot and mouth disease, you should keep them out of school, or playschool, while they are feeling unwell. However, there is no need to keep them out of school until the last blister has disappeared, providing that they are otherwise well.
Source: NHS Direct
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