What is Hand-Foot-and-Mouth Disease?

It’s got a funny name, but there’s nothing humorous about this childhood illness.  Hand-foot-and-mouth disease (HFMD) has been making the rounds, and if you know a young child, you’ve likely heard about someone suffering from it.

“We’re seeing a lot of cases coming through,” says Dr. Eva Hernandez-Chin, a pediatrician with the University of Miami Health System. “Typically we’re getting kids who are in a daycare or nursery setting, mostly those who spend time in groups.”

HFMD is seen more frequently in children younger than five, but older children, as well as adults, can also get it. Usually, adults don’t show symptoms, but that’s not always the case.  A few months ago, the disease made national news when New York Mets pitcher Noah Syndergaard was sidelined by it. Media outlets made much of the fact that HFMD was an unusual reason for a baseball player to go on the disabled list. It was believed that Syndergaard contracted the virus at a kids’ baseball camp he hosted in the summer.

While the Mets pitcher case is rare, it’s important to recognize that “adults are still carriers even when they show no symptoms,” she says.

They can still transmit it without knowing they’re doing so.

Dr. Hernandez-Chin

Blame hand-foot-and-mouth disease on coxsackievirus a16 and enterovirus 71 — or what Dr. Hernandez-Chin and other pediatricians call the coxsackie virus. Unfortunately, it’s easily transmittable, not unlike a pesky cold that makes the round of a preschool. A child (or a grown-up) can catch it from someone who has it or by simply touching a surface with the virus, such as doorknobs, toys, tables, or the weeping sores that accompany the illness. Infected people “are highly contagious” for the first week of the illness.

Symptoms can be annoying at the very least, and painful, in a bad case. Fever and a sore throat tend to be the earliest manifestations of the virus. These initial symptoms are usually followed by a rash on the palms of the hands and the soles of the feet, along with the rash on the legs, buttocks, and elbows. HFMD is also characterized by blisters that look like cold sores on the back part of the mouth and tongue.

It’s often these mouth sores that give children the most trouble because it makes swallowing very painful.

We tell parents that they have to make sure to keep the children hydrated.

Dr. Hernandez-Chin

While most HFMD cases are mild and uneventful, there can be complications. The blistery rash can get infected and there have been rare cases of viral or “aseptic” meningitis, encephalitis (inflammation of the brain) and a polio-like paralysis. The Centers for Disease Control and Prevention has also reported fingernail and toenail loss within a few weeks of the disease onset, though doctors don’t know if this can be directly attributed to HFMD.

Because some of the symptoms of HFMD can mimic other illnesses, it’s best to take a child to the doctor for an accurate diagnosis, particularly during the virus’s high season of spring through fall. “We arrive at the diagnosis by examining the patient,” Hernandez-Chin explains. “There’s no blood test or culture done.”

Hand-foot-mouth is sometimes initially confused with herpangina, another common childhood illness also caused by a virus. Like HFMD, herpangina shows up with blister-like sores in the mouth and a fever and sore throat. However, the two illnesses can be differentiated by the rash on the hands and feet that is typical of hand-foot-and-mouth disease, Hernandez-Chin adds.

There is no quick cure to hand-foot-and-mouth disease.

“We have no antibiotics, no vaccine, no magic medication to cure it,” she says. “All we can do is treat the symptoms.”

Since the illness usually goes away on its own after seven to 10 days, Hernandez-Chin and other pediatricians recommend ibuprofen or acetaminophen to treat fever and numbing sprays for painful mouth sores. Calamine and other kinds of anti-itch lotion can ease the discomfort of rashes. She also recommends plenty of fluids, neither hot nor cold, to soothe the throat.

In addition, Dr. Hernandez-Chin suggests these steps to stop the spread of the highly contagious illness:

• Wash hands with soap and water frequently and thoroughly. A patient is most contagious during the first week, but the virus can remain for weeks in the body. Even if you, an adult, don’t display symptoms, you can pick up the virus through a child’s spit, stool, or other bodily fluids, including the discharge from a rash.
• Avoid close contact with anyone who displays symptoms. So don’t share eating utensils or hug and kiss. The patient should be isolated as best as possible. A child shouldn’t return to school or daycare without a doctor’s okay.
• Disinfect soiled items and possible surfaces that have been contaminated, including toys, school supplies, and doorknobs.
• Teach your child to cough or sneeze into the elbow instead of a cupped hand.

Ana Veciana-Suarez, Guest Contributor

Ana is a regular contributor to the University of Miami Health System. She is a renowned journalist and author, who has worked at The Miami Herald, The Miami News, and The Palm Beach Post. Visit her website at anavecianasuarez.com or follow @AnaVeciana on Twitter.

Tags: Ana Veciana Suarez, coxsackie virus, Dr. Eva Hernandez-Chin, Hand-foot-and-mouth disease, HFMD, Pediatrics