HAND, FOOT AND MOUTH DISEASE COMMON IN CHILDREN

(10/19/2004)
Hand, foot, and mouth disease (HFMD) is a common illness of children.

Several cases have been reported among students at Calhoun Middle-High School.

It is characterized by fever, sores in the mouth, and a rash with blisters. It begins with a mild fever, poor appetite, malaise ("feeling sick") and frequently a sore throat.

One or two days after the fever begins, painful sores develop in the mouth. They begin as small red spots that blister and then often become ulcers.

They are usually located on the tongue, gums, and inside of the cheeks. The skin rash develops over one to two days with flat or raised red spots, some with blisters.

The rash does not itch, and it is usually located on the palms of the hands and soles of the feet. It may also appear on the buttocks. A person with HFMD may have only the rash or the mouth ulcers.

HFMD is moderately contagious. Infection is spread from person to person by direct contact with nose and throat discharges, saliva, fluid from blisters, or the stool of infected persons.

A person is most contagious during the first week of the illness. HFMD is not transmitted to or from pets or other animals.

The usual period from infection to onset of symptoms ("incubation period") is three to seven days. Fever is often the first symptom.

HFMD occurs mainly in children under 10 years old, but adults may also be at risk. Everyone is susceptible to infection, but not everyone who is infected becomes ill.

No specific treatment is available for this or other enterovirus infections.

Symptomatic treatment is given to provide relief from fever, aches, or pain from the mouth ulcers.

PREVENTION

Make sure that all children and adults use good hand-washing technique (see above), especially after diaper changes.

Thoroughly clean contaminated surfaces and items using dilute solution of chlorine-containing bleach.

Wash soiled articles of clothing.

CDC has no specific recommendations regarding the exclusion of children with HFMD from schools or child care programs.

Children are often excluded during the first few days of the illness, which may reduce the spread of infection, but will not completely interrupt it.

Exclusion of ill persons may not prevent additional cases since the virus may be excreted for weeks after the symptoms have disappeared.

Also, some persons excreting the virus, including most adults, may have no symptoms. Some benefit may be gained, however, by excluding children who have blisters in their mouths and drool or who have weeping lesions on their hands.