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An ailment more common than you think

Hand, foot and mouth disease tends to emerge during spring and early summer

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When we think of the prime time for childhood viruses to spread, we usually think of fall and winter, but there’s at least one common virus that likes to emerge during spring and early summer: the aptly named hand, foot and mouth disease.

Dr. Alia Sunderji, a pediatric emergency physician at the Hospital for Sick Children, said the virus can confound parents because it typically starts with a fever, seemingly out of nowhere. Here’s her advice on what to do if your child contracts the disease.

What exactly is hand, foot and mouth disease?

It’s caused by a virus called Cox- sackie and is typified by fever and ulcers in the mouth and on the hands and feet. However, other ar- eas of the skin, such as the buttocks and upper thighs, can be involved. Because it’s a virus, it does not need to be treated with antibiotics. Par- ents often want a confirmed diagnosis with a swab or blood work, but in the case of hand, foot and mouth, blood tests and additional investigations are rarely necessary.

Is there anything specific about this kind of rash?

The rash can vary. In some kids, it looks like fluid-filled vesicles; in others, it looks like red bumps. The thing to know is if there’s a combination of ulcers in the mouth, a rash on the hands and feet, accompanied by a few days of fever it’s likely hand, foot and mouth.

Is it always accompanied by fever?

In most cases, yes. Typically, the fever comes before the rash, and it can be quite high. If it’s hand, foot and mouth, after between two and four days of fever, you’ll start to see the ulcers in the mouth.

With babies, you might also see excessive drooling and general fussiness. Often your child will refuse to eat as much, due to painful ulcers evolving in the mouth.

So, if you’ve got a young, preverbal child, the important takeaway is: If your child spikes an otherwise symptom-free fever, they’re drooling a lot and are reluctant to eat or drink — check inside their mouth.

How do kids typically pick it up?

There are three main ways the virus is spread.

The first is through sneezing, coughing. I nfection can arise from direct contact with droplets that have been expelled. Furthermore, those droplets can also survive on objects — most commonly toys or countertops. It can also be transmitted through the stool.

The third way is through oral secretions. A young child with mouth ulcers can spread the virus through their drool. Direct contact with fluid from the oral lesions can also promote spread.

When should you take your child to see a health-care provider?

If your child isn’t improving after a week, or the ulcers haven’t disappeared after 10 days, I would suggest seeking medical attention. Also, if your child’s pain is not relieved by acetaminophen or ibuprofen, see your health-care provider.

The thing to watch for is dehydration. Any time your child has a fever, you want to make sure they’re drinking enough. It’s especially important to pay attention to hydration with hand, foot and mouth because the ulcers inside your child’s mouth might make them reluctant to drink as much as usual. Small amounts of frequent fluids can help your child stay hydrated.

The easiest way to measure adequate hydration is by tracking the number of wet diapers. If your child has fewer wet diapers (no wet diapers in eight hours, for example), has dry lips, sunken eyes, laboured breathing, is lethargic or has difficulty walking — those are reasons to seek emergency care. Other symptoms that would signal a trip to emergency include neck stiffness, neck pain, or an inability to move the neck up and down.

When can my child go back to school or daycare?

If your child has a fever, is in pain and is drooling excessively — keep them home. However, part of the reason hand, foot and mouth spreads so quickly is that even when kids are symptom-free, they could still spread the virus. It can be spread by children who are asymptomatic, or who no longer have no symptoms.

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2023-05-31T07:00:00.0000000Z

2023-05-31T07:00:00.0000000Z

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