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Hand-Foot-and-Mouth Disease

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What is hand-foot-and-mouth disease?

Hand-foot-and-mouth disease is a viral infection most often seen in infants and children younger than 10 years. It is most commonly caused by coxsackievirus A16. Coxsackieviruses are one type of enterovirus.

Despite the similarity in names, hand-foot-and-mouth disease is a completely different infection than foot-and-mouth disease, which occurs only in animals and is caused by another type of virus.

Symptoms

Hand-foot-and-mouth disease is generally mild. The signs and symptoms of hand-foot-and-mouth disease include a fever and small but painful sores on the throat, gums, and tongue and inside the cheeks. It also may cause a rash, often with blisters, on the hands, soles of the feet, and diaper area, as well as headaches and a poor appetite.

When to call the pediatrician

Call your pediatrician if your child complains of neck pain, chest pain, difficulty breathing, listlessness, or lethargy. Also consult your pediatrician if your child's mouth sores are causing difficulty swallowing, which may lead to dehydration.

Diagnosis

Your pediatrician will conduct a physical examination that evaluates signs and symptoms which may indicate an enteroviral infection. If the doctor suspects that your child has hand-foot-and-mouth disease, your pediatrician will look for the rash associated with this infection as well as sores in the mouth and throat.

To confirm the diagnosis, your doctor can test specimens from the throat or stools, as well as other areas of the body. Also, tests of the blood and urine may indicate the presence of enteroviruses. If meningitis is suspected, the pediatrician will perform a lumbar puncture (spinal tap) so that the spinal fluid can be examined in the laboratory. If myocarditis is suspected, a chest x-ray film will be taken and an electrocardiogram (EKG) will be performed.

Treatment

There is no licensed specific treatment available for infections caused by enteroviruses. Your pediatrician may recommend the use of acetaminophen to reduce your child's fever and ease the discomfort of the mouth sores.

Prognosis

In most cases, children recover from these infections within 7 to 10 days without problems. If your child is feeling well and is able to participate in regular activities, she does not need to be kept home from school or child care unless the school or child care determines there are other criteria for keeping your child home. However, if your child is very ill or is unable to eat or drink because it is painful to swallow, she may need a few days to rest and recover at home.

Prevention

Children and adults should adopt good hand-washing habits to reduce the chances of spreading these viruses. In particular, parents and other caregivers who change baby diapers should wash their hands frequently.

Source: Adapted from Immunizations and Infectious Diseases: An Informed Parent's Guide (Copyright © 2006 American Academy of Pediatrics) and updated 10/2012

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