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.
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.
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.
There is no licensed specific treatment available for infections caused by enteroviruses. An antiviral drug, pleconaril, has been tested, but is not yet licensed for general use. Your pediatrician may recommend the use of acetaminophen to reduce your child's fever and ease the discomfort of the mouth sores.
In most cases, children recover from these infections within 7 to 10 days without problems. Complications do occur on occasion, including heart failure related to myocarditis and even sudden death related to abnormal heart rhythms. Newborns with enteroviruses can get severe infections leading to liver failure and massive bleeding, which may be fatal.
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. When a child becomes ill with an enteroviral infection, she should be kept out of school, swimming pools, and child care settings for the first few days of her illness.