Hand, foot and mouth disease (HFMD) is a viral infection that most commonly affects children under the age of 5. Although it sounds serious, most cases are mild, but the symptoms can be troublesome for little ones, particularly during the summer. HFMD is most often caused by Coxsackie A viruses and less often by enteroviruses. The infection spreads through droplets, but also through contact with faeces or objects that have come into contact with an infected child's saliva.
Symptoms of Hand, Foot and Mouth Disease:
- small red spots or blisters on the hands, feet and sometimes the buttocks,
- mouth ulcers that may make eating and drinking difficult,
- fever (not always present),
- general weakness and irritability,
- some children also develop a dry cough and a runny nose.
When It Itches… a Lot
One of the more difficult symptoms of hand, foot and mouth disease to manage, especially at night, is troublesome itching. Children scratch the lesions, which can easily lead to a secondary bacterial infection. Zinc preparations, black-tea compresses, cool baths and antihistamines selected individually by a doctor can help relieve the symptoms. It is also worth keeping the child's nails trimmed short and using lightweight cotton pyjamas to avoid aggravating the skin irritation.
How can the symptoms of hand, foot and mouth disease be relieved?
Skin-related:
Itchy lesions can be gently treated with:
- panthenol,
- with zinc ointment,
- cooling creams free from known irritants, for example products based on hemp, oats or aloe vera, provided the child is not allergic or sensitive to the ingredients.
Symptoms in the mouth:
If ulcers are present, consider the following supportive measures:
- mild, cool liquids,
- avoiding acidic and spicy foods,
- oral moisturising products, used only on the advice of a healthcare professional.
Diet and hydration during an infection
Enteroviruses can cause throat irritation and reluctance to eat. The most important thing is to maintain adequate hydration by offering fluids frequently in small amounts.
Hand, Foot and Mouth Disease Does Not Always Look ‘Textbook’
Although hand, foot and mouth disease is best known for a characteristic rash on the hands and feet and lesions in the mouth, its presentation can vary, including in children who have had it before. Skin changes may also occur on areas such as the buttocks, knees or behind the ears. In some children the rash can be subtle and may resemble an allergic reaction rather than an obvious viral illness. The source also notes that itching can sometimes precede visible lesions. Because several conditions can look similar, medical advice may be needed for diagnosis.
When Should You Seek Medical Advice?
If the symptoms are mild and the child is drinking, has no fever and is breathing freely, the symptoms can be treated at home. Consult a doctor if:
- the child refuses fluids,
- the fever persists for more than 3 days,
- shortness of breath, a severe cough or lethargy occurs,
The source says that hand, foot and mouth disease usually lasts 5-7 days and that a child may be contagious for several days before the rash appears and until it has completely resolved.
Is hand, foot and mouth disease a risk to a pregnant woman?
The source states that evidence about hand, foot and mouth disease during pregnancy, particularly in the first trimester, is limited. It says that no clear effect on fetal development has been established, while isolated reports have raised questions about possible complications. It recommends reducing close contact with infected people where practical and seeking advice from a maternity-care professional after exposure or if symptoms or concerns arise.
Complications: Uncommon but Possible
In most cases, the illness is mild and resolves within 5–7 days.
Possible complications include:
- dehydration (as a result of pain when swallowing),
- secondary bacterial infection of the blisters,
- very rarely: meningitis (caused by Enterovirus 71).
Hand, foot and mouth disease does not require hospitalisation, but it does require care, observation and understanding. The illness can recur, and immunity is not always lasting, particularly when other strains of the virus are involved. Knowledge, appropriate care and patience are essential; the child needs time to make a full recovery.