Hand, foot, and mouth disease (HFMD) cases have increased significantly across the United States since late August 2023. This viral infection primarily affects children under five years old, although adults are not immune. While HFMD is typically mild, it is highly contagious and can cause discomfort and concern among parents.
According to Dr. E. Caroline McGowan, a board-certified pediatrician with UCR Health and an assistant clinical professor of pediatrics at the UC Riverside School of Medicine, the illness is caused by common viruses, particularly strains of enteroviruses such as coxsackievirus A16 and echovirus. Symptoms generally begin with a low-grade fever, runny nose, and irritability, followed by a rash that manifests as small blisters on the hands, feet, and inside the mouth.
Most healthy children recover from HFMD without specific treatment, aside from supportive care. This includes ensuring adequate rest, hydration, and the use of medications like acetaminophen (Tylenol) or ibuprofen (Motrin) to alleviate discomfort. Serious complications are rare, but Dr. McGowan emphasizes the importance of recognizing warning signs. Symptoms requiring immediate medical attention include extreme weakness, difficulty waking, trouble breathing, and a persistently fast heart rate.
Understanding Symptoms and Treatment
HFMD symptoms typically start with mild cold-like signs, followed by the characteristic rash. The blisters can emerge in and around the mouth as well as on the palms and soles. The mouth sores may cause pain that can hinder a child’s ability to eat or drink, leading to the risk of dehydration.
To manage discomfort, parents are advised to ensure their children stay hydrated, using small sips of water or oral rehydration solutions like Pedialyte. Cold, soft foods such as smoothies and yogurt can also provide relief. While most children experience mild illness with rashes lasting 7 to 10 days, some may develop more extensive symptoms that can take up to three weeks to resolve.
Despite being most common in children under five, older children and adults can contract HFMD. The disease spreads easily through close contact, with viruses residing in respiratory droplets, stool, and blister fluid.
Transmission and Prevention Strategies
Preventing the spread of HFMD involves diligent hygiene practices. Dr. McGowan highlights the importance of disinfecting toys and common play areas, promoting frequent handwashing, and avoiding shared eating utensils among children. However, controlling transmission in young children can be challenging due to their natural exploration behaviors.
Children with HFMD do not need to remain at home until all rashes have healed. They may return to school or childcare once they have been fever-free for 24 hours without medication and are comfortable participating in normal activities. Mild lingering symptoms, such as a healing rash or mild cough, are not sufficient reasons to keep a child at home.
The recent rise in HFMD cases aligns with seasonal patterns, often peaking in late spring and early fall. Increased awareness and reporting may contribute to the perception of a surge in cases, but Dr. McGowan reassures parents that HFMD is a common illness. Outbreaks can occur in places like daycares and playgrounds, but exposure can also help build children’s immune systems over time.
While HFMD can be concerning, understanding its symptoms, treatment, and prevention can help parents navigate this common childhood illness effectively.
