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Hand, Foot & Mouth Disease

Today's Parent / October 2013

It’s as common in daycares as fingerpaint. How can you tell if your child has it?

Last fall , Monica Sangoi’s three-year-old daughter, Olivia, complained that her mouth hurt. “When she wouldn’t eat or drink, I immediately checked her hands and feet for blisters,” she says. It’s not the most obvious reaction, but Sangoi – a kindergarten teacher in Richmond Hill, Ont. – knew exactly what she was looking for: Hand, Foot and Mouth Disease (HFMD).

The illness, most commonly caused by the coxsackievirus, presents as painful oral lesions and a spotty rash or blisters on the hands, feet and bum. Anyone can catch it (adults included) but it’s at daycare centres and nursery schools – where the virus clings to surfaces and toys and the kids spread it through saliva, mucus and feces – where HF MD runs rampant.

Usually, by the time parents notice the characteristic rash, kids have been contagious for a few days. “Children may initially have a low-grade fever, headache and sore throat, and this is when they’re most contagious,” says Alyson Shaw, a paediatrician in Ottawa.

Generally, sores will then appear in the mouth. “They can look like little yellowish ulcers on the inside of the mouth, palate or even the tonsils,” says Shaw. (Or, like Sangoi, you might not see them at all.) Two-thirds of kids with HFMD also get red lesions on their hands or feet, which blister and eventually scab. A doctor doesn’t need to diagnose HFMD, but if you’re unsure about the symptoms, make an appointment.

Complications of HF MD include pneumonia and meningitis, explains Shaw, but are very rare. “The main issue parents need to watch for is dehydration,” she says. “Sometimes, the lesions are so sore that your child won’t eat or drink.” If you see signs – such as your child not peeing very much, having a dry mouth and seeming lethargic – have her checked out.

The good news is that HF MD will probably run its course naturally within a week or so. The bad news is, since it’s a virus and therefore not treatable with antibiotics, little ones have to wait it out. “I gave Olivia acetaminophen to treat the pain and fever, and encouraged her to
drink as much water as possible,” says Sangoi, who also whipped up easy-to-eat comfort foods, like chicken soup. Popsicles are another kid-friendly source of hydration (and may help your child’s mood, too!). The rash doesn’t usually itch, but a soothing cream may discourage kids from picking at the sores.

As soon as kids feel better, whether the rash has healed or not, they’re ready to go back to school. Repeat infections are common, though, so try to avoid HFMD as you would any other virus – by encouraging frequent, thorough handwashing, especially before meals.