Symptoms Of Hand Foot Mouth Disease

Q. My 8 month old niece has a rash that consists of little pimply spots that appear on her butt, the palms of her hands, the soles of her feet, and the lower part of both legs. The rash doesn't seem to be itchy. She's very crabby and has a slight fever. What could this be? Milagro, USA

A. While many conditions can cause a rash in young children, the pattern of her rash is suggestive of Hand, Foot, and Mouth Disease (HFMD).

Typical symptoms include ulcers in a child's mouth (especially his tongue, gums, and inside of the cheeks), blisters on his hands and feet (palms and soles) and a low grade fever. Other symptoms can include a rash on the child's buttocks and mild pain from the mouth ulcers.

Hand, Foot, and Mouth Disease is usually caused by the coxsackievirus A16 virus and goes away without treatment, although symptomatic treatments to control pain can be helpful. Important complications to look for include dehydration, especially if your child has painful mouth ulcers and is not eating and drinking well.

Hand, Foot, and Mouth Disease in the Child Care Setting

If an outbreak of Hand Foot Mouth Disease occurs in the child care setting, like a school or daycare, the CDC recommends that you:

• make sure that all children and adults use good handwashing technique, especially after diaper changes. Remember Hand Foot Mouth Disease is moderately contagious. Infection is spread from person to person by direct contact with nose and throat discharges, saliva, fluid from blisters, or the stool of infected persons. A person is most contagious during the first week of the illness.
• thoroughly clean contaminated surfaces and items using dilute solution of chlorine-containing bleach. Wash soiled articles of clothing.
• remember that the CDC has no specific recommendations regarding the exclusion of children with HFMD from child care programs, schools, or other group settings. Children are often excluded during the first few days of the illness, which may reduce the spread of infection, but will not completely interrupt it. Exclusion of ill persons may not prevent additional cases since the virus may be excreted for weeks after the symptoms have disappeared. Also, some persons excreting the virus, including most adults, may have no symptoms. Some benefit may be gained, however, by excluding children who have blisters in their mouths and drool or who have weeping lesions on their hands.

Is HFMD the same as foot-and-mouth disease?

No. HFMD is often confused with foot-and-mouth disease of cattle, sheep, and swine. Although the names are similar, the two diseases are not related at all and are caused by different viruses.

^{reproduced in part from the CDC Hand Foot Mouth Disease Fact Sheet}