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Hand, Foot, and Mouth Disease (HFMD)

Hand, foot, and mouth disease is an illness caused by a group of viruses that are generally most active during the summer and fall.  It’s the most common in infants and children under age 5 but can at times cause disease in older children and adults.  Typically the illness starts with a fever which can be quite high, along with decreased energy and appetite, and sometimes a sore throat.  A few days after the fever small red spots appear in the back of the mouth that can turn into a painful blister.  Additionally a rash of red spots and blisters can appear, and while they are classically on the palms and soles, they can also be around the mouth, on the torso, and in the groin.  These lesions can also be very painful.

While this is the typical course, there can be great variability including no fever, minimal rash, and some people who have no symptoms but pass the virus along.  The virus is spread through contact with an infected person’s saliva, nasal mucus, stool, or the fluid inside the blisters.  Thus prevention is achieved through excellent hand washing and thorough cleaning of surfaces that have come in contact with an infected person’s secretions.  Diagnosis is usually done clinically in the office based on a history and physical exam.

Since HFMD is caused by a virus there are no specific treatments, rather symptomatic care.  Fever and pain can be treated with over the counter analgesics/antipyretics and is especially important in infants as they are at the greatest risk of dehydration due to mouth pain.  Generally HFMD is self-limited, with few if any severe complications.  Sometimes several weeks after the rash children will lose one or more finger or toenails.  The loss is not painful and the nails will grow back without problem.  There are several different viruses and multiple strains of these viruses that cause clinical HFMD so it is possible for a person to have the disease more than once.  For more information check out the CDC:

Alaina M. Brown, MD FAAP

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