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Hand, Foot and Mouth Disease

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Hand, Foot, and Mouth Disease

Dr. Gina DiRenzo-Coffey, Boys Town Pediatrics

Hand, Foot and Mouth Disease is a common virus called Coxsackie virus which is in the enterovirus family.  We all get various enteroviruses multiple times in our lives.  They symptoms vary greatly.

Hand, Foot and Mouth typically starts with fever followed by sores that develop on the lips, inside the mouth, and in the back of the throat.  It can also be associated with diarrhea, vomiting, extreme fussiness and irritability.  The reason we worry about it is because they are running a fever and because they don't want to drink, children can progress to pretty impressive dehydration.  There are some other complications that are very rare with Hand, Foot and Mouth but dehydration is by far the most common. 

The younger you are the more likely you are to get Hand, Foot and Mouth because you haven't had previous exposures.  Every time you get exposed to a virus in a particular class or family you build up immunity so the younger children who have never been exposed to the enterovirus family are far more likely to get more severe cases.  It also varies year to year.  We have some years with a strain that goes through the community that is very mild and other years where children not only develop the fever and sores on their mouth and their throat but head to toe.  We've had kids that look like full blown chicken pox or worse, from Hand, Foot and Mouth. 

It is an air born virus which means it spreads extremely easily.  Yes if they are in daycare they have a high chance of getting it but I joke with parents, you can bring the wrong can home from the grocery store that someone coughed on and your child is going to get a virus.  You know, when it is in the community your child has a high chance of getting it.

Treatment is really supportive care.  Its treat the fever, treat the pain, push hydration.  So if they are under six months of age just Tylenol, beyond six months of age you can use ibuprofen, and if you need to, you can rotate ibuprofen and Tylenol for short periods of time and then pushing whatever fluids that child likes to drink, so cold liquids, popsicles, apple sauce.  If the only thing the child will drink is milk, give them milk.  It is not going to hurt them.  We need to get fluids in.

Depending on the age of the baby it can last quite a long time so in very young children who get it, it can last seven to ten days.  The older children, the more severe symptoms tend to last three to four, and by older, you know three and four year olds that may have had exposure to other enteroviruses.

Parents can get Hand, Foot and Mouth.  Like I said, it tends to be not as severe because their immune system has had some previous experience so they fight it off a little better, but I have heard parents describe pretty bad cases even in adults.  They were shocked by how much it hurt.  One of the things I hear, older children and adults describe when they get it is a pretty severe headache.  Babies can't tell you they have a headache.  I tell parents if they are not running a fever, they are eating ok, assume they have a headache and treat it. 

Good hand washing, good hand hygiene.  Keep you kids home from school and daycare when they are sick.  I tell parents at least 24 hours fever free, drinking well before you send them back to daycare.

Hand, Foot and Mouth Disease is a common virus that is easily spread from child to child. Dr. Gina DiRenzo-Coffey, pediatrician with Boys Town Pediatrics, discusses the symptoms, treatment options, and how parents can prevent their child from getting the virus.

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