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Hand, foot and mouth disease common in children

Hand, foot and mouth disease is a common ailment often picked up by children in day care. While it may make for a cranky child, Dr. Benjamin N. Lockshin, a Silver Spring dermatologist who also teaches at Georgetown University and the Johns Hopkins University, said the disease is easily treated.

What is hand, foot and mouth disease?

Hand, foot and mouth disease is a common, self-limited viral infection typically affecting children ages 2 to 10 years old.

What are the symptoms?

After approximately a five-day incubation period, the infection presents with a brief fever and sore throat. This is followed by painful oral ulcerations involving the gums, palate and tongue, as well as skin lesions. These lesions initially present as red bumps that quickly evolve into red-gray oval shaped blisters on the hands, feet and, less often, on the buttocks. Other self-resolving skin changes can be observed. These include palmar peeling and nail separation. Nail changes can appear up to one month after infection and can take approximately six months to improve.

Rarely, the virus that causes hand, foot and mouth disease can cause viral meningitis. This presents with fever, headache, stiff neck, and/or back pain. If these symptoms are observed, you should consult your physician immediately.

How is the disease detected?

Diagnosis is often made clinically by your dermatologist or pediatrician. When the clinical diagnosis is in question, a viral culture can confirm the diagnosis. Hand, foot and mouth disease is typically caused by coxsackievirus A16, but other enteroviruses species have been implicated. A viral culture can detect the virus from a representative lesion or in the patient's stool.

How is it spread?

Transmission is via direct contact with an infected person's saliva, feces, respiratory droplets and open lesions. Additionally, contact with contaminated household objects can transmit the virus. Children in day care are at particular risk. A combination of a lack of immunity, close contact and poor hand-washing facilitate transmission. Although less common, adults can also be infected. This frequently occurs in parents with affected children or in day care providers.

How long after treatment can it stay in the body leaving somebody contagious?

Hand, foot and mouth disease is most contagious when the skin and oral findings are present, but even after the skin findings resolve, the patient is still contagious for a few weeks because the virus is still detectable in the stool.

How is it treated?

Treatment is generally supportive since this infection is self-limited, lasting about one week. If the oral lesions are sensitive, topical oral anesthetics like Anbesol gel or Orabase can be helpful for symptomatic relief. Hand-washing, especially after diaper changes, cleaning all potentially contaminated objects and avoiding contact with infected persons will decrease transmissibility.

Is it the same thing as foot and mouth disease?

Foot and mouth disease is not related to hand, foot and mouth disease, despite the similar name. Cattle and other farm animals are especially vulnerable, whereas human infection is extremely rare.

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