What is hand, foot and mouth disease?
Rachel Roth, her husband and their 1-year-old daughter, Zoe, approached last Fourth of July weekend with one simple aim: to have some old-fashioned, patriotic fun. But when the family kicked it off at a friend's party, it became increasingly clear their goal was easier said than done.
"[Zoe] wasn't acting herself – she wasn't eating; she was whining a lot," remembers Roth, a business development manager at a law firm in New York City. "We went home and all hell broke loose." Specifically, Zoe continued to refuse food, scream and generally act miserable. Soon, Zoe developed a fever, and a rash appeared on the backs of her legs and arms, which prompted Roth to take and send pictures to their pediatrician. Thankfully, the doctor was checking emails over the holiday.
"Oh yeah, that's coxsackie – there's nothing I can do for her," Roth recalls the clinician responding. The virus is one in a family that causes hand, foot and mouth disease, a contagious illness particularly common among toddler-aged kids with no treatment besides patience, time and symptom management.
"I had maybe heard of it in passing; I hadn't really focused on it," Roth says.
But now she and her family had to. They spent the week avoiding playgrounds, kids and other fun summer activities. "We watched a lot of Sesame Street," Roth laughs now. She kept Zoe hydrated with juice (usually not in stock in their house), alternated between Motrin and Tylenol and waited for the symptoms to subside.
"She had been sleeping through the night for months, but was up at 4 in the morning crying and crying, and it was so sad," Roth remembers. Needless to say, "I'm hoping for no coxsackie this July Fourth weekend," she says.
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Other parents of young kids are hoping the same thing: The virus, which is named after the body parts on which rashes or blisters typically appear, is in high tide this time of year, says Dr. Jason Newland, an associate professor of pediatrics at the Washington University School of Medicine in St. Louis and a spokesperson for the Infectious Diseases Society of America.
"Hand, foot and mouth is caused by a family of viruses called enteroviruses and, from an infectious disease standpoint, those viruses circulate ... in late summer, early fall," he says, noting it's one of the most common reasons – if not the most common reason – kids currently wind up in pediatrician's clinics and emergency rooms.
And while there's only so much you can do to prevent the disease and no medication for the disease itself, you can minimize your child's risk and manage its symptoms. Here's what experts and Roth suggest:
1. Don't be fooled by doppelgangers.
Depending on the family of viruses causing the infection and the body parts infected kids are touching, outward symptoms of hand, foot and mouth disease aren't universal. Some kids only get blisters in their mouths that can change their speech or be mistaken for cold sores, while others get blisters on their arms that look like bug bites and others sprout rashes on their rear ends that parents chalk up to diapers, says Dr. Natasha Burgert, a pediatrician in Kansas City, Missouri, and spokesperson for the American Academy of Pediatrics. "A lot of [people] will say, 'I didn't have it [as a kid]," she says, "but you probably did, but maybe you didn't get the full-body rash."
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2. Know the symptoms.
One telltale sign your child's red bumps aren't bug bites but rather hand, foot and mouth disease is that they won't itch, Burgert says. And don't rule out a diagnosis just because a rash appears somewhere that's not in the disease's name, she adds. Other common symptoms of hand, foot and mouth mimic a cold: sore throat, runny nose and fever, says Beth Mattey, president of the National Association of School Nurses. "Children generally do not feel well," she says.
3. Cut your losses.
Because hand, foot and mouth disease is diagnosed by symptoms, not a test, and treated mostly with time, not medication, it doesn't require a visit to the pediatrician or emergency room, experts say. Still, when in doubt, talk to or visit a professional, especially since the same virus that causes hand, foot and mouth disease can (rarely) cause meningitis. "If they're having high fevers and they're miserable and they're not taking in fluids, they need to be seen to be sure they receive appropriate, supportive care – and to make sure it's not something else," Newland says.
4. Bend the rules.
Just because there's only so much you can do to treat hand, foot and mouth doesn't mean there's nothing you can do. Some health care providers might recommend an over-the-counter pain medication like ibuprofen or acetaminophen or a mouthwash to soothe mouth blisters, Mattey says. Simple antifungal creams can help ease the discomfort of rashes, Burgert adds.
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One of the most important steps parents can take is to keep their kids hydrated – something that's not always easy when they have sore mouths or throats. That's why Roth resorted to juice. "Even if you're normally a 'no screen time' parent or a 'no juice parent,' it's the kind of thing where you have to bend the rules," she says.
5.Protect yourself and others.
While it's far less common for adults to catch hand, foot and mouth since they've likely built up an immunity over their lives, it's possible. Protect yourself by washing your hands thoroughly and frequently, and encouraging everyone else in your household to do the same. (There's no hand, foot and mouth disease vaccine, and there likely won't be anytime soon since it's caused by too many viruses, Burgert says.) Kids with hand, foot and mouth should stay home from school or, like Zoe, avoid the playground until their fever has subsided without medication and no new rashes are appearing. It typically resolves completely in seven to 10 days, according to the World Health Organization. As Roth puts it, "You want to be careful not to be patient zero."
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