Hand, Foot and Mouth Disease: Understanding and Managing the Infection

Overview of Hand, Foot and Mouth Disease (HFMD): Identification and Characteristics

Hand-foot-mouth disease (HFMD) is a common viral infection that mainly affects children, but can occasionally affect adults as well. It is a usually benign condition characterized by rashes in the form of small blisters on the hands, feet and around the mouth, sometimes accompanied by fever and sore throat. The eruptions may also spread to the elbows, buttocks and knees. The disease is mainly caused by Coxsackie A16 and Enterovirus 71 viruses.

Triggers of Hand, Foot and Mouth Disease

HFMD is mainly caused by the Coxsackie A virus and other enteroviruses.

The virus is mainly transmitted through:

• Direct contact: via infected secretions such as saliva, mucus or faeces
• Indirect contact: via surfaces contaminated with the virus

Schools and nurseries, where children are in close contact with one another, are common places where the disease spreads. The disease is more common and contagious during the summer and autumn months, when outbreaks are more frequent.

Although generally benign, HFMD can be extremely challenging in children with active atopic dermatitis, particularly if they have recently been treated with corticosteroids, as their skin is more vulnerable to infection and skin complications.

In such cases, to soothe skin inflammation, it may be helpful to apply wet compresses soaked in a Potassium Permanganate solution, which help to disinfect the skin, promote healing and reduce the risk of secondary infections.

How Hand, Foot and Mouth Disease begins: the symptoms

Hand, Foot and Mouth Disease has fairly distinctive early symptoms, but it can be mistaken for other viral infections in children. Here are the main signs:

• Mild fever
  This is often the first symptom and may appear 1–2 days before the skin lesions develop.

• General malaise
  Fatigue, irritability and loss of appetite are common in the first few days.

• Sore throat and difficulty swallowing
  Painful sores may appear in the mouth (stomatitis), making it difficult to eat.

• Skin rashes
  Small blisters on the hands, feet and around the mouth; they may also spread to the elbows, buttocks and knees.

• Skin peeling and scabs
  The blisters tend to burst, leaving small scabs that heal on their own.

• Possible complications (rare)
  In some cases, particularly in adults or immunocompromised children, persistent high fever, secondary infections or dehydration due to a lack of fluid intake may occur.

Practical Approaches for the Management of Symptoms of Mani-Pedi-Bocca Disease

There is no specific treatment for hand, foot and mouth disease, as it tends to clear up on its own within a week.

Treatment is mainly supportive and aims to ensure the child’s comfort. It is advisable to:

• temporarily stop washing the affected area and do not apply creams to the blisters, to avoid further irritating the skin
• if the lesions become larger or particularly itchy and painful, PEG Ointment can be applied morning and evening to aid healing
• in the event of stomatitis, it is important to avoid irritating foods and not to administer any medication, even if the child has a fever
• staying well hydrated is essential, especially if the child is having difficulty eating due to mouth sores

When to see a doctor

Although hand, foot and mouth disease tends to clear up on its own within a few days, it is important to monitor the progression of symptoms closely. In the event of:

• persistent or high fever,

• very painful or extensive injuries,

• difficulty drinking or signs of dehydration,

it is advisable to consult your doctor or paediatrician for a full assessment and to rule out any complications or secondary infections.