When I was an intern, I came down with hand, foot, and mouth disease.
Strictly speaking, I had herpangina, since the horribly painful blisters were only in my mouth.
It was one of my most miserable experiences. I feel for every child who I see with it.
Hand, foot, and mouth disease is a viral illness caused by members of the enterovirus family, especially coxsackievirus A16.
It affects mainly younger children, but even adults can get it. It occurs mainly in summer and fall, but I have seen outbreaks at other times of the year.
The illness usually starts with a fever, decreased appetite, malaise and a sore throat. After a day or two, painful blisters or ulcers develop in the mouth.
A day or two after that, a red spotty rash can develop. This is usually on the hands and feet, but it can be other places. The rash may turn into blisters.
HFMD without the rash is referred to as herpangina.
Sometimes a person will get the skin rash without the mouth blisters. Symptoms usually last a week.
HFMD is spread by nasal and oral secretions, skin blister fluid and bowel movements. It can be spread by direct contact and from contaminated surfaces.
A person is most contagious the first week of the illness. The time from exposure to coming down with symptoms of the disease is three to seven days.
The disease can best be prevented by washing the hands with soap and water, washing and disinfecting toys and surfaces, and avoiding close contact with those who have it.
It is best to keep children with the illness home from school or daycare until they are fever-free for at least 24 hours.
Treatment of HFMD consists mainly of pain control and staying hydrated. Acetaminophen or ibuprofen can be given for pain and fever.
Older children and adults can use analgesic throat sprays or mouthwashes for relief.
Cold liquids and foods may give some relief. Although plenty of liquids are recommended to avoid dehydration, hot and acidic liquids (such as some juices) should be avoided.
Rare complications of HFMD include viral meningitis, encephalitis, and temporary fingernail and toenail loss.
HFMD is not the same as hoof-and-mouth or foot-and-mouth disease that livestock can get. It is not spread from animals to humans or vice-versa.
I will be very happy if I never get it again.