Clinical Reference Systems: Pediatric Advisor 10.0
Hand, Foot, and Mouth Disease
- small, painful ulcers in the mouth
- small water blisters or red spots located on the palms
and soles, and on the webs between the fingers and toes
- five or fewer blisters per hand or foot
- sometimes, small blisters or red spots on the buttocks
- low-grade fever between 100 and 102 degrees F (37.8 and
38.9 degrees C)
- mainly occurs in children age 6 months to 4 years.
Hand, foot, and mouth disease is always caused by the
Coxsackie A-16 virus. It has no relationship to hoof and
mouth disease of cattle.
The fever and discomfort are usually gone by day 3 or 4.
The mouth ulcers resolve in 7 days, but the rash on the
hands and feet can last 10 days. The only complication seen
with any frequency is dehydration from refusing fluids.
- Antacid solution for pain relief
For very young children, put 1/2 teaspoon antacid
solution in the front of the mouth four times a day
after meals. Children over age 4 can use 1 teaspoon of
an antacid solution as a mouthwash after meals.
Offer a soft diet. Use a cup instead of a bottle to
give fluids to very young children. Cold drinks,
milkshakes, Popsicles, and sherbet are good choices.
Avoid citrus, salty, or spicy foods.
Give acetaminophen or ibuprofen for severe mouth pain or
fever over 102 degrees F (38.9 degrees C).
Hand, foot, and mouth disease is quite contagious.
Usually some of your child's playmates will develop it
at about the same time. The incubation period after
contact is 3 to to 6 days. Because the spread of
infection is extremely difficult to prevent and the
condition is harmless, these children do not need to be
isolated. They can return to day care or school when
the fever returns to normal. While most children are
contagious from 2 days before to 2 days after the rash,
avoiding other children is unnecessary.
CALL YOUR CHILD'S PHYSICIAN IMMEDIATELY IF:
- Your child has not urinated for more than 8 hours.
- Your child starts acting very sick.
CALL YOUR CHILD'S PHYSICIAN DURING OFFICE HOURS IF:
- The fever lasts more than 3 days.
- You have other concerns or questions.