A Unique Child: Health - A guide to hand, foot and mouth disease

- What is hand, foot and mouth disease?

Hand, foot and mouth disease is a common illness in children and is usually caused by a virus called the coxsackie A virus, although some cases can be caused by coxsackie B virus or enterovirus. The disease is more common in the summer and early autumn and the children affected are usually under the age of ten.

Older children and adults can get it too, but they will usually develop a more mild form of the disease. Foot and mouth disease that affects animals is an entirely different disease.

- How is the disease passed on?

The virus is very contagious and can be easily passed from child to child. When an infected child coughs or sneezes, the virus can live in droplets of mucus or saliva that are suspended in the air. These droplets can be breathed in by another child who will then go on to contract the virus. A child can also become infected after being in direct contact with another child who has the disease - this is because the virus will live in the fluid in blisters that may develop.

The incubation period for an infection is three to five days; this means that the symptoms in a child will develop between three and five days after being infected from another child. Children are infectious until the spots and ulcers have cleared up, although it is thought that they can be mildly infectious for a few weeks afterwards, as the virus can also be found in faeces.

- What are the symptoms of hand, foot and mouth disease?

Like many viral infections, children can initially appear unwell for a few days and may have a slight temperature. As the name of the disease suggests, a rash will then usually develop on the palms of the hands and soles of the feet, and mouth sores can appear on the gums and sides of the tongue as well as the inside of the cheeks. The pink spots that appear may develop into blisters which can last from seven to 10 days. The spots that develop are similar to chickenpox, but are usually smaller. Unlike chickenpox, they are not itchy but can be quite tender to the touch. The sores that develop in the mouth can be quite sore.

Hand, foot and mouth disease is rarely serious. In a very small number of cases, complications occur as the virus can affect the heart muscle or brain. This, however, is very rare.

- How is hand, foot and mouth disease treated?

There is no actual treatment for hand, foot and mouth disease other than simple remedies that can be given to help relieve the symptoms. Paracetomol or ibuprofen (at the appropriate dose and intervals) can be given for pain relief and to help reduce any fever. It is also important that children get plenty of rest. The sores that develop in the mouth may make it difficult for them to drink and eat, and this can lead to dehydration. Offering them fluids and soft foods like yogurt and ice cream will encourage them to eat.

Dealing with cases of hand, foot and mouth disease in a childcare setting

Outbreaks in nurseries and playgroups are quite common because the disease is contagious and easily spread. Children should be kept home from nursery while they are unwell, but it is not necessary to exclude children once they are better, as this is unlikely to stop the virus spreading.

It is important that staff are all aware of the importance of good hygiene to prevent the spread of hand, foot and mouth disease as well as other infections. Staff need to regularly wash their hands, especially after coming into contact with items that may be contaminated with the virus, such as tissues and nappies. It is also important that staff encourage children to wash and dry their hands after using the toilet, as this will also reduce the likelihood of the virus being passed on.

- Further information: WellChild Helpline on 0808 801 0330, email helpline@wellchild.org.uk or text 0778 147 2599.