April

Illness of the Month
Hand, Foot, and Mouth Disease
taken from

Web MD

Topic Overview
Hand, foot, and mouth disease is a viral infection that is commonly seen in children and babies. The main symptoms include fever, sore throat, and fluid-filled blisters that appear on the hands, feet, mouth, and sometimes buttocks. The blisters develop from small red spots or a skin rash that can break open and become crusted over on the skin within 7 to 10 days.

Hand, foot, and mouth disease is contagious and is spread through human contact. The type of virus that most often causes hand, foot, and mouth disease is known as enterovir particularly by coxsackie 16 (or less commonly by enterovirus 71). Those with hand, foot, and mouth disease can pass it on to others through infected saliva, mucus, and feces.The virus types that most often cause hand, foot, and mouth disease are normally found in humans throughout the world. However, outbreaks of hand, foot, and mouth disease commonly occur in the United States, Europe, Australia, Brazil, and Malaysia. The disease occurs most often in the summer and autumn months, but may appear at any time. Children under the age of 10 years are most commonly affected, but can pass the infection on to others in the same household, school, or day care.^The incubation period is 3 to 6 days. Your child may at first feel tired, develop a sore throat, and have a fever of around 101°F (38.33°C) to 103°F (39.44°C) for 1 to 2 days. Skin sores will then appear in and on the mouth, and then can develop on the palms of hands, soles of feet, and sometimes buttocks. These sores can be painful, especially in younger children.

Treatment for hand, foot, and mouth disease is not usually needed, as it most often goes away on its own within about 7 to 10 days. You may give your child acetaminophen or a nonsteroidal anti-inflammatory drug (NSAID) if your child is uncomfortable from the symptoms associated with this disease—fever, sore throat, or open blisters.

Hand, foot, and mouth disease is not the same as foot and mouth disease (sometimes called hoof and mouth disease) or mad cow disease, which are infections that occur almost exclusively in animals.

Hand, Foot, and Mouth Disease

Symptoms
While adults can get symptoms of hand, foot, and mouth disease, their symptoms are usually more mild than symptoms in children. Symptoms of hand, foot, and mouth disease begin with a sudden onset of:

Sore throat.

Fever of around 101°F (38.33°C)) to 103°F (39.44°C).

Fatigue.

Loss of appetite.

Within 1 to 2 days, small sores or fluid-filled blisters will appear both inside and on the outside of your child’s mouth. The number of mouth sores averages between 5 and 10. Mouth sores are usually painful and may interfere with your child’s ability or desire to eat.

Within 4 to 6 days after the blisters appear in the mouth, your child may develop red spots (papules about 3 to 7 mm in size) or a skin rash that turns into blisters on the:

Top of the hands and between fingers.

Palms of hand.

Tops, sides, and in between toes of feet.

Soles of feet.

Buttocks (sometimes).

The small red spots or rash quickly develop into small blisters that break open and crust over within 3 to 7 days. The number of fluid-filled blisters may vary from just a few to hundreds on the skin. The hands are affected more often than the feet. The blisters usually last about 7 to 10 days. Once the blisters are healed, your child should be well. It is possible for the skin sores to recur, although this is not common. If skin sores do reappear, your child may need medical treatment to completely heal from hand, foot, and mouth disease.

Hand, Foot, and Mouth Disease

Treatment Overview
Treatment for hand, foot, and mouth disease is not usually needed. Symptoms of the disease generally go away within one week to 10 days without treatment.

You may choose to treat your child’s symptoms to soothe discomfort and pain associated with hand, foot, and mouth disease such as sore throat, fever, or pain from blisters. The following treatment may be appropriate choices:

Acetaminophen, such as Tylenol

Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen

Home Treatment
Hand, foot, and mouth disease often goes away on its own without any treatment. Symptoms of discomfort or pain vary, with pain most often caused from the pressure of fluid in the blisters. Uncomfortable symptoms can usually be treated at home. In addition to nonprescription pain relievers and topical or oral medications that your child’s doctor may prescribe, the following may help make your child more comfortable during the course of the illness:

Have your child drink plenty of cool fluids (try a popsicle for variety).

Treat fever and pain with acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs).

Avoid acidic foods (such as apple juice).

To prevent the disease from spreading to other members in the family, the following measures can be taken:⁵

Reduce the amount of physical contact you have with the infected person (child or adult).

Disinfect the household with diluted bleach or other cleaning supplies and keep it clean.

Practice good hygiene, such as frequent handwashing (especially after changing a child’s diaper).

Do not let the child share toys or give kisses while he or she is infected.

Use gloves to apply any prescribed ointment to the child’s blisters.

Keep the child at home during the course of the illness to prevent spread of the disease.

Your child will be contagious during the course of the illness for around 7 to 10 days. However, it is possible your child may remain contagious for a longer period of time, as the virus is found in stool for several weeks.⁵ Careful hygiene practices should continue for several weeks or months after the child is better.

You or your doctor may want to let your local health agency know that someone in your family has hand, foot, and mouth disease. The health agency keeps track of this information to determine whether an outbreak of the disease is occurring in your area.

Safety Tip Nutrition

Taken form the American Academy of Pediatrics

Feeding Kids Right Isn’t Always Easy

Tips for Preventing Food Hassles

Did You Know That…

…encouraging your child to wash his or her hands thoroughly before meals may help prevent food borne illness?

Feeding Kids—What’s Your Role?

While parents are the best judges of what children should eat and when,

children are the best judges of how much they should eat.

Here are five important feeding jobs for parents and caregivers:

1. Offer a variety of healthful and tasty foods. Be adventurous!

2. Serve meals and snacks on a regular schedule.

3. Make mealtime pleasant.

4. Teach good manners at the table.

5. Set a good example.

Happy encounters with food at any age help set the stage for sensible eating

habits throughout life. Handling food and eating situations positively

encourages healthful food choices. This brochure gives helping hints for food and nutrition for young children. For specific advice, talk to your child’s pediatrician or a registered dietitian.

Mealtime: Not a Battleground

"Clean your plate."

"No dessert until you eat your vegetables."

"If you behave, you can have a piece of candy."

To parents and caregivers, these phrases probably sound familiar. However,

food should be used as nourishment, not as a reward or punishment. In the

long run, food bribery usually creates more problems than it solves.

Here are six common childhood eating situations. Try these simple tips to make mealtime a more pleasant experience.

Feeding Challenges... Feeding Strategies...

Food Jags: Allow the child to eat what he or she wants if the "jag" food is wholesome. Offer other foods at each meal. After a few days, the child likely will try other foods. Don’t remove the "jag" food, but offer it as long as the child wants it. Food jags rarely last long enough to cause any harm.

Food Strikes: Have bread, rolls or fruit available at each meal, so there are usually choices that the child likes. Be supportive, set limits and don’t be afraid to let

the child go hungry if he or she won’t eat what is served. Which is worse, an occasional missed meal or a parent who is a perpetual short-order cook?

"The TV Habit": Turn off the television. Mealtime TV is adistraction that prevents family interaction andinterferes with a child’s eating. Value the time spent together while eating. Often it is the only time during the day that families can be together.

An occasional meal with TV that the whole family can enjoy is fine.

The Complainer: First ask the child to eat other foods offered at the meal. If the child cannot behave properly, have the child go to his or her room or sit quietly away

from the table until the meal is finished. Don’t let him or her take food along, return for dessert or eat until the next planned meal or snack time.

"The Great American White Food Diet" Avoid pressuring the child to eat other foods.

Giving more attention to finicky eating habits only reinforces a child’s demands to limit foods. Continue to offer a variety of food-group foods. Encourage a taste of red, orange or green foods. Eventually the child will move on to other foods.

Fear of New Foods: Continue to introduce and reinforce new foods over time. It may take many tries before a child is ready to taste a new food… and alot of tastes before a child likes it. Don’t force children to try new foods.