What You Need to Know about Hand-Foot-and-Mouth

January 25, 2018

Viruses happen.

We are so aware of it here at High Hopes Inclusive Preschool.  There are many wonderful benefits to bringing your child to an environment that they share with their peers all day, every day!  But we know that one of the drawbacks is how easily contagious bugs can spread around.  Hey, these kiddos are still building their immune systems, right?

So we thought it might be a good idea to share some of the signs, symptoms, common misconceptions, and prevention tips for a few of the most common illnesses that can spread in schools.  One of the grossest is hand-foot-and-mouth disease.

So What Exactly Is It?

 

Well, hand-foot-and-mouth disease is a viral illness belonging to the Enterovirus genus.  That’s the same family of viruses that brought us polioviruses, all the variations of the coxsackieviruses, echo viruses, and other enteroviruses.

 

Specifically, Coxsackievirus A16 is the one most commonly associated with outbreaks of hand-foot-and-mouth in the United States.  Enterovirus 71 is a guilty culprit too.  But of course, this is a viral illness like the common cold, so it’s always changing, always mutating, and multitudinous fun versions of the virus now exist for us to contract!  Yay!

Signs & Symptoms

The very earliest signs of hand-foot-and-mouth will show up one or two days before that characteristic rash that’s so noticeable.  The early signs are more subtle, harder to spot.  The most common early sign of hand-foot-and-mouth is a fever, usually pretty high.

In addition to the fever, children with hand-foot-and-mouth may have a sore throat and a reduced appetite.  They might be irritable, or they might experience malaise, which is a fancy word for when you’re feeling bleugh.

At this stage, when most cases of hand-foot-and-mouth are not even noticeable, the disease is already contagious.

After a couple of days, the fever fades, and the sores begin.  Painful sores will start in the back of the mouth.  This is sometimes called herpangina, and it can be a symptom of other viruses beyond hand-foot-and-mouth.  Hand-foot-and-mouth sores will look similar to cold sores, but they can blister or become ulcers too.

Soon the sores will move to the tongue, gums, and the insides of the cheeks.  In many cases, they also appear outside the mouth on the chin, lips, and surrounding areas.

It’s important to remember that these mouth sores, though they look like chicken pox or a rash, are not itchy.  They are painful.  This means that children, especially younger ones, are at a risk for dehydration.  The sores can make sucking and swallowing hurt a lot.  Children may even drool more than usual just to avoid swallowing.  If your little one is affected by hand-foot-and-mouth, it’s a good idea to stay on top of their intake of fluids to avoid these risks.

 

As the mouth sores move to the front, the rash begins to present on the palms of the hands and the soles of the feet.  Sometimes the bumps can even show up between the toes or on fingertips.  They might look like little bug bites at first, but they usually blister in short order.

It is pretty common for the rash to also affect the diaper area in young children, and in some cases it may even spread to the knees and elbows.

Every child’s case of hand-foot-and-mouth will be different, and symptoms can range from so-mild-it’s-barely-noticeable to extremely prevalent.  Of course, there are those special few rare cases where something totally crazy happened in conjunction with hand-foot-and-mouth disease.  If a child with hand-foot-and-mouth develops a stiff neck, back pain, or any level of paralysis, it’s time to call the doctor.

Usually, though, hand-foot-and-mouth disease clears up on its own after 7 to 10 days.  It isn’t pleasant, it isn’t pretty, but it also isn’t really all that threatening, as diseases go.

How Is It Spread?  Who Can Get It?

Hand-foot-and-mouth disease most often affects infants and children younger than five.

Most older children and adults have developed immunity to hand-foot-and-mouth, kind of like we do to chicken pox, and won’t contract it past that age.  Of course, there are always the unlucky few, the exceptions to the rule, that continue to be susceptible to it even after contracting it multiple times.

 

For the most part, however, adults are safe from this virus’s ill effects.  But that doesn’t mean they don’t carry it around in their bodies, not showing any symptoms, but ready to pass the silently-waiting virus on to the next unsuspecting human.

But for all the adults who are carriers, we are nothing compared to the affected children.  The most potent infectants are by far the bodily fluids, blister and sore secretions, and feces of affected children showing symptoms.  The virus can be spread by close contact with the child, with contaminated fluids or feces, and with contaminated objects and surfaces.  It can also become airborne, through coughing and sneezing.

Most often, hand-foot-and-mouth is orally ingested.  One child slobbers on a toy, the next child picks up the same toy and pops it into their mouth – boom, infection.  Adults do this, too, but more indirectly:  we touch a door handle one child sneezed on, then we eat a hamburger for lunch – bang, we’re a carrier.

The virus is the most contagious in the first few weeks of illness, especially in the first seven days.  The virus seems to favor the summer and fall, with more and larger outbreaks happening in those two seasons than in the rest of the year.

There is a common misconception about hand-foot-and-mouth no longer being contagious after the fever has abated.  This is simply not true.  As long as there are sores, the virus is still present and contagious, and in fact, people can sometimes be contagious for days or weeks after their symptoms go away completely.  It is important to wait for a doctor’s okay to return to school and/or work after being infected with hand-foot-and-mouth disease.

Prevention & Treatment

Hand-foot-and-mouth is usually a pretty mild disease that the body can fight off on its own.  There is no vaccine for hand-foot-and-mouth, because there are too many different strains of viruses that can cause it.  There is also no specific treatment for hand-foot-and-mouth.

The main thing you can do to prevent hand-foot-and-mouth is to observe good hygiene practices.  Wash your hands, sanitize and clean toys and surfaces regularly, cough and sneeze into your elbow.  All of these things help to prevent the spread of viruses of all kinds, including hand-foot-and-mouth.

Here at High Hopes, we are very aware of how much the preschool environment lends itself to the spread of these yummy viruses.  On our end, we are teaching our students good hygiene practices.  Handwashing protocols are strictly observed for both staff and children throughout the school day.  Children are encouraged to cough and sneeze into their elbows.

The next time you’re in your child’s classroom, look for the “yuck bucket.”  That’s where we put any toy that has been spotted in a child’s mouth that day.  As soon as they put their spit-baptized toy down, a teacher picks it right up and places it directly into the “yuck bucket,” out of reach of the other children and ready for a thorough cleaning and sanitizing that night when the room is cleaned.

In addition to these daily routines, teachers sanitize tables and surfaces throughout the day and during room cleaning at night.  Toys in the “yuck bucket” and on the shelves are disinfected daily.  And that’s on top of the other routine cleaning of the entire classroom and restroom that takes place every afternoon throughout the week.

Every Friday, a staff member goes to every room and sets off what we affectionately term a “germ bomb.”  A germ bomb is basically a citrus-based aerosol hospital disinfectant that effectively destroys the vast majority of germs, bacteria, viruses, etc. in the classroom over the two-day weekend.  If we have had a known case of hand-foot-and-mouth or another contagious bug in a classroom during the week, we’ll often set off an extra “germ bomb” just especially for that room.

It is very important when your child is affected by hand-foot-and-mouth that they be kept isolated until a doctor has approved them to return to school.

While they are recovering from hand-foot-and-mouth, some children benefit from general painkillers like children’s Tylenol or Motrin.   Antibiotic ointments can help to prevent infection in and from popped blisters.  There are also numbing mouthwashes and sprays that can bring relief from the sores in their little throats and mouths.

Another good relief for sore throats is a popsicle!  Cold treats and drinks are generally easier to swallow for children with hand-foot-and-mouth, as the cold has a natural numbing effect on the nerves.

Viruses happen, unfortunately.  But with a little good hygiene, a sense of humor, and some patience, hand-foot-and-mouth disease doesn’t have to be a huge ordeal.

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