October 27, 2022 Author : Alexandre Braga 'Dr., our kid has spots and in the nursery there cases of Hand, foot and mouth disease, is it serious?' This is a very common question of parent to the pediatrician, mainly during summer and autumn months. Parents are concerned about a disease that has a somewhat strange name and that wanders through the nursery. But as a Pediatrician, few situations leave me more relaxed and calm than the suspicion of this disease. This disease is indeed common, but of little clinical severity . What is hand, foot and mouth disease and how is it transmitted? Hand, foot and mouth disease is a viral infection caused by multiple viruses of the genus Enterovirus . The disease is more common in children under 7 years of age. However, it can affect children of all ages and even adults. As the name suggests, i t usually affects children's hands, feet and mouth, with 'spots' (rash) on the skin with a characteristic distribution, and sores in the mouth (oral enanthema). It occurs in outbreaks in day care centers, kindergartens and schools, during the summer, early autumn and sometimes also in winter. The most important route of transmission is fecal-oral , that is contaminated hands after diaper changes, and/or using the toilet. Transmission can also occur through contact with saliva, respiratory secretions (coughing) and sometimes through fluid from skin lesions. Between infection and the onset of symptoms (incubation period) pass 3 to 5 days. So no, the cause it was not an air stream, nor was it because the child slept uncovered the night before. It is a disease caused by a virus that came from another infected child a few days ago. In the first week after being infected, the probability of transmission is higher, but contagion remains possible for a few weeks, mainly through feces, where the virus can be found up to two months after infection. Symptoms and diagnosis Hand, foot and mouth disease typically manifests by lesions that first look like small red spots (macules and/or papules) and later develop into fluid-filled blisters (vesicles). The number of lesions is not the same in all infected children, nor is their distribution. More typically appear on the tongue and inside the mouth as canker sores; On hands and feet, although children do not always have them in these three regions; Sometimes lesions also occur on the buttocks and genital area. Other common symptoms of this infection are: Sometimes mild fever; Pain when swallowing, with decreased appetite or even refusal to eat or drink; Malaise; Abdominal cramps. The lesions are usually non-itchy and painless , although in some cases the child may complain of pain or discomfort. The diagnosis is made mainly on the basis of the symptoms and the history of the disease, and it is not usually necessary to carry out any diagnostic tests. The prognosis is excellent, with full recovery within a week in most cases . Hand, foot and mouth disease treatment There is no specific treatment for this disease. It i s usually self-limiting and disappears within a week . However, symptoms are bothersome, and treatment aimed at relieving symptoms may be needed , which may include: Antipyretics; Oral and/or topical analgesics; Recommendation to have cold drinks and cold soft diet to relieve pain when swallowing. It is also important to ensure that sufficient fluids are drunk to maintain adequate hydration status. Sometimes children even refuse to drink because of the canker sores that cause them pain. This is one of the few times when your pediatrician may suggest something that is usually unthinkable: Drink a cold sugary tea or eat ice cream! The explanation is simple: cold and ice help with the pain and is a way to ingest fluids. Prevent contagion These are measures that help reduce the risk of becoming infected and/or transmitting the hand, foot and mouth disease virus: Wash hands thoroughly with soap and water, especially after changing a baby diapers, using the toilet, sneezing or coughing; Avoid touching your eyes, nose and mouth without washing your hands first; Keep surfaces, objects and toys touched by children or other infected people clean and disinfected; Avoid sharing objects and unnecessary close contact with infected people. Of course, this is one of those situations where talking is easy . It is very difficult to maintain good hand hygiene when we are talking about children (or even adults). Anyone who has children knows that it is not easy to maintain proper hygiene even with just one or two children, so what about when there are 10 or 15 children together in a nursery, all running and putting their hands in each other's mouths. In short… Hand, foot and mouth disease is a common disease with a clinical diagnosis and without the need for additional diagnostic tests. It is quite benign and without clinical severity, although it can sometimes be uncomfortable for the child, mainly due to complaints of pain in the oral cavity and refusal to eat. The duration is usually less than one week, with treatment aimed at complaints and with a very good prognosis. I often say that if all diseases were like this, Pediatricians would not be needed. So, the next time you have this suspicion at the day care center or kindergarten, go to your Pediatrician and discuss the clinical situation and ask your doubts and questions , but don’t worry! It is a disease with a very good prognosis and soon your child will be running around the house again. Meet the pediatrics clinical team from Hospital da Luz network. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
