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Offered by Richard W. Martin, M.D.

Hand-foot-and-mouth disease peaks in the summer and fall, so many parents may have had experience with this childhood viral illness in the past few months. It is most common in young children but can occur in older children and adults. Three different strains of enterovirusescoxsackie virus A16 and A6 and enterovirus 71 are known to cause hand-foot-and-mouth disease so it is possible to get it more than once. The incubation period is 3-6 days. Careful handwashing helps prevent spread of the virus, which is present in respiratory secretions and stools.

Hand-foot-and-mouth disease presents with a distinctive combination of mouth sores, especially on the back of the roof of the mouth, and red spots and small blisters on the hands and feet, including the palms and soles. The rash is also often present on the buttocks and thighs and can sometimes be widespread. The mouth sores are painful and often cause drooling in young children and not wanting to eat or drink. A fever is often present in the first few days. Hand-foot-and mouth disease is sometimes confused with chicken pox, but the blisters of chicken pox have a distinctive teardrop appearance and start on the trunk and then spread outwards.

Since hand-foot-and-mouth disease is caused by a virus, antibiotics (which work only against bacteria) are of no benefit. Antiviral medications and vaccines against enteroviruses are in the research stage. The most important treatment is encouraging ample liquids to avoid dehydration. Cold liquids, popsicles and chilled, bland, soft foods may be soothing for the mouth sores. Spicy or acidic foods or liquids such as orange juice should be avoided. Tylenol or ibuprofen may be given for fever and pain. Fortunately, the fever usually resolves within 2-3 days and the mouth sores within seven days. Your child should be seen by a medical provider if symptoms last longer or if your child looks unusually sick or dehydrated.

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