Hand, foot and mouth syndrome: is it a new disease?

A few days ago, while waiting to pick up my son from school, I overheard some mothers talking. They were talking about a new disease affecting the skin and mouth with sores, which many children were like this in their nephew's daycare.

Immediately the syndrome came to my mind, mouth, hand and foot, I saw many outbreaks in my country, it was really alarming at times the amount of lesions, but only in the eyes of a worried mother, then I changed my eyes and put on those of a pediatrician and they did not look so serious.

Despite it has a somewhat worrisome name, Hand, Foot and Mouth Syndrome is a common and contagious disease caused by different viruses.

The disease is a mild, contagious viral infection common in young children. Symptoms include mouth sores and maculopapular rash on the hands and feet. The most common cause of Hand, Foot and Mouth Syndrome is Coxsackievirus.

There is not a specific treatment for this condition. Only the use of hygienic measures and avoiding contact with sick people. See your doctor in case of fever of more than 3 days, worsening of lesions, frequent vomiting and signs of dehydration.

Who can get the disease?

It usually affects infants and children under 5 years of age, but older children and adults can also contract it, in these cases, it is associated with immunodeficiencies.

What causes it?

The most common cause of Hand, Foot and Mouth Disease is infection with Coxsackievirus A16. This virus belongs to the non-polio enterovirus group. Other types of enteroviruses can also cause the disease.

How do we become infected?

The disease is transmitted by contact with the infected person, through the following routes:

Respiratory route

• Contact with large droplets that form when the child talks, coughs or sneezes. These droplets may land in the eyes, nose or mouth. Most of these droplets do not remain airborne; they usually do not travel more than 3 feet (91.4 cm) and then fall to the ground.

• Contact with secretions (nasal mucous or saliva) from objects contaminated by children who have the virus.

Fecal-oral route

• Contact with the stool of infected children. This usually happens when a sick child smears his or her fingers and then touches an object that another child touches. The child who touches the contaminated surface then puts his or her fingers in his or her mouth.

What are the symptoms?

• Fever.

• Sore throat.

• Nausea.

• Painful blister-like lesions on the tongue, gums and inner cheeks.

• Rashes on the palms of the hands, soles of the feet and buttocks. It does not itch, but sometimes blisters. Depending on the skin tone, it may be red, white, gray or only appear as small bumps.

• Irritability in infants and young children.

• Loss of appetite.

The usual period from initial infection to onset of symptoms (incubation period) is 3 to 6 days. Children may have fever, sore throat, runny nose. Sometimes they lose their appetite and do not feel well. Mistaken for a common cold.

One or two days after the onset of fever, painful sores may appear in the front of the mouth or in the throat. A rash may also appear on the hands and feet, and sometimes on the buttocks. It may even become generalized, although lesions always predominate on the sites that give the disease its name.

Sores appearing on the back of the mouth and throat may suggest a related viral disease, known as herpangina, but this disease, although it may cause a generalized rash when the fever ends, is not of the maculopapular type.

When should you consult a doctor?

Hand, foot and mouth disease is usually a minor illness. It usually only causes fever and mild symptoms for a few days. See your doctor if your child is younger than six months old, has a weakened immune system, or has mouth sores or a sore throat that makes feeding impossible. Also see your doctor if your child's symptoms do not improve after 10 days.

Are complementary or laboratory tests done?

No, it is a clinical diagnosis, which depends on a good interrogation, on the data provided by the parents and on the doctor's expertise.

Depending on the phase in which the doctor evaluates the child, different doubts may arise. In an initial phase, with general symptoms and few respiratory symptoms, as it is a common cold. After the appearance of the lesions, it is important to ask where they started, because they are peripheral eruptions, although they have been seen generalized. The diagnosis becomes difficult when there are other concomitant infections, such as Scabies, there may be confusion with Scabies superinfection, but the previous respiratory symptoms and oral mucosal lesions help us to differentiate them. It is also often confused with Varicella, but this is a central exanthema.

How long is it contagious?

It is usually more contagious during the first week of the disease. However, children who have Hand, foot and mouth disease may "shed" or excrete the virus through the respiratory tract (nose, mouth and lungs) for 1 to 3 weeks and in the stool for weeks or months after the onset of infection.

How can I help prevent and control the spread of the disease?

Frequent hand washing and avoiding close contact with people who have Hand, foot and mouth disease can help reduce your child's risk of getting this infection.

Excluding a child from childcare center or school does not reduce the spread of Hand-foot-and-mouth disease because children can spread the virus even when they have no symptoms and the virus can be present in their stool for weeks after symptoms disappear.

• Teach your children to cover their mouth and nose with a tissue when sneezing or coughing as much as possible or with their shirt sleeve if a tissue is not available. Teach them to wash their hands after using tissues or coming in contact with mucous secretions. Change or cover contaminated clothing.

• Wash hands after changing diapers. Parents can spread the virus to other surfaces by contact with stool, blister fluid or saliva.

• Clean and disinfect toys that have been in contact with your child through saliva.

• Prevent sharing of food, drinks and personal items that your child may touch with his or her mouth, such as eating utensils, toothbrushes and towels.

• Protect other children in your home. Make sure they do not come in contact with the child who is infected. Kissing, hugging and sharing drinking glasses and eating utensils can spread the infection quickly. If your children share a room, separate them while the sick child is contagious.

• Disinfect surfaces that your child touches frequently. This can help prevent a sibling from getting the disease, and it can be done if you are careful and keep surfaces clean.

If my child has already suffer Hand, foot and mouth disease, can he or she get it again?

Yes, a child can get the infection several times with the same type of virus or different viruses that cause the disease.