Hand, foot and mouth disease

Dr Matthew Jackson writes:

There is currently an outbreak of hand, foot and mouth disease affecting Islay and Jura.  This often happens around this time of year after the school year resumes following the summer break.  The disease is a common infection, caused by a virus which causes mouth ulcers and spots on the hands and feet. It usually occurs in children under the age of ten, but can occur in older children and adults.  Hand, foot and mouth disease, while being unpleasant, doesn’t usually cause any lasting harm and usually clears up in 7 – 10 days. Generally, you can look after yourself or your child at home.  The infection is not the same as that which causes foot and mouth disease in farm animals.

Symptoms of hand foot and mouth disease

Symptoms usually develop three to five days after being exposed to the infection and include a high temperature (fever) between 38-39˚C, feeling generally unwell, loss of appetite, cough, tummy pain and sore throat and mouth.  One to two days after the infection develops, mouth ulcers usually appear on the tongue and inside the cheeks. These develop into large ulcers with red edges. They are generally sore and can make eating difficult, drinking and swallowing difficult but generally pass within seven days. Shortly after the mouth ulcers appear, spots also develop on the skin – small, red raised spots on the fingers, palm and back of the hands, the soles of the feet and sometimes also the bottom or legs. The spots are often itchy or slightly sore and usually last for around ten days.

What to do if you or your child has hand, foot and mouth disease.

The best thing to do is stay at home until you are feeling better. There is no cure for the disease. To help manage the symptoms, take plenty of fluid to avoid dehydration – water or milk are ideal, babies may need smaller but more regular feeds of breast or formula milk. Soft foods will be easier to swallow and avoiding hot, spicy or acidic foods will also help.  Painkillers including paracetamol and ibuprofen will help with pain and fever. Aspirin shouldn’t be given to people under 16 years old and paracetamol is best if you are pregnant.  Gargling with warm salty water can help relieve the discomfort of mouth ulcers, but shouldn’t be swallowed so this isn’t recommended for young children.  You should keep your child off school or nursery until they are feeling better although it isn’t usually necessary to wait until the blisters have healed provided they are feeling well. The same advice applies to adults and work.

When to see a doctor.

It isn’t usually necessary to take your child to see a doctor if you think they have hand, foot and mouth disease. The infection should pass in 7-10 days and there isn’t anything else a GP can do. If you are unsure whether the condition is hand, foot and mouth disease you can phone the GP or NHS24 on 111 for advice.  You should also seek advice if your child is unable or unwilling to drink any fluids, there are signs of dehydration such as drowsiness, passing small amounts of urine, or none at all, or has cold hands and feet. Any child under three months old with a temperature greater than 38oC or aged between three to six months with a temperature greater than 39oC should also see a GP.

Other reasons to see a GP would include very red, swollen or painful skin, pus discharging from the skin or if the symptoms are getting worse or are not resolving after 7 to 10 days.  You should contact your GP if you develop hand, foot and mouth disease and you are pregnant and within a few weeks of your due date. The disease won’t normally cause any problems in pregnancy but if you are infected just before your baby is born, it is possible they could become unwell.

Hand, foot and mouth disease is spread by virus particles in infected person’s saliva, poo and blisters entering another person’s mouth. Simple hygiene precautions such as covering the mouth when coughing/sneezing and washing hands regularly, especially after using the toilet and before eating/preparing food, can significantly reduce the spread. Avoiding sharing cups, utensils, towels and clothes with people who are infected and washing bedding or clothing that could have become contaminated separately on a hot wash cycle.

Disinfecting contaminated surfaces with an antimicrobial or bleach-containing solution will also help.