Hand, Foot, and Mouth Disease, or Herpangina (if only mouth involvement)

Question 1

What is Hand, Foot, and Mouth Disease caused by?

Answer 1

Caused by viruses belonging to enterovirus genus. Coxsackie A viruses (especially A16) is the most common.

Question 2

How is it transmitted?

Answer 2

Transmitted by direct contact with infected fecal, oral secretions; spread mostly through saliva
• Peak incidence during spring and summer, particularly in children who wear diapers (1- to 4-year-olds)
• Incubation period: 3–6 days
• Communicable from time of infection until fever resolves; virus is shed for several weeks after the infection begins

Question 3

S/S

Answer 3

• High fever usually occurs first.
• Vesicles on tongue and oral mucosa erode to shallow ulcers; vesicles on hands and feet are football shaped, with erythematous rims.
• Extensive mouth lesions may lead to anorexia, dehydration, and drooling.

Question 4

Management

Answer 4

• Usually mild and self-limiting, resolving within 1 week
• Treatment is mainly supportive.
• Encourage oral fluids of preference, such as popsicles.
• Provide analgesics as needed.
• Mouthwash or sprays to numb the mouth may be needed.
• Standard precautions and good hand hygiene are necessary.

Question 5

Complications

Answer 5

dehydration, meningitis, encephalitis, and possible fingernail/toenail loss