A Case of Hand, Foot, and Mouth Disease


Our youngest {8 years old} had two episodes of low-grade fever for two days. I wasn't really bothered by the fever. I was bothered by the usual lack of causes. He doesn't have colds nor cough. I knew right away that it wasn't dengue because the symptoms didn't match the disease. But, I couldn't just rely on textbook symptoms, so I still didn't bush off that possibility. I was sure of one thing though, whatever he had was viral in nature.

We went to his pediatrician on the third day and got confirmation that my son was indeed suffering from a viral illness. "He has Hand, Foot and Mouth Disease", his pediatrician said. With the knowledge of how the disease progresses, I went from calm to frantic, but on the inside only. I didn't want my son to worry. He didn't say anything nor cried, but his facial expression said it all. He was very scared.

On our way home, he quietly sobbed. I knew that the only way to calm him down or erase his fears was to educate him about the disease, the things that he should expect, the symptoms that he has, and other necessary facts. After hugging him and telling him that we'll take good care of him, I told him about Hand, Foot and Mouth Disease.


What is Hand, Foot and Mouth Disease or HFMD?

Hand, Foot and Mouth Disease is a viral illness that affects mostly kids and babies.


What causes HFMD?

HFMD is caused by a virus. The two most common strain that causes HFMD is the Coxsackie A 16 virus under the Enterovirus family. This type of virus causes less complications and is self-limiting according to World Health Organization Western Pacific Region or WPRO.

There are so many subtypes and the one that caused a major stir in Cambodia in July 2012 was Enterovirus 71. This type of virus is associated with serious complications.

HFMD is not caused by being exposed to animals. HFMD is different from the Foot-and-Mouth {also called hoof-and-mouth} disease that affects animals such as pigs.


What are the symptoms of HFMD?

*Most symptoms listed below are based on my son's symptoms.

Day 1:

> Body malaise {discomfort}
> Flushing {reddening} of the skin during the first and second day
> Low-grade fever {38.6 degC}

Day 2:

> Low-grade fever
> Difficulty swallowing

Day 3:

> No fever
> Red spots on the roof of the mouth which causes difficulty in swallowing
> Raised red spots on fingers

Day 4:

> No more difficulty in swallowing
> Red spots on fingers increased in count in the morning but disappeared during the night

Day 5:

> Red spots on the roof of the mouth disappeared
> Red spots on the fingers dried up
> No red spots on feet
> No fever
> No complaints of difficulty in swallowing

Common Symptoms:

> Low-grade fever
> Sore throat
> Poor appetite
> Red spots inside the mouth than turns to blisters
> Rashes on the palms of the hands, soles of the feet, knees, elbows, and buttocks


Red spots on the roof of the mouth


He had one red spot on his left pointer finger


Three red spots on his right thumb

What is the treatment for HFMD?

Since the disease is viral in nature, the treatment is aimed at the symptoms of the disease and not the disease itself. HFMD doesn't have a cure or a vaccine yet.

This is a virus, not a bacterial infection, so antibitiocs will not be of help.

Since the disease was caught early, my son's doctor gave him an antiviral drug from day 3. It helped a lot in terms of disease progression. I was concerned that the sore throat might worsen {which might lead to decrease in fluid and food intake and eventually dehydration} and that the red spots would be filled with fluids {blisters}.Thankfully, it didn't happen.

There are doctors who treat HFMD conservatively. They give medications to relive pain, fever, or sprays to numb the throat. Talk to your doctor for the best treatment tailored for your child's case.

Drinking lots of water will also be very helpful.


How does one get HFMD?

HFMD is contagious. It can be transmitted through direct contact with the infected person {saliva, nose and throat discharges, fluid from blisters, or stool}. The infected person is most contagious during the first week.

My mother-in-law called to inform us that her 10-month old grandson also has HFMD. The older brother had fever first followed by the younger brother. My son played with them, so he most probably got it from either one.


Who gets infected?

It is common in children under 10 years of age, but mostly prevalent in those younger than 5 years old. Kids have lower immune system than adults that's why they are more susceptible.

Adults can get infected too. My son's doctor told us about a whole family who got infected by HFMD. The father was the one who got hit the most because he had the lowest resistance at that time due to colds. That's why it is very important to boost your immune system when a family member is infected. 


What should I do to prevent getting infected by HFMD?

There is really no specific way to prevent getting infected by HFMD. There are, however, ways to lower the risk of getting one.

> Frequent and proper HANDWASHING is very important! Wash your hands thoroughly after touching an infected person's blister.

> Avoid close contact with those infected with HFMD


What should I do to minimize/stop the spread of HFMD?

> Since HFMD is a communicable disease, it should be reported immediately. Inform your child's adviser and tell her/him to tell the parents to check their kids for symptoms.

> Don't allow your child to go to school until his doctor says otherwise.

> Teach your kid to cough or sneeze in their inner elbow, otherwise known as the "Dracula Cough". 

Dracula Cough
> Separate your child's eating utensils and plate from the rest of the family members. Clean them using a different sponge.

> Ask everybody in your home to wash their hands frequently.

> Don't allow your child play with his siblings or other kids until his rashes have cleared-up or until the doctor says it's ok.

> Don't allow your child to share towels, toothbrushes, and other personal hygiene products with anyone else.

> Wash anything that was contaminated by nasal or oral secretions with soap and water then disinfect with chlorine bleach {mix 1 tablespoon or bleach in 4 cups of water}.


Can my child get infected by HFMD again?

Yes. Your child will only get immunity from the virus he contracted. She/he can get one again from another type.


I really don't believe in waiting for severe symptoms before getting medical attention. Once you see any of the following symptoms listed above, bring your child to his/her pediatrician immediately. 


Onward and Upward!
 
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Photo Credit: mcdaid-science.wikispaces.com

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