Please raise your hand if you were surprised when you were told your child had hand, foot and mouth. Keep your hand up if you thought this was a disease that only cows got. Well you certainly aren’t alone. In fact, hand, foot and mouth cannot spread between animals and humans.
I am hoping to clarify some myths about hand, foot and mouth and offer some basic advice on how to recognise the signs and symptoms and what to do to when you suspect your child has it. Having experienced it with my own children and having seen it plenty of times as a GP, I hope to help you get through what can be a painful 7-10 days, and maybe even avoid a trip to the doctor’s office.
What are the symptoms?
The first symptom of hand, foot and mouth is often just a temperature. This is normally between 38-39?C.
The next thing you will notice will be your child refusing food. This is often because the second sign, blisters in the mouth, have taken hold. You will be forgiven for not noticing this! I certainly put the temperature and food refusal in my child down to the old classic ‘brewing a cold’.
It wasn’t until the third symptom of blisters on the hands and feet appeared that the penny finally dropped for me. This can sometimes be followed by a rather aggressive blistering rash in the nappy area.
The timing from the onset of the temperature to developing the rash is around 3-5 days. About 25% of children only get the temperature and blisters in the mouth so you may never realise they even had it. It is most common in the summer and autumn months and outbreaks often occur amongst groups of children, for example at nursery or school.
How does it spread?
Hand, foot and mouth disease is contagious and easily passed on to other people. It is spread through coughing, sneezing, and contact with fluid from the blisters or the poo of infected people, so be aware when you are changing nappies.
You’re infectious from a few days before you have any symptoms, but you’re most likely to give it to others in the first 5 days after symptoms start.
How can you reduce the chance of it spreading?
- Wash your hands in warm soapy water often, and get your children to do the same.
- Trap sneezes in a tissue and bin as soon as possible. Sanitising hand gel won’t kill all bugs.
- Don’t share towels or household items such as cups or cutlery.
- Use a hot wash on clothing and bed sheets for a week or so.
How long does the hand, foot and mouth virus last?
The good news is that you will normally have your happy child back within 7-10 days with no long-term damage done, but the bad news is that antibiotics won’t work as it is a virus, so you just have to ride it out.
The treatment is based around controlling the symptoms until your little one’s immune system fights it off.
Give paracetamol and ibuprofen for the temperature.
Make sure you offer plenty of fluids to prevent dehydration but avoid acidic drinks such as fruit juice as they will aggravate the blisters. Offer soft cool food rather than hot or spicy food.
You can buy some over the counter sprays and gels which can help numb the mouth like the ones used for teething such as Bonjela. Any friendly local pharmacist can help advise on these. Be sure to follow the dosing instructions.
When should you contact your GP?
Most children will not need to see a GP when they have got hand, foot and mouth disease.
A call to your GP is advised if
- The symptoms persist for more than 7-10 days.
- Your child has a very high temperature that won’t come down with paracetamol and ibuprofen
- You are unable to get your child to drink and they are not weeing or having wet nappies as they normally would
- You are pregnant and get hand, foot and mouth disease. A
A GP would rather you call to discuss the problem with them as it is contagious, so it is best to avoid the doctor’s waiting room if possible.
When is it okay to send them back to school?
Once your little one is feeling back to normal they can resume normal activities. The official government advice on school and nursery avoidance is that if your child has hand, foot and mouth but feels well then it is fine to send them. You don’t need to wait until the rash has gone.
I’m pregnant. Will hand, foot and mouth affect my unborn baby?
Although there is normally no risk to the pregnancy or baby, it is best to avoid close contact with anyone who has hand, foot and mouth disease. We know that a temperature due to any cause in the first trimester can increase the risk of miscarriage. There is also a small chance if you get hand foot and mouth in the very late stages of pregnancy that your baby can be born with a very mild version. Although this unlikely to be cause for concern it is best to let your midwife know.
What’s the bottom line?
So, it is just a waiting game I’m afraid. These little people are a lot stronger than they look and can go for an alarmingly long time eating very little. For me it involved a lot of tears (baby and me), a lot of lovingly cooked but uneaten food, hundreds of hugs and more Peppa Pig than I would ever admit to.
Dr Lucy Ansell is a private doctor at Concierge Medical Practice. Concierge Medical is an award-winning, private GP service which has been providing round-the-clock comprehensive family medicine to members in the Cotswolds, Gloucestershire, Oxfordshire and Warwickshire since 2013. www.conciergemedical.co.uk
Dr Lucy Ansell
Private GP and Hormone Specialist based in The Cotswolds
Lucy was born and grew up in The Cotswolds. She qualified from Nottingham Medical School in 2006 with first class honours and completed her GP training in Gloucestershire in 2011, before becoming a full time GP partner in Cirencester. She left the NHS in 2016 to embark on a career as a private GP for Concierge Medical Practice which is based in and around The Cotswolds.
Image credits: NHS English