American Medical Association Family Medical Guide - American Medical Association [217]
Hand-Foot-and-Mouth Disease
Hand-foot-and-mouth disease is a mild viral infection caused by a type of virus called the coxsackievirus. The infection tends to occur during the summer and early fall, and usually affects children under age 10, especially those in preschool or day care.
The infection can be spread when a child inhales infected droplets coughed or sneezed into the air. The virus also can spread when an infected child touches the infected secretions in his or her nose or mouth or does not wash his or her hands properly after using the bathroom and then touches other children or shares toys, cups or glasses, eating utensils, or food.
Hand-foot-and-mouth disease is not related in any way to foot-and-mouth disease, which is caused by a different virus and occurs only in livestock such as cattle and sheep.
Symptoms
The initial symptoms of hand-foot-and-mouth disease include a sudden fever (a temperature between 101°F and 103°F), sore throat, and runny nose. A day or two after the fever begins, small red blisters appear inside the mouth—usually on the tongue and gums, inside the cheeks, and down the throat. The blisters break open and form open sores. Chewing and swallowing may become painful, and the child may lose his or her appetite. He or she may also avoid drinking, which can cause dehydration. A painful, red, blistery rash that is not itchy appears on the palms of the hands and the soles of the feet. The rash also may occur between the fingers and toes and on the thighs or buttocks or in the groin area.
Diagnosis and Treatment
To diagnose hand-foot-and-mouth disease, the doctor will ask about your child’s symptoms and perform a physical examination. In some cases, a doctor may take a throat swab or a stool sample for laboratory analysis to detect the virus and confirm the diagnosis.
To treat hand-foot-and-mouth disease, give your child acetaminophen or ibuprofen (not aspirin) to relieve the pain and reduce the fever, and plenty of fluids to prevent dehydration. If he or she has trouble swallowing, try giving him or her ice chips to suck. Cold foods such as frozen yogurt or ice cream can help numb the inside of the mouth and relieve pain. Most children recover from the infection within about 10 days.
Prevention
To prevent hand-foot-and-mouth disease, wash your hands frequently and thoroughly, especially after using the bathroom or changing diapers. Teach your child to wash his or her hands carefully after using the bathroom. If your child has hand-foot-and-mouth disease, do not let him or her share cups, glasses, or eating utensils. Disinfect potentially contaminated surfaces in your home with a household cleaner. Wash your child’s soiled clothing in detergent and hot water. Keep your child home from school or day care and away from other people until the fever is gone and the sores have healed.
Polio
Polio (poliomyelitis) is a viral infection that affects the brain and spinal cord. The infection can be spread through contact with an infected person or by ingesting food or water that is contaminated with the virus. Thanks to routine vaccination (see page 374), polio is now rare in the United States. Children are vaccinated against polio when they are 2 months, 4 months, 6 to 18 months, and 4 to 6 years of age.
Symptoms
In most cases, a polio infection is mild, does not affect the nervous system, and does not produce symptoms. In some cases, symptoms—such as a slight fever, sore throat, upset stomach, and headache—develop suddenly and disappear after a few days.
In rare cases, the virus causes a severe infection that produces muscle aches and twitching, and pain and stiffness in the neck, legs, and back. About a week after