Your Health

Child's rash may indicate hand, foot and mouth disease

Hand foot and mouth disease in child
Photo of Donna Alden-Bugden DONNA ALDEN-BUGDEN
Winnipeg Regional Health Authority
Published Friday, September 23, 2016

Children get rashes all the time.

Some, such as those caused by hives, heat or insect bites, are relatively harmless and can vanish as quickly as they appear.

Others do not fade way so easily. Take the rash that accompanies hand, foot and mouth disease, for example.

This disease will sometimes send parents into a state of panic because the condition sounds like it must be linked to foot-and-mouth disease. It is not.

Foot-and-mouth disease (also known as hoof-and-mouth disease) is caused by the picornavirus. It afflicts cattle, sheep and swine and can be fatal.

Hand, foot and mouth disease, meanwhile, is caused by strains of coxsackieviruses or other enteroviruses. It afflicts only humans, mostly children under the age of 10, and is less serious.

That's not to say hand, foot and mouth disease does not pose issues for children. A bout of it usually starts with a high fever and fussiness. Other symptoms include irritability, fatigue, headache, cough, runny nose, sore throat and reduced appetite. Two days after these symptoms begin, a rash will appear in the form of red bumps on the hands, feet, mouth or buttocks. These bumps can be itchy but more often are painful.

The location of the bumps - and the fact they are raised rather than flat or blotchy - distinguishes hand, foot and mouth disease from other childhood rashes, including roseola and fifth disease.

Because it is spread by a virus, there is no cure. Generally speaking, the virus, along with the rash, will play itself out and disappear in seven to 10 days. In the meantime, ibuprofen or acetaminophen can be used to relieve the fever and pain. Numbing gels or sprays can also help with mouth pain. (Remember: do not give aspirin to children as it may cause Reye's syndrome).

Hand, foot and mouth disease is a relatively minor health issue that can be managed at home. If you're not sure what your child has or have questions, be on the safe side and call Health Links-Info Santé at 204-788-8200 or toll-free outside Winnipeg at 1-888-315-9257, or have the child seen by a health-care provider.

In addition, parents should still keep an eye out for potentially serious problems that can develop with hand, foot and mouth disease, albeit rarely. It has occasionally been linked to illnesses such as pneumonia, flaccid paralysis, encephalitis, viral meningitis and neurological or cardiac abnormalities. In addition, there have been reports of children temporarily losing their fingernails and toenails following a case. The reason is unknown.

It's important to monitor your child's symptoms. If your child develops a severe headache, seizure, stiff neck, extreme fatigue, shortness of breath, racing heart or a dramatic change in behaviour, you should take him or her to a hospital emergency department as soon as possible. Keep in mind children with chronic illnesses or immune compromised systems are more at risk of complications. Again, if you're not sure what your child has, call Health Links-Info Santé or have the child seen by a health-care provider.

Hand, foot and mouth disease can appear out of nowhere because it is highly infectious and often flies under the radar. Your child can pick it up from droplets in the air, by touching contaminated objects or through fecal contact. While it is highly contagious, it is not seen as often as the common cold or influenza. It is also spread by various routes.

The disease will usually incubate (the time between infection and onset of symptoms) for about three to six days. That means people can have the virus in their body and spread the disease without even having any symptoms.

There is a slight uptick in the number of cases reported during spring, summer and fall. Outbreaks can occur in daycares or schools.

So what can you do to help your child avoid hand, foot and mouth disease?

Good hand hygiene is key. Disinfecting toys with a bleach solution and avoiding the sharing of utensils are recommended.

Adults are also susceptible. There is some evidence hand, foot and mouth disease can cause miscarriage in early pregnancy. As a result, pregnant women should avoid anyone infected with hand, foot and mouth disease.

Donna Alden-Bugden is a nurse practitioner at the Winnipeg Regional Health Authority's McGregor QuickCare Clinic. This column was originally published in the Winnipeg Free Press on Sept. 23, 2016.

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