Herpangina and hand, foot and mouth disease

What are herpangina and hand, foot and mouth disease?

Both herpangina and hand, foot and mouth disease are viral infections caused by the Coxsackie virus. In herpangina, small red ulcers appear at the back of the mouth. In hand, foot and mouth disease, the rash can also appear as small, red blisters or spots on the hands, feet, mouth, and possibly on the skin in other areas of the body. Both illnesses can cause fever and may cause your child to refuse food and liquids due to throat or mouth pain.

The ulcers and spots in both illnesses will go away on their own within 10 days.

What are the signs and symptoms of herpangina and hand, foot and mouth disease?

Both herpangina and hand, foot and mouth disease can start with fever, sore throat and generally not feeling well for several days before the small red spots appear. Children may not want to eat and may become very irritable. Older children may complain of headache, sore throat and lack of energy.

The virus spreads by touching or breathing

Herpangina and hand, foot and mouth disease are most common in the summer and early fall, however they can occur throughout the year.

A child with herpangina or hand, foot and mouth disease is most infectious during the first week of illness, but they can still spread the virus for several weeks after their symptoms have disappeared. It takes about three to six days after your child has been exposed to develop symptoms. During this time, a child can spread the virus without having any signs of being sick. The virus that causes herpangina and hand, foot and mouth disease is found in an infected person’s saliva and stool.

The virus spreads from person to person through sneezing or coughing. It can also survive on surfaces and objects, such as countertops and toys, long enough to spread to another person. Your child can also get infected if they touch the stool or fluid from the blisters of an infected person.

Many parents have questions about when their child can return to daycare after they have been sick with herpangina or hand, foot and mouth disease. It is important to keep your child away from daycare if they have a fever or are not well enough to participate in activities. Keeping children away from daycare does not prevent the spread of herpangina or hand, foot and mouth disease. Check with your child’s childcare centres about their policy about attendance when a child has herpangina or hand, foot and mouth disease.

Preventing spread and future episodes of herpangina and hand, foot and mouth disease

To prevent the spread of infection, wash your hands and your child’s hands often. Be sure to do so:

• after wiping the child’s nose
• after changing a diaper
• after using the toilet
• before preparing food

There is no vaccine against Coxsackie virus.

Complications of herpangina and hand, foot and mouth disease are mild

The most common complication of herpangina or hand, foot and mouth disease is dehydration. Children may refuse to drink fluids due to the pain in their mouth or throat. However, with care at home, most children can get enough liquids to stay hydrated.

Other complications are very rare.

Taking care of your child at home

Keep your child hydrated and as comfortable as possible while treating the symptoms of the illness.

Antibiotics do not work on viruses. They will not help to treat herpangina or hand, foot and mouth disease.

Drink small amounts of fluids often

Give your child fluids often and in small amounts to prevent dehydration. Cold foods and soft foods such as ice cream and apple sauce are soothing and will not irritate the sores. Citrus, soft drinks, and salty or spicy foods may cause more pain.

Pain relief

To control pain, give your child acetaminophen or ibuprofen. Pain-relieving rectal suppositories can be given if your child cannot take the medication by mouth. Always follow the instructions on the label or speak with a pharmacist.

When to get medical assistance

Call your child’s health-care provider if:

• the pain is not relieved with acetaminophen or ibuprofen.
• the ulcers in the mouth last for more than 10 days.

Go to your nearest emergency department if:

• your child has chest pain, shortness of breath, feels their heart racing or seems overly tired.
• your child has a headache, vomiting, neck pain or stiffness, or a change in behaviour.
• your child is showing signs of dehydration.