It was a normal day as I was getting back to work from my lunch break. I sat down and opened my email before I got back to seeing patients. Then I saw it: that information that parents dread. An email from my son’s preschool with the words “HAND, FOOT AND MOUTH DISEASE EXPOSURE” (in all capitals) in the subject line. My heart sunk. I knew how contagious the disease was and that more than likely we would have to deal with the disease in our family.
We were already acquainted with the disease. Our oldest son had an exposure when he was just over one year old. It was actually how he was weaned from the bottle (though I wouldn’t recommend this to anyone). The mouth sores caused pain when he would suck from a bottle and he only wanted water from a cup. It was a rough few days but we got through it. We were dreading going through it again.
What is Hand Foot Mouth Disease?
Hand, Foot and Mouth Disease is a very contagious viral illness that typically affects children under age 5 but can affect older children and adults as well. The disease is typically milder the older you are. It starts with a fever then is followed by sores in the mouth and development of red spots and blisters over the hands and feet. The rash can also be seen on the buttocks or genital area. Dehydration can occur because it is so painful to eat and drink. It is transmitted through nasal and mouth secretions, blister fluid and stool.
The best prevention is washing your hands and avoiding contact with sick individuals. The rash has a classic appearance and doctors can make the diagnosis without any special tests. Symptoms typically start 3-5 days after exposure and may last 7-10 days as the body clears it on its own. There is no specific treatment except tylenol for irritability and mouth numbing sprays.
Back to our exposure. We have 3 children: a 7 year old boy, 4 year old boy and 1 year old girl. Our 4 year old was the one exposed and true to form he developed a fever about 3 days after receiving the email. A few days later he developed a rash over his buttocks which cleared up after a few days. Thankfully there were no mouth sores. Unfortunately, he exposed our other 2 children as well. The oldest skated through it with 1 day of fever and no rash or mouth sores (likely because of his previous exposure and age) but our little girl was not so lucky.
She got it bad. She started with a fever and general crankiness. Typically she will wake once a night but this increased to 3 times. Then came the sores. She developed a nasty rash around her lower lip and sores in her mouth (see the picture above). Drinking and eating were painful and she went on strike for a day from taking anything orally. Even her usual calming device, the pacifier, was rendered useless because the sucking caused pain. There was a severe night where she was up every hour and barely slept. We kept here on Tylenol around the clock because it was the only thing that gave her relief. We opted not to do numbing sprays and oragel because she didn’t like these when she was teething.
She also developed the classic rash on her hands and feet. We calmed all of these down with an oatmeal and tea tree oil bath. Slowly, over the course of 3 days, the sores healed and she started taking fluids and eating. It cleared completely after a week. The process was rough but we got through it.
As a doctor, I often forget the experience of going through an illness as I will only see patients for a short period of time in the course of their disease process. Having experiences like the one above heighten my empathy and allow for more compassionate care. For the parents who have gone through or are currently going through a similar experience to us, I identify with you. I appreciate all of the sacrifices parents make to care for their children, especially when they are sick. I especially appreciate the care my wife gives to our children. Without her to help, hold and love our children, their care would be incomplete.