FAMILY MEDICINE® COLUMN
By John C. Wolf, D.O.
Associate Professor of Family Medicine®
Ohio University College of Osteopathic Medicine

HAND, FOOT AND MOUTH DISEASE

Question: I was listening to TV last night, and the newscaster read a story about something called "hand, foot and mouth" disease. He said that several area schools were closed because a number of children in those schools had this disease and that it could "spread like wildfire." What is hand, foot and mouth disease? I've never heard of it before. How serious is it? Is it related to hoof and mouth disease that affects cattle?

Answer: Hand, foot and mouth disease is a very common illness that typically afflicts children, and no, it is not related to hoof and mouth disease. Although, some individuals incorrectly apply the "hoof and mouth disease" label to the human illness as well.

Hand, foot and mouth disease begins like many illnesses in children a low grade fever, sore throat, body aches and generally not feeling well. One or two days later tender "bumps" develop in the mouth. These then become small blisters that ultimately break, leaving a red, sore ulcer area that may be as large as one inch across. These are usually on the tongue as well as on the inside of the cheeks.

As you would guess from the name of this disease, sores also develop on the skin, particularly on the palms and backs of hands and bottoms and tops of feet. These start as small bumps and progress, just as the mouth sores do, to form blisters that ultimately break and leave ulcer-like sores or lesions in doctor language. The ones on the hands and feet are usually somewhat smaller that those in the mouth uncommonly larger the one-half inch across.

The skin lesions can look a great deal like chicken pox, but heal without forming crusts or scabs, as is typical of that disease. The lesions also typically heal without scarring. The entire illness usually lasts 7 to 10 days, and complications are infrequent.

The reason local officials closed schools is that this illness is very contagious and "spreads like wildfire" just as the newscaster said. This type of epidemic occurs because children often come to school with mild symptoms that accompany the beginning of this illness. After one to three days, when the mouth sores begin, it is obvious that they need to stay home, but by then it is too late to stop the spread of infection.

It only takes a few days for one or two children to unintentionally start an epidemic. Limiting the opportunity for children to be together for the incubation period of the disease - two or three days - is the best way to stop hand, foot and mouth disease. Closing schools and day care centers is a good way to do this. Any child who has been exposed will have signs of the illness by then. After these days pass, any sick child should stay out of school until he or she are well.

Family Medicine® is a weekly column. To submit questions, write to John C. Wolf, D.O., Ohio University College of Osteopathic Medicine, Grosvenor Hall, Athens, Ohio 45701.