Symptoms of Hand, Foot, and Mouth Disease in Children

Written by Feng Hai Tao
Pediatrics
Updated on September 08, 2024
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The symptoms of hand, foot, and mouth disease in children primarily result from viral infections of the intestine, a common communicable disease particularly prevalent among children under five, especially those under three years of age. The symptoms can be categorized into typical cases where most children experience a sudden onset of illness, often accompanied by upper respiratory tract infection symptoms such as fever, nasal congestion, runny nose, sneezing, loss of appetite, nausea, and vomiting. Some may also experience headaches. Additionally, rashes or vesicles may appear on the hands, feet, mouth, and buttocks, typically surrounded by inflammatory red skin with little fluid inside the vesicles. These lesions are characterized by being painless, non-itchy, non-crusted, and non-scarring. It is important to note that not all children will have simultaneous rashes on their hands, feet, and mouth areas. In severe cases, while most children experience only mild symptoms and can be isolated at home, some may develop complications involving the nervous system and impairment of respiratory and circulatory functions. This can manifest as muscle spasms, encephalitis, acute flaccid paralysis, cardiopulmonary failure, and neurogenic pulmonary edema. Therefore, once a severe case is identified, hospitalization is recommended to prevent potential fatalities or long-term sequelae.

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Initial symptoms of hand, foot, and mouth disease

Hand, foot, and mouth disease is a contagious disease caused by viral infection, which is common in infants and toddlers, especially those under the age of three. The main symptoms include fever, accompanied by maculopapular rashes or vesicles on the hands, feet, mouth, and buttocks. Some initial symptoms are similar to having a cough, runny nose, headache, mouth pain, or sore throat. Sometimes there may be drooling; consequently, babies might drink less milk, and there can be nausea and vomiting. Additionally, some children may experience nausea and diarrhea along with other gastrointestinal symptoms. Another major sign is the presence of vesicles in the hands, feet, and mouth, or maculopapular rashes on the buttocks.

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Characteristics of hand, foot, and mouth disease rash

Hand, foot, and mouth disease is a rash disease caused by an intestinal virus infection, characterized by scattered maculopapular and vesicular rashes on the hands, feet, buttocks, and other areas. Typically, small vesicles appear on the oral mucosa, or they may already have ruptured into shallow ulcers, primarily located on the tongue, buccal mucosa, palate, and inner lips. Subsequently, rashes appear on the hands and feet, most commonly as maculopapules, which then develop into vesiculopapules about three to seven millimeters in size. The vesicles have a relatively thick covering and are surrounded by reddened skin, predominantly located at the extremities. Sometimes, they may extend to the arms, legs, buttocks, or perineal area. The distribution of the rash is centrifugal, with the number of lesions varying from a few to dozens. Generally, the lesions absorb on their own within two to three days without desquamation, scarring, or pigmentation. The vesicles and ulcers in the mouth mostly heal on their own within a week.

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Is hand, foot, and mouth disease contagious?

Hand, foot, and mouth disease is a contagious disease caused by an infection of enteroviruses. There are more than 20 types of enteroviruses that cause the disease, with Coxsackievirus A16 and Enterovirus 71 being the most common. The main clinical manifestations of this disease include blisters on the hands, feet, mouth, and buttocks. Some patients may experience fever, while others may have no fever or only a mild fever. The disease is contagious and primarily transmitted through contact. For example, it can be spread through saliva, droplets, hand-to-mouth contact, and contact with the secretions from the blisters, among other methods.

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Does hand, foot, and mouth disease cause fever?

Hand, foot, and mouth disease is a contagious childhood exanthem caused by an intestinal virus infection. The primary symptoms of most hand, foot, and mouth diseases include fever, followed by rashes on the hands, feet, mouth, and buttocks, as well as vesicles in the throat. However, not all children with the disease necessarily experience continuous fever or any fever at all. Some only show symptoms after coming into contact with an infected person, with rashes on the hands, feet, mouth, and buttocks, and vesicles in the throat. In such cases, it is still considered hand, foot, and mouth disease, and fever is not a requisite for diagnosis. Thus, the presence of fever should not be solely relied upon for diagnosing the disease.

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Prevention of Hand, Foot, and Mouth Disease

Hand, foot, and mouth disease is a common contagious exanthematous disease in pediatrics, caused by a viral infection with a certain epidemic nature. Its main modes of transmission include respiratory, digestive tracts, and close contact. During the epidemic, usually in the summer and autumn seasons, it is recommended that parents avoid taking children to public places. If a suspected case is found, timely isolation should be carried out, and close contacts should be quarantined for 7-10 days. Additionally, it's important to maintain good personal hygiene, such as washing hands before eating and after using the toilet, and to keep indoor ventilation in the home. If a child has been in contact with an infection or a suspected case of hand, foot, and mouth disease, it is crucial to monitor the child for any discomfort and check their temperature regularly. If the child feels unwell, take them to the hospital for treatment promptly.