From the Guidelines
Schools should prioritize good hygiene practices, including frequent handwashing with soap and water, to prevent the spread of hand, foot, and mouth disease, as recommended by the 2017 Infectious Diseases Society of America clinical practice guidelines 1. When dealing with hand, foot, and mouth disease in a school setting, it is essential to consider the following key points:
- Hand hygiene should be performed after using the toilet, changing diapers, before and after preparing food, before eating, after handling garbage or soiled laundry items, and after touching animals or their feces or environments, especially in public settings such as petting zoos 1.
- Infection control measures, including the use of gloves and gowns, hand hygiene with soap and water, or alcohol-based sanitizers, should be followed in the care of people with diarrhea, which can be a symptom of hand, foot, and mouth disease 1.
- Appropriate food safety practices are recommended to avoid cross-contamination of other foods or cooking surfaces and utensils during grocery shopping, food preparation, and storage 1.
- Schools should routinely disinfect commonly touched surfaces and shared items to prevent the spread of the disease.
- Children with hand, foot, and mouth disease should be excluded from school until fever is gone and mouth sores have healed, typically 3-5 days after symptoms begin, to prevent the spread of the disease.
- Good hygiene practices, such as frequent handwashing with soap and water, are essential for prevention, especially after diaper changes and before eating 1.
From the Research
School Guidance for Hand Foot Mouth
- The disease is caused by human enteroviruses and coxsackieviruses, and outbreaks can occur in the spring to fall, commonly in North America, with most cases occurring in patients younger than 10 years 2.
- Hand-foot-and-mouth disease is transmitted by fecal-oral, oral-oral, and respiratory droplet contact, and patients present with a low-grade fever, a maculopapular or papulovesicular rash on the hands and soles of the feet, and painful oral ulcerations 2.
- The best methods to prevent the spread of hand-foot-and-mouth disease are handwashing and disinfecting potentially contaminated surfaces and fomites 2.
- Treatment is supportive and directed toward hydration and pain relief as needed with acetaminophen or ibuprofen, and oral lidocaine is not recommended, and antiviral treatment is not available 2.
- Children younger than 5 years are most commonly affected, and hand, foot, and mouth disease caused by enterovirus A71 is more severe and has a higher rate of complications than that attributed to other viruses such as coxsackievirus A16 3.
- Vaccination of susceptible individuals in high-risk areas and good personal hygiene are important preventative measures to combat the disease 3.
- Familiarity with the disease, including its atypical manifestations, is crucial so that a correct diagnosis can be made, and appropriate treatment initiated 3.
- A timely diagnosis can help avoid contact with the affected individual and decrease the risk of an outbreak 3.
- Hand, foot, and mouth disease can be associated with complications, leading to severe neurological sequelae and, rarely, to death 4.
- Vaccines able to confer protection against the most common aetiologic agents in a given country have been developed, but simultaneous circulation of more than one causative virus and modification of the molecular epidemiology of infectious agents make preparations based on a single agent relatively inadequate 4.