From the Research
Hand, foot, and mouth disease (HFMD) management is primarily supportive, focusing on symptom relief and prevention of complications, as it is a self-limiting viral illness that typically resolves within 7-10 days. Treatment focuses on symptom relief, including acetaminophen (10-15 mg/kg/dose every 4-6 hours, maximum 5 doses/day) or ibuprofen (10 mg/kg/dose every 6-8 hours) for fever and pain, as recommended by the most recent study 1. Maintaining hydration is crucial, especially when mouth sores make drinking painful; cold liquids, popsicles, and soft foods are recommended while avoiding acidic, spicy, or salty foods that may irritate sores. Saltwater rinses (1/2 teaspoon salt in 1 cup warm water) can soothe mouth ulcers, and calamine lotion may relieve skin rash discomfort. Good hygiene practices are essential to prevent transmission, including frequent handwashing, avoiding close contact, and disinfecting contaminated surfaces. Children should remain home from school or daycare until fever subsides and mouth sores heal. While most cases resolve without complications, parents should seek medical attention if their child shows signs of dehydration, persistent high fever, or neurological symptoms like excessive sleepiness or weakness, as HFMD is caused by enteroviruses (commonly Coxsackievirus A16 or Enterovirus 71) that can rarely lead to more serious complications, as highlighted in a recent review 2.
Some key points to consider in the management of HFMD include:
- The disease is highly contagious and can be spread through fecal-oral, oral-oral, and respiratory droplet contact, as noted in a study from 2019 3.
- The epidemiology of HFMD is changing, with a shift in the molecular epidemiology of HFMD-causing pathogens, and coxsackievirus A6 and coxsackievirus A10 causing more infections, as reported in a 2024 study 1.
- Vaccines against EV-A71 have been approved and are now used in mainland China, as mentioned in a 2023 review 2.
- There are no effective antiviral therapies available to treat enterovirus infections, and treatment is mainly symptomatic and supportive, as stated in a 2022 narrative review 4.
- Early detection and appropriate treatment of severe neurological complications can minimize the risk of adverse health outcomes, as emphasized in a 2020 review 5.
Overall, the management of HFMD should prioritize symptom relief, prevention of complications, and good hygiene practices to prevent transmission, as supported by the most recent and highest quality studies 2, 1.