From the Guidelines
Parents of children with Hand, Foot, and Mouth Disease (HFMD) should be counseled on symptom management and provided with emotional support, considering their needs and resources, as well as the support of extended family and community members 1. When treating HFMD, the primary focus is on managing symptoms while the viral infection runs its course, typically lasting 7-10 days.
- Provide children with plenty of fluids to prevent dehydration, especially cold liquids like popsicles or ice chips that can soothe throat pain.
- For pain and fever relief, use acetaminophen (Tylenol) or ibuprofen (Motrin, Advil) at appropriate doses based on the child's weight.
- Avoid spicy, acidic, or hot foods that may irritate mouth sores; instead offer soft, bland foods like yogurt, mashed potatoes, or smoothies.
- Salt water rinses (1/2 teaspoon salt in 1 cup warm water) can help relieve mouth discomfort for older children who can rinse and spit.
- Keep the affected skin areas clean and monitor for signs of secondary infection. The disease is highly contagious, so keep children home from school or daycare until fever subsides and mouth sores heal.
- Practice good hygiene including frequent handwashing and disinfecting commonly touched surfaces.
- Contact a healthcare provider if your child has a high fever (above 102°F), shows signs of dehydration (decreased urination, dry mouth, excessive sleepiness), or if symptoms worsen or don't improve after 10 days. In terms of counseling strategies, establishing an ongoing collaborative alliance with the family is crucial, where the clinician participates as a partner in the treatment, maintaining neutrality and respecting the parents' cultural and family traditions, personal style, and values 1. This supportive care approach works because HFMD is caused by viruses (typically coxsackievirus) that must run their course, with the body's immune system eventually clearing the infection.
From the Research
Treatment Options for Hand, Foot, and Mouth Disease (HFMD)
- Treatment of "classical" HFMD is usually symptomatic, and a generally recommended antiviral therapy does not exist 2
- In severe HFMD cases, suitable treatment also encompasses mechanical ventilation, as well as the additional application of antiviral agents such as ribavirin 2
- Intravenous immunoglobulin should be considered for the treatment of severe/complicated hand, foot, and mouth disease 3
- Drugs such as ribavirin, suramin, mulberroside C, aminothiazole analogs, and sertraline have emerged as potential candidates for the treatment of hand, foot, and mouth disease 3
- Oseltamivir, a neuraminidase inhibitor, has been frequently used as an adjunctive therapy for the treatment of HFMD, and meta-analysis of randomized clinical trials shows its effectiveness in reducing fever clearance time, rash regression time, and clinical cure time 4
Counseling Strategies for Parents of Children with HFMD
- Parents should be informed that HFMD is a highly contagious disease, and good personal hygiene is important to prevent the spread of the disease 3
- Children are particularly infectious until the blisters have disappeared, but exclusion from school or childcare is not practical as the virus may be present in the faeces for several weeks 5
- Parents should be aware of the potential complications of HFMD, such as circulatory failure and neurogenic pulmonary edema, and seek medical attention immediately if they notice any severe symptoms 3
- Counseling on the use of symptomatic treatment, such as pain relief and hydration, can help parents manage their child's symptoms and reduce the risk of complications 2, 3
Future Directions for HFMD Treatment
- Drug repositioning is an attractive drug discovery strategy aimed at identifying and developing new drugs for HFMD, and various types of drugs have been studied in relation to their therapeutic potential to treat HFMD 6
- Further research is needed to develop effective antiviral therapies and vaccines for HFMD, and to improve our understanding of the disease and its treatment options 2, 3, 6