What is the treatment for hand, foot, and mouth disease?

Treatment for Hand, Foot, and Mouth Disease

Hand, foot, and mouth disease (HFMD) is primarily managed with supportive care focused on hydration and pain relief, as it is typically a self-limiting viral illness that resolves within 7-10 days without specific antiviral treatment.

Disease Overview

• HFMD is a highly contagious viral illness caused by enteroviruses, primarily coxsackieviruses A6, A10, A16, and enterovirus 71 1, 2
• Most commonly affects children under 5 years but can occasionally affect adults 3
• Characterized by:
  • Low-grade fever
  • Painful oral ulcerations/enanthem
  • Maculopapular or papulovesicular rash on hands and soles of feet
  • Incubation period of 3-10 days 1

Supportive Treatment Approach

Pain Management

• Acetaminophen or ibuprofen as needed for pain relief and fever 2
• Oral lidocaine is not recommended 2

Hydration

• Ensure adequate fluid intake
• Cold liquids, popsicles, or ice cream may help soothe oral pain and maintain hydration
• Avoid acidic, salty, or spicy foods that may irritate oral lesions

Oral Care

• Gentle oral hygiene with soft toothbrush
• Mild salt water rinses for older children and adults

Management of Specific Symptoms

For Oral Lesions

• Cold foods and beverages to numb pain
• Soft, bland diet to minimize discomfort while eating

For Skin Lesions

• Keep affected areas clean and dry
• Avoid harsh soaps or excessive washing that may irritate lesions
• Light, loose-fitting clothing to minimize friction on skin lesions

Special Considerations

When to Seek Medical Attention

• Signs of dehydration (decreased urination, dry mouth, lethargy)
• Persistent high fever (>101.5°F or 38.5°C)
• Severe headache, neck stiffness, or altered mental status (potential neurological complications)
• Difficulty breathing or rapid breathing (potential cardiopulmonary complications)

Severe Cases

• Rare neurological or cardiopulmonary complications may occur, particularly with enterovirus 71 1, 4
• Intravenous immunoglobulin should be considered for severe/complicated HFMD 4
• Mechanical ventilation may be required in cases with pulmonary edema 1

Prevention Measures

• Handwashing is the most effective preventive measure 2
• Disinfection of potentially contaminated surfaces and fomites
• Isolation of infected individuals, particularly from schools or daycare centers
• Avoid close contact (kissing, hugging, sharing utensils) with infected individuals

Prognosis

• Most cases resolve within 7-10 days without complications 2, 4
• Nail dystrophies (shedding) may occur weeks after initial symptoms 5

Emerging Treatments

While not yet approved for routine use, research is investigating potential antiviral agents including ribavirin, suramin, mulberroside C, aminothiazole analogs, and sertraline for treatment of HFMD 4.

Remember that HFMD is typically a benign, self-limiting illness that responds well to supportive care. The focus should be on symptom management, hydration, and preventing transmission to others.