This season alone, hand, foot and mouth disease took three MLB pitchers temporarily off the mound, so baseball fans may wonder just what’s going on at that position. However, it’s just a coincidence, experts say,…
This season alone, hand, foot and mouth disease took three MLB pitchers temporarily off the mound, so baseball fans may wonder just what’s going on at that position. However, it’s just a coincidence, experts say, and not surprising with this highly contagious condition.
With seeping blisters on the palms and soles, and painful mouth sores as hallmark symptoms, hand, foot and mouth disease is as unappealing as it sounds.
Hand, foot and mouth disease is especially common in the late summer and early fall. Viruses to blame can easily spread through locker rooms, day care centers, military barracks, college dorms and anywhere else where people spend a lot of time in close quarters.
Infants and children under 5 years old are most likely to have the infection, according to the Centers for Disease Control and Prevention. Fever and a sore throat are early symptoms. Hand, foot and mouth disease can also affect the skin of the buttocks and is sometimes at first mistaken for diaper rash in babies.
Hand, foot and mouth disease is not at all related to sound-alike hoof-and-mouth disease, which affects farm animals but not humans. Different viruses are responsible for the two conditions.
In the U.S., the virus called coxsackievirus A16 is the most common cause of hand, foot and mouth disease. Coxsackie viruses belong to the group of enteroviruses, which usually affect the gastrointestinal tract. A virus called enterovirus 71, more common in East and Southeast Asia but also present in the U.S., is more likely to lead to severe complications such as encephalitis or viral meningitis, according to the CDC.
Fortunately, hand, foot and mouth disease is seldom serious and usually runs its course in a week or so. Organizations from ball clubs to preschools are working to be more proactive in reducing contagion. Even so, it’s hard to eliminate the viral infection altogether. If you or your child comes down with hand, foot and mouth disease, here’s what you should know.
Hand, foot and mouth disease spreads through casual contact from person to person. The virus appears in feces (poop), saliva, mucus or fluid oozing from blisters of someone who has the infection. In day care settings, it can spread by hand from providers who change multiple diapers. Contamination can occur when a small child puts unwashed hands in his or her mouth.
“With hand, foot and mouth disease, the major way you can get it is fecal-oral,” says Dr. Robert Flannery, a sports medicine specialist at University Hospitals Sports Medicine Institute in Cleveland and a team physician with the NFL’s Cleveland Browns. “So washing your hands after you go to the bathroom is very important.”
Hand, foot and mouth viruses may lurk on surfaces, as well. Training room tables, wrestling mats and shared towels are all potential sources of contagion, says Flannery, who is also a clinical assistant professor of orthopedics at Case Western Reserve University School of Medicine. Among athletic organizations, he says, there’s been growing awareness and emphasis on improved disinfection and cleaning.
“Another way is direct contact with the fluid that can come out of the blisters on the hands or feet,” Flannery says. “So if someone does have it, we make sure to tell them they should not be shaking hands. We really try to isolate them as much as possible. We want to make sure there are no open lesions and that anything that is open is covered and treated appropriately before [players] are allowed back into competition and practice.”
When people get tired or fatigued, they might be more vulnerable to hand, foot and mouth disease, including elite athletes. “They’re doing a lot of traveling,” Flannery says. “There’s a lot of stress involved in professional sports and all of those things can kind of run down your immune system.”
On the other hand, you could just be a busy parent. “If you’ve got young kids running around your house, that’s stressful and it can run down your immune system,” Flannery says. “So, you’re more susceptible to a virus like that.”
One problem is that by the time you’ve started to show hand, foot and mouth symptoms, you’ve probably already contaminated a few other people during the incubation period, Flannery notes. Some people may only develop a mild case, with a low-grade fever and one or two blisters they barely notice, and then it’s all too easy to pass along.
“It comes down to being vigilant,” Flannery says. “If you notice something as a player, you say something to your athletic trainer or team physician. As a parent, it’s keeping your eyes open as to which kids may have rashes on their hands and feet. Also, as a parent, don’t think that you’re immune to it because you’re an adult.”
Hand Hygiene and Hydration
“Most cases of hand, foot and mouth disease do not require a visit to a health care provider,” says Dr. Gail Harrison, a pediatric infectious disease doctor, clinical virologist and professor of pediatrics at Baylor College of Medicine and Texas Children’s Hospital. “As long as you can keep your baby or child hydrated and comfortable, you just need to notify your pediatrician or primary care doctor and have the diagnosis confirmed.”
However, Harrison notes that along with meningitis and encephalitis, enteroviruses can also cause inflammatory conditions of the heart, like myocarditis, and lead to hospitalization. “Rarely, there are complications, so if your baby — or you — aren’t getting better as expected, call your doctors,” she advises.
Unlike the flu, there’s no antiviral or other treatment that specifically targets hand, foot and mouth disease. “What you’re left with is your own immune system that will — in a normal, healthy host — eventually get the virus in check,” Harrison says.
Making sure kids stay hydrated is important. “Babies often won’t eat or drink well for a while if the mouth sores hurt them,” Harrison says. It’s also harder for adults to eat. Although “it’s not the worst pain you’ve ever had,” she says, acidic foods and beverages (like orange juice) will burn the mouth, while popsicles and ice cream are soothing. Mild pain relievers like ibuprofen may help as well.
Hand-washing with soap and water prevents hand, foot and mouth disease from spreading, and hand sanitizer might also help, Harrison says. Disinfecting surfaces like high chairs and changing tables is a must. “Don’t share towels,” she says. “Don’t share food and drink.”
It’s a good time to hang out at home. A child with hand, foot and mouth disease should probably skip birthday parties to avoid sharing the infection.
Hand, foot and mouth disease tends to be harder on kids than adults. “In children, they’re usually seeing it for the first time, whereas adults may be seeing it for the seventh time,” says Dr. Frank Esper, a pediatric infectious disease specialist with Cleveland Clinic Children’s. In pediatric infections, he says, a rule of thumb is: The first time is the worst time.
When it comes to prevention, Esper says, “Good hand hygiene is one of the best things you can do. But if you are sick, try to stay away from other individuals. You definitely want to talk to your doctor if you’re really feeling sick.” For milder cases, he says, “You can just try and stay home and chicken-soup yourself to good health.”