If your child has a fever and seems to have completely gone off their food suddenly, get them to open wide so you can look for the first signs of hand, foot and mouth disease...
What is it?
Well, it does exactly what it says on the tin. Caused by one of a number of coxsackie viruses, hand, foot and mouth disease is distinguishable by the red sores and blisters is causes on the palms of the hands, soles of the feet and in and around the mouth.
Highly contagious, it is most common in children under 10, and is prevalent among toddlers who joyfully swap slime with one another at nursery and stay & play groups.
Most people have become immune to the virus by the time they reach adulthood, but rarely an adult does catch it (their symptoms are likely to be much milder than those of a child, however).
The first symptoms of hand, foot and mouth are feeling unwell generally, with a sore throat and a fever. That will be followed by small, red sores appearing in the mouth and throat and, a couple of days later, a red rash on the skin.
The rash is not always confined to the hands, feet and mouth – sometimes spots might appear on the bottom or generally in the nappy/pants region, on the back, arms or legs. The small red sores are not usually itchy, but they can blister and subsequently become infected.
Even though hand, foot and mouth is not serious, it will probably make your child feel pretty miserable. Because it causes pain in the mouth and throat, children are likely to go off eating and drinking, which could lead to dehydration. Very, very rarely, hand, foot and mouth can lead to more serious illness but in the vast majority of cases, the symptoms will clear up on their own within seven to 10 days.
Children can catch hand, foot and mouth more than once but, in the same way they can't get the same cold twice, they are unlikely to get it again during the same outbreak.
What can I do?
Hand, foot and mouth disease can not be treated with antibiotics, but that's not to say you shouldn't visit your GP to confirm it is present and certainly you should go if your child develops a high fever.
At home, giving your child the appropriate dose of liquid paracetamol or ibuprofen will reduce their temperature and relieve their sore throat and any pain they might be experiencing because of those mouth ulcers (teething gel might also offer some temporary relief, but do make sure you use a children's gel – little ones must not be given mouth ulcer treatments intended for adults).
If their fever persists for more than two or three days, it is possible their skin has become infected, so go back to your GP who will prescribe antibiotics if that is the case.
It's highly like your child will not be even remotely interested in food for a couple of days – try not to worry about that too much. It is considerably more important that you get them to drink plenty of fluids, so they don't become dehydrated – offer sips of cool milk, water and diluted fruit juice frequently.
If you have a baby with hand, foot and mouth, keep offering them the breast or bottle, as well as additional sips of water from a spoon or syringe. If you are concerned your child is becoming dehydrated, ask your pharmacist for oral rehydration sachets, or visit your doctor.
Plenty of drinks and rest should mean your child is over the worst in a few days – the rash should have cleared up after 10 days or so. Beware though, the virus is highly contagious – not only can it spread via coughs and sneezes, it can stay in your child's poo for up to four weeks after they have recovered. To limit the chances of anyone else in the house catching it, remain vigilant about cleanliness and always wash hands after toilet visits or nappy changes.
What else could it be?
If your child has red spots and a fever, but they seem not to be contained to the hands, feet and mouth, they might have chicken pox.
If your child seemed to have a cold, and developed red spots around their ears and neck, followed by spots elsewhere on their body, they might have measles.