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How to manage hand, foot and mouth disease

By Rhea-Simone Auguste rhea.auguste@trinidadexpress.com

It has nothing to do with eating beef. You cannot get it from being around cows.

Hand, foot and mouth disease, according to paediatrician Dr Alison Murphy, is not hoof and mouth disease, which cattle get. "You can only get hand, foot and mouth disease from other people; not even pets," she informed.

"It usually affects toddlers and young children and is usually caused by a coxsackie virus, a member of the enterovirus family," Murphy added. But it can affect adults as well, so caution is advised. "The disease is highly contagious, so it often occurs in outbreaks like the one currently reported by the Ministry of Health," Murphy noted.

Last Monday, the Ministry of Health issued a statement to alert the public of an outbreak of hand, foot and mouth disease among children in the East-West Corridor and Central Trinidad.

"It is generally a mild illness, starting with fever, some tiredness, tummy pain and soft stools and the appearance of red areas on the palms and soles of the feet that then blister.

"There may be ulcers in the mouth and red areas on the palate. The blisters may extend to the sides of the hands and feet and occasionally involve the elbows and diaper area.

"Children who have eczema may get a more extensive rash with many more skin lesions," Murphy explained. "The diagnosis is usually made by recognising the clinical features as described above."

The Ministry's statement noted that older children and adults are not usually at high risk, but may develop a milder form of the illness.

In addition to the symptoms mentioned by Dr Murphy, the Ministry recommends paying attention if you notice a sore throat, which commonly occurs one or two days after the fever has started. So what should you do if you notice your child has some of these symptoms?

"You should consult your private doctor or go to the nearest health centre for advice in managing the symptoms," informed the statement.

"There is no specific treatment for hand, foot and mouth disease. In healthy children, the body's immune system clears the virus, and symptoms go away after about seven to ten days."

Murphy added, "It is a viral illness so treatment consists of making the child comfortable using oral paracetamol or acetaminophen for the pain of mouth sores and fever, ensuring that they are drinking adequate fluids, especially if there are a lot of mouth sores, keeping the mouth clean and loving care and rest.

"The illness usually resolves within a week and during this time the child should be cared for at home, not daycare or nursery or sent to school.

"Parents should seek medical advice if the mouth is painful and the child is becoming dehydrated, as shown by thirst, passing less urine than normal; and requires stronger pain killers than paracetamol.

"Very rarely children can develop viral meningitis, so any child who is extremely irritable or complains of severe headache and neck stiffness should also be evaluated. Children with very high fevers, especially infants, should also be seen by a doctor," she added.

The most important point to note is that the virus is highly contagious and spread by contact with secretions from the nose, mouth and stool of infected children.

So what can you do to minimise your chances of contracting the virus? "The best method of prevention is good, old-fashioned hand-washing with soap and water for children and their caregivers, especially after diaper changes."

Additional preventative measures for those in outbreak areas include disinfecting dirty surfaces and soiled items, including toys. First wash items with soap and water, then disinfect in a solution of chlorine (bleach) made by mixing one tablespoon of bleach to four cups of water.

And avoid close contact, including kissing, hugging or sharing utensils or cups with people infected with hand, foot and mouth disease until the disease has taken its course.

The Ministry gave this advice: "Do not wrap up a feverish child. Keep the room or house cool by opening the window, or using a fan on the other side of the room to keep the air circulating."

Children diagnosed with hand, foot and mouth disease must be kept well hydrated to ensure water is offered often.

"This helps to prevent dehydration or a lack of body fluids. Cool, slushy foods such as yogurt may be best for a day or so if the mouth is sore. Ice lollies may help to ease a sore mouth, and are also a way of giving a drink...

"Consult a doctor if a child stops drinking due to a sore mouth, as dehydration may develop in rare cases. Consult a doctor promptly if you are concerned about any unusual symptoms that develop."

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