Q: My nephew was just diagnosed as having Hand Foot and Mouth disease. The doctor said it was a "classic" case. I am having a birthday party for my six year old son. I told my sister that I didn't think that her son should attend because he still had a fever. Did I do the right thing? What is Hand Foot and Mouth disease anyway? It sounds like something cattle get.
A: Hand Foot and Mouth disease is caused by a virus, Coxsackie A virus to be exact. It primarily affects children between the ages of 6 months and five years of age. It is a self-limiting illness which means that it resolves without any specific treatment.
The symptoms include fever (usually mild), painful "canker sores" on the lips and in the mouth, and small water blister-like lesions on the palms and soles. The blister-like lesions may be concentrated on the webs of the digits, and can actually spread to the lower legs and buttocks. Hence the name, Hand Foot and Mouth disease.
The fever usually lasts around 3-4 days, the canker sores around 7 days, and the blisters about 10 days. Most children with this illness are contagious from 1-2 days before the rash starts, until around 2 days after it disappears.
The incubation period is 3-6 days. This means that it will take that amount of time for the symptoms to show up after coming in contact with a child that has active Hand Foot and Mouth disease.
There is no specific treatment to shorten the course of the illness. Acetaminophen or Ibuprofen can be given to control the fever, and it is important to encourage fluid intake. Since the oral lesions can be quite painful, children usually tolerate things like cold drinks, Jell-O, popsicles or otter pops.
It is a contagious disease and the single most important step in preventing spread is good hand washing. It is wise to keep children from others while they have fever. I think you did the correct thing in asking your nephew to not attend the party.
Q: My son just had his one year well-check two days ago. He received his chickenpox vaccine. The sitter who watches him during the day takes care of three other children. She said that one of the older kids she watches just broke out with chickenpox today. Will my son be protected?
A: This is a very interesting question. A child with chickenpox is contagious from 1-2 days before the onset of the rash, until all the lesions have crusted. This takes around 7-10 days. Your son, therefore, may have been exposed as of two days ago...the day that he received the vaccine.
Once a person receives the chickenpox vaccine, they are fully protected after 2-3 weeks.
The incubation period for chickenpox is 14-21 days. This means that after exposure to a person with active chickenpox a susceptible individual must go up to a full 21 days without symptoms before one can assume they are not going to get the disease.
In your son's case, he was exposed around two days ago and received the shot two days ago. The protection from the vaccine will be optimal at 2-3 weeks, the same time the disease should present if he were to become infected.
There is no way to predict what will be the outcome. Time will tell. The worse possible case scenario is that your child may have a very mild/modified case of chickenpox if in fact it does occur.