Saturday, July 25, 2009

Hand Foot & Mouth Disease

Monday afternoon I got a call from daycare saying that Caitlyn had a temperature of 100.7. They said if it got to 101 that I'd have to come pick her up. That was at about 2:30. I didn't get another call but I did end up leaving early at 4 to go get her. I couldn't concentrate on work. I was pretty sure it was just teething but they said she just hadn't been herself all day. Tuesday she still had the fever so I stayed home with her. Wednesday she still had the fever so I stayed home and called the nurse. She said they didn't usually need to see them until the fever had been going on for 3 days. So I waited. Caitlyn wasn't horrible during this time. She was a little fussy and much more cuddlely but she'd still play intermittedly and was okay for the most part. She's been sleeping really well and taking extra long naps during all this. Thursday still had a fever. Called and made an appt. I was pretty sure it was still teething - but wanted that confirmed from the Dr. Took her in at 9:20. I changed her diaper at 9 right before we left. At 9:50 when we were seen by the Dr. she had a horrible rash on her chest and tummy. My eyes about popped out of my head. The Dr. said that a viral rash could appear that quickly. He checked her mouth and she had open sores in her mouth. Poor baby girl...she was diagnosed with Hand Foot & Mouth disease. On top of that she also has a ear infection in her right ear. So more antibiotics. Our regular pediatrician was out on vacation, her back up didn't mention tubes but I'm assuming the conversation will come up when we go in for her f/u in 2 weeks.

See some info below on Hand Foot & Mouth disease.

Description Hand, foot, and mouth disease (HFMD) is a common viral illness of infants and children. The disease causes fever and blister-like eruptions in the mouth and/or a skin rash. HFMD is often confused with foot-and-mouth (also called hoof-and-mouth) disease, a disease of cattle, sheep, and swine; however, the two diseases are not related—they are caused by different viruses. Humans do not get the animal disease, and animals do not get the human disease.
The disease usually begins with a fever, poor appetite, malaise (feeling vaguely unwell), and often with a sore throat.
One or 2 days after fever onset, painful sores usually develop in the mouth. They begin as small red spots that blister and then often become ulcers. The sores are usually located on the tongue, gums, and inside of the cheeks.
A non-itchy skin rash develops over 1–2 days. The rash has flat or raised red spots, sometimes with blisters. The rash is usually located on the palms of the hands and soles of the feet; it may also appear on the buttocks and/or genitalia.
A person with HFMD may have only the rash or only the mouth sores.
HFMD is caused by viruses that belong to the enterovirus genus (group). This group of viruses includes polioviruses, coxsackieviruses, echoviruses, and enteroviruses.
Coxsackievirus A16 is the most common cause of HFMD, but other coxsackieviruses have been associated with the illness.
Enteroviruses, including enterovirus 71, have also been associated with HFMD and with outbreaks of the disease.

How It Is Spread Infection is spread from person to person by direct contact with infectious virus. Infectious virus is found in the nose and throat secretions, saliva, blister fluid, and stool of infected persons. The virus is most often spread by persons with unwashed, virus-contaminated hands and by contact with virus-contaminated surfaces.
Infected persons are most contagious during the first week of the illness.
The viruses that cause HFMD can remain in the body for weeks after a patient's symptoms have gone away. This means that the infected person can still pass the infection to other people even though he/she appears well. Also, some persons who are infected and excreting the virus, including most adults, may have no symptoms.
HFMD is not transmitted to or from pets or other animals.
Factors That Increase the Chance for Infection or Disease
Everyone who has not already been infected with an enterovirus that causes HFMD is at risk of infection, but not everyone who is infected with an enterovirus becomes ill with HFMD.
HFMD occurs mainly in children under 10 years old but can also occur in adults. Children are more likely to be at risk for infection and illness because they are less likely than adults to have antibodies to protect them. Such antibodies develop in the body during a person’s first exposure to the enteroviruses that cause HFMD.
Infection results in immunity to (protection against) the specific virus that caused HFMD. A second case of HFMD may occur following infection with a different member of the enterovirus group.
HFMD is one of many infections that result in mouth sores. However, health care providers can usually tell the difference between HFMD and other causes of mouth sores by considering the patient’s age, the symptoms reported by the patient or parent, and the appearance of the rash and sores.
Samples from the throat or stool may be sent to a laboratory to test for virus and to find out which enterovirus caused the illness. However, it can take 2–4 weeks to obtain test results, so health care providers usually do not order tests.

Treatment and Medical Management
There is no specific treatment for HFMD.
Symptoms can be treated to provide relief from pain from mouth sores and from fever and aches:
Fever can be treated with antipyretics (drugs that reduce fevers).
Pain can be treated with acetaminophen, ibuprofen, or other over-the-counter pain relievers.
Mouthwashes or sprays that numb pain can be used to lessen mouth pain.
Fluid intake should be enough to prevent dehydration (lack of body fluids). If moderate-to-severe dehydration develops, it can be treated medically by giving fluids through the veins.

Thanks to my September mommy friend Leah for looking this up for me!!!

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