Understanding Hand, Foot, and Mouth Disease: A Guide for Parents in the Cayman Islands

Hand, foot, and mouth disease (HFMD) is a relatively common viral illness, particularly affecting infants and young children. In the Cayman Islands, where our communities are closely knit and outdoor lifestyles are common, HFMD can spread quickly among children. This guide aims to provide parents in the Cayman Islands with essential information on identifying, managing, and preventing HFMD to keep our children and communities healthy.

Symptoms to Watch For

HFMD symptoms typically develop 3-6 days after exposure and can include:

• Fever
• Sore throat
• General malaise
• Painful, red lesions in the mouth or on the tongue and gums
• A rash or blister-like sores on the hands, feet, and sometimes the buttocks
• Irritability in infants and toddlers
• Loss of appetite

These symptoms are particularly important to monitor in the warmer months, which can see a rise in viral infections like HFMD.

Causes and Transmission

The disease is caused by viruses such as coxsackievirus A16 and enterovirus 71. It spreads through direct contact with an infected person’s bodily fluids, including saliva, blister fluid, or faeces. Given the close interactions within schools and daycare centres in the Cayman Islands, HFMD can spread swiftly among children.

Home Care and Management

While there’s no specific cure for HFMD, the following home care measures can alleviate symptoms:

• Stay Hydrated: Encourage fluid intake to prevent dehydration. Cool drinks, ice pops, and soft foods can soothe mouth sores.
• Pain and Fever Management: Acetaminophen or ibuprofen can help reduce fever and relieve pain. Remember, aspirin should never be given to children. Difflam mouth spray can reduce pain and can help your child to eat or drink
• Soft Foods: Opt for soft, bland foods that won’t aggravate mouth sores. Avoid spicy, hot, or acidic foods.
• Adequate Rest: Rest is crucial for recovery, so ensure your child gets plenty of sleep.

Preventing HFMD

Prevention is key in controlling the spread of HFMD, especially in island communities like Cayman.

• Frequent Handwashing: Teach children the importance of washing hands thoroughly with soap and water, particularly after using the bathroom, playing outdoors, and before meals.
• Disinfect Surfaces: Regularly clean toys, doorknobs, and other surfaces that children frequently touch.
• Limit Contact: If your child is infected, minimize their contact with others until they’re no longer contagious, which is usually a few days after the fever resolves and blisters begin to heal.
• Stay Informed: Pay attention to public health notices, especially during outbreaks, and follow any guidance provided by health authorities in the Cayman Islands.

When to Seek Medical Attention

Most cases of HFMD are mild and resolve without medical treatment. However, seek medical advice if:

• Your child is under 6 months old or has a weakened immune system.
• Signs of dehydration appear, such as a dry mouth, crying without tears, or reduced urine output.
• Mouth sores prevent your child from drinking fluids, leading to dehydration.
• The fever persists for more than three days or if you notice any signs of neurological involvement, like unusual sleepiness or irritability.

In the Cayman Islands, where access to healthcare is readily available, don’t hesitate to consult a healthcare provider for advice or if your child’s condition worsens.

How long is my child contagious and when can they return to school

If your child has HFMD, keep them home from school or daycare until their fever has gone away and mouth sores have healed to help reduce the spread of the virus to others. Always follow the advice of your healthcare provider or local health guidelines regarding when it is safe for your child to return to school or daycare.

A child with HFMD is most contagious during the first week of the illness. However, the virus can remain in the body and continue to be shed through saliva, stool, and respiratory droplets for weeks after the symptoms have disappeared. Specifically, the virus can be found in a child’s stool for up to several weeks and in the respiratory secretions for one to three weeks following infection.

Due to this extended period of contagion, it’s important for parents and caregivers to maintain good hygiene and preventive practices, such as regular handwashing especially after changing diapers and disinfecting common surfaces, even after the visible symptoms of HFMD have resolved.

Dr Watkin has also created a video resource on HFMD which you can watch here.