Signs a Child Has Hand, Foot, and Mouth Disease and Needs Immediate Medical Attention

Despite being considered one of the most childhood illnesses, hand, foot, and mouth disease can lead to dangerous complications such as encephalitis, myocarditis, acute pulmonary edema, and death if not detected, monitored, and treated promptly. Parents need to recognize the signs of the disease early on.

As an infectious disease caused by a virus, HFMD typically occurs year-round but can escalate into an epidemic if not well controlled from February to April and from September to December. The disease commonly affects children under 5.

Signs a Child Has HFMD with Complications or is at Risk of Complications

Usually, HFMD is mild, causing only a fever for a few days with characteristic symptoms. However, doctors have encountered many cases of this disease with subtle outward symptoms that are difficult to recognize.

• Non-specific systemic symptoms: These are initial symptoms in children when they contract the disease. At that time, children may have a fever above 38.5 degrees Celsius lasting more than 48 hours, not respond to medications and have sore throat and mouth pain, making the child uncomfortable and reluctant to eat. About 1 or 2 days after the onset of fever, fluid-filled blisters will begin to appear in the mouth, throat, or both.
• Child startles without cause twice in 30 seconds: Parents need to pay attention to the frequency of a child's unexplained startles over time because if the child startles more than twice in 30 seconds, it could be a sign of neurotoxicity. In severe cases, children may experience continuous startles, or startle even when in deep sleep.
• Prolonged persistent crying: Children may cry a lot or cry all night without sleep, waking up every 15-20 minutes and crying inconsolably.
• Child has difficulty breathing, vomiting frequently, dry heaving, difficulty swallowing, weak limbs, unsteady gait: In addition to the typical symptoms of fluid-filled blisters on the hands, feet, buttocks, knees, mouth ulcers, if children also show symptoms such as excessive vomiting, abnormal breathing, trembling limbs, unsteady gait, sitting unsteadily, parents need to take the child to the hospital immediately. Skin lesions with fluid-filled blisters make diagnosing the disease easy but are not broad prognostic signs of the disease. Note that in cases with subtle skin lesions that are difficult to detect, children with suspicious symptoms of complications need to be carefully examined, hospitalized and treated promptly.

Common Misconceptions about HFMD in Children

• Only children in damp weather get HFMD: Many people think that HFMD only occurs during damp weather. But in reality, the disease occurs year-round, often in spring, summer, and early fall. Currently there is no vaccine for prevention.
• Children with HFMD only get it once and won't get it again: Many parents believe that children who have had HFMD will develop natural immunity to the virus and not get it again. HFMD is a syndrome caused by many types of viruses, so children can get it multiple times in different outbreaks.
• If HFMD is mild this time, it will be severe next time, and vice versa: The virus causing HFMD has many strains. Therefore, it is possible that a child infected with one strain with mild symptoms this time may be infected with another strain with severe symptoms next time, and vice versa, so parents should not be complacent. When assessing severity, it is necessary to closely monitor clinical symptoms.
• Only children under 3 years old get HFMD: HFMD is a common infectious disease, but the age group most affected is children under 5 years old. Older children and adults can also get it, but it is less common.
• All children with HFMD need to be hospitalized: Many children with HFMD can recover on their own without needing hospitalization. Many cases of mild HFMD with no complications will recover on their own. Only a small number of cases with complications or at risk of complications need to be hospitalized.

Checklist of Effective Measures to Prevent HFMD in Children

Currently, in Vietnam, the progression of HFMD is very diverse, and there is no vaccine. Therefore, the most effective measures in preventing and controlling outbreaks are to prevent transmission from sick individuals to healthy individuals. Non-specific preventive measures include:

• Limiting children's contact with those with HFMD. If there is contact or care for a child with HFMD, parents need to thoroughly wash their hands with soap or disinfectant to ensure cleanliness and prevent disease transmission
• Absolutely do not puncture or break the blisters or vesicles on the child's skin to avoid more severe infection. Do not self-administer treatment for the child
• Carefully cover the child's nose and mouth when they sneeze or cough, dispose of used tissues and diapers in tightly closed trash bins
• Always clean toys, utensils, and the child's room with appropriate disinfectants
• Ensure that children eat and drink clean, cooked food, maintain cleanliness in daily activities, do not let children put unclean food in their mouths, suck their fingers, or share toys, and do not allow children to share eating utensils, or towels that have not been disinfected.
• When suspected of having the disease, children need to be closely monitored at medical facilities, pediatric departments, or infectious disease treatment facilities with pediatric specialties
• When infected, children need to be closely monitored, and signs of complications need to be promptly detected and treated.

The Pediatrics Department at Hanoi French Hospital is one of the few multidisciplinary hospitals with a team of skilled pediatric specialists with extensive experience and understanding of children's psychology in Hanoi.

We can swiftly detect and treat diseases, bringing trust and satisfaction to thousands of parents with young children.

The hospital offers comprehensive healthcare services with in-depth techniques to enhance the effectiveness of treatment. Additionally, the clean, friendly environment helps children quickly adapt to the hospital environment