Hand, Foot, and Mouth Disease (HFMD) is a common and contagious viral illness, primarily affecting young children, though adults can also contract it. The infection is most often caused by enteroviruses, particularly Coxsackievirus A16. HFMD typically begins with flu-like symptoms, including a fever. The overall illness is usually mild and resolves within seven to ten days.
The Typical Duration and Pattern of HFMD Fever
The fever is frequently the first noticeable symptom of HFMD, signaling the start of the acute viral phase. This initial temperature elevation typically lasts a relatively short period, ranging from two to five days in most cases. The fever’s presence marks the time when the individual is often most contagious, even before the characteristic skin and mouth lesions appear.
The temperature usually ranges from low-grade to moderate, often falling between 101°F and 103°F. It can occasionally spike higher, particularly in young children, which may cause significant discomfort. This fever pattern is typical of many viral infections, showing regular peaks and valleys throughout the day.
The resolution of the fever generally precedes the full manifestation of HFMD’s hallmark symptoms. This is a significant turning point in the illness’s progression, suggesting the body is successfully fighting the initial systemic infection. Once the temperature returns to normal, the focus shifts to managing the discomfort caused by the developing sores and rash.
Managing Fever and Discomfort During the Acute Phase
Caregivers can utilize approved over-the-counter medications to manage the fever and associated body aches during this acute period. Acetaminophen or ibuprofen are commonly recommended to help reduce the temperature and improve comfort. It is important to follow precise dosing instructions based on the patient’s age and weight. Never give aspirin to children due to the risk of Reye syndrome.
Keeping the patient adequately hydrated is a non-medicinal measure that supports the body during a fever. Cool compresses or a lukewarm bath can provide physical relief and assist in temperature regulation. Continuous monitoring of fluid intake is necessary, especially if a sore throat or reduced appetite makes drinking difficult.
While HFMD is generally mild, certain signs warrant immediate medical attention. A temperature that remains elevated above 100.4°F for more than five days, or a sudden spike to very high levels, should prompt a consultation. Caregivers should also watch for signs of complications, such as extreme lethargy, unusual irritability, severe headache, or any neurological symptoms.
What Happens After the Fever Breaks
The cessation of the fever usually signals the transition to the eruptive phase of HFMD. This stage is characterized by the appearance of the distinctive lesions that give the illness its name. These typically manifest as painful sores, known as herpangina, which develop in the mouth on the tongue, gums, and inside of the cheeks.
Concurrently, or shortly after the mouth sores, a non-itchy rash appears on the body, most commonly on the palms of the hands and the soles of the feet. This rash may present as flat red spots or small blisters, and it can sometimes be seen on the buttocks or in the diaper area. The primary discomfort in this phase shifts from systemic flu-like symptoms to localized pain from these lesions.
The duration of these secondary symptoms is typically longer than the fever, with the rash and mouth sores generally taking seven to ten days from their onset to fully resolve. Maintaining hydration remains a high priority because the painful mouth sores can make swallowing difficult, leading to a reluctance to drink. Recovery is marked by the complete healing of these skin and mucosal lesions.