Hand, Foot, Mouth Disease

Has anyone ever had it run through their daycare? How long did you close for? Did you contract it? How early did you tell the parents?

I have a little one who had a mild fever at drop off yesturday. She was treated with tylenol as it was assumed to be teeth. She was fussy all day but ate and drank normally. She napped ok, however did seem irritated and again, slightly warm. When she woke up from her nap she had what appeared to be small pimples around her mouth. She uses a soother so it could just be a rash from that too.

She showed up this morning and still has the rash around her mouth, but a little more pronounced. She also has a small rash on the bum and had a loose poop this morning. (she's been here for an hour)

I'm a little worried as I know her older sister contracted the same virus about 3 weeks ago.

Here's the funny thing about kids and viruses. You don't know they have them until they are way past the contagious stage... so by the time you see the rash, all of the harm is already done.

Anyone with experiances with this virus?

A child is considered contagious until all the blisters have dried up as fluid from the blisters contain the virus ......I would send the child home and notify the other parents that the incubation period is 5-7 days. I googled it.

I personally do not exclude for hand, foot and mouth disease itself - so unless the child has a fever still or is so miserable they cannot eat or cope with the demands of a group program they can attend.

It is not listed as one of the exclusions on our Public Health list for group care ... HFM is kinda like the common cold for most people it is an annoying thing that passes without treatment cause it is a virus - for others they have a lower immunity and end up with a nasty case of it and end up being home because of those 'extended' symptoms not the 'virus' itself but rather how their body reacted too it.

My understanding is that is contagious before symptoms are present through 'saliva', during the outbreak through the liquid in the blisters and is still contagious for WEEKS after the blisters are gone it is carried in the stool of anyone who had it - so when the kids do return if you exclude them make sure you are on top of hand washing with the kids and if you got a bum itcher whose had HFM really keep on top of them to keep their hands out of their pants cause if they itch themselves and touch surfaces - it is being spread as well. (not that we do not keep on top of them to keep hands out of their pants anyway but the risk is even higher to spread germs)

ETA .... link from the Health Unit in my area

http://www.healthunit.com/article.aspx?ID=10195

I sent her home. I hope I'm completely wrong, but based on the fever, irritability over the last few days ... oh... and the fact that her older sister had it a few weeks back (which the parents didn't disclose to me, I heard from my other client how has her son in the same class as her) I'm staying on the side of caution.

It's one of those things thats super contagious and it's so hard to control, but it looks bad to the other parents that pick up their kids when they see the mess around the mouth.

It could also just be a coincidence too that just because the sister had it doens't mean the baby will get it. Everything you described is still totally attributable to teething. The fact the rash is around the mouth and on the bum would never have me suspecting hfm disease - yes if the sister had it maybe and I see where you are coming from. But does it not start as blisters on the hands, feet and mouth first - hence the name. Rash around the mouth and not in it is more likely from drooling and acidic reaction to foods as well as the bum rash and all of that is because of changes in the child due to teething. Hopefully for everyone's sake it is just teething.

Actually according to the website I read it's starts as fatigue, loss of appetite,and fever, then sores in the mouth eventually coming around the mouth and onto the hands and feet and depending on the severity if it sore throat too

yes, she's been overly tired since monday. Went to bed 2 hours early Monday night and still slept for 3 hours yesturday during her nap. Her eating has been find, low grade fever yesturday morning and the rash started after her nap yesturday afternoon. The rash looked worse today and some were blistering with fluid in them. Feet looked ok with the exception of maybe one on the toe and the hands were starting to rash, with one defineable blister on the finger. I'm pretty certain it is. I'm still hopeing I'm wrong. I know it's not a huge deal, just a pain in the butt but parent's see rash on another child and panic!

Public Health told me that as long as the child still has the fever or the undried blisters, they are contagious.

We had this last year. All but one of my 5 daycare kids had it, and my son got it as well. Normally adults do not get it, because they've either had it as a kid and don't remember, or they have built up an immunity over their lifetime due to exposure. I was also informed that older children don't get it as easily either.

I quarantined my daycare. Everyone was out until they were fever and blister free.

Mom just let me know that the doctor has said it is a virus but not chicken pox and "probably not hand/foot" Probably.... So, we'll wait to see what else pops up. I'm closing on Friday (because it's convienient for all of my clients) and doing a huge disinfectant sweep through the daycare room. Thanks for all of your feedback.

Funny how Health Units can vary ... they do not even require exclusion for chicken pox anymore according to our Health .... which IME is a way bigger PITA and risk of complications ... yup it is 'contagious' in one sentence but like HFM under exclusion it says not required as long as they are able to participate in program ... yup joys of trying to care for 5 children with itchy oozing scabs and discomfort - umm no thanks :rolleyes:

This is where having a FEVER policy helps cause yes if they have a FEVER than you can exclude them under that even if the parent is saying 'but the health unit says' ;)

Yup, I read that under my local public health as well. I don't think I would send my child to daycare if they have open sores on their face or hands. I think that's cause for keeping them home any day. Well, I'm glad mom was so quick to find a solution to pick her up. I feel a little bad that I sent a child home and I was wrong in the diagnosis, but I'm a daycare provider, not a doctor. I made the best call for my daycare.

We had Hand, Foot and Mouth disease two summers ago at daycare and the carrier is a boy who never actually gets sick or shows symptoms so it wasn't his parent's fault that he brought it in. The next two children who caught it had extremely high fevers for a few days and the spots showed up on them. So I followed my fever and open sore policies as stated in my contract and they all ended up being out of daycare for just a few days. Except for the carrier boy who never gets a fever or anything bad. I wish we all had immune systems like that little guy!

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Originally Posted by apples and bananas

Yup, I read that under my local public health as well. I don't think I would send my child to daycare if they have open sores on their face or hands. I think that's cause for keeping them home any day. Well, I'm glad mom was so quick to find a solution to pick her up. I feel a little bad that I sent a child home and I was wrong in the diagnosis, but I'm a daycare provider, not a doctor. I made the best call for my daycare.

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What was the fianal outcome? I had a daycare parent call me last night to tell me her DD has it. :( She was in care only yesterday and got the blisters last night. I disenfected EVERYTHING last night and pray no one else will get it.

turned out to just be a virus. A fever for 2 days then a rash for a few days and that's it. No blisters. All of my daycare kids had it including my own son and step daughter. It wasn't too bad, the fever made them uncomfortable, but the rash didn't bother them at all. I hope you can stop it right away, so you don't loose too much time with the kids.

THanks for all the info. I have 3 kids sick with HFMD and they're all at home. Luckily, my daughter didn't get it. I will develop my own policy and send an email to all parents stating that a doctor's note is required for them to be able to return.