Segann March

segann.march@shreveporttimes.com

Though she knew the signs, Jessica Shuler never expected her 16-month-old daughter, Catherine, would encounter hand, foot and mouth disease.

But when Catherine's fever persisted through a recent weekend, she started to worry.

"We noticed she had a couple of spots on her foot, one on her ear, one of the tip of her nose and a few in different areas," she said. "At that point, it looked like bug bites. The next morning, she had more on her feet, hands and in her diaper area — that's when I knew."

Shuler believes her daughter contracted the virus at a children's program connected to an international bible study group.

She likely isn't the only child to suffer this year. Health experts say the viral illness typically circulates in the summer, and it's already showing up at local day care facilities.

Cathy Dennis, Calvary Baptist Daycare director, said this is the time of year she sees hand, foot and mouth disease the most at her day care, which serves more than 300 children, ages 6 weeks to 12 years old.

"Every year around this time, we have some cases and we've had a couple this year already," she said. "Some cases are more severe than others. We do have a policy that you have to be symptom free for 24-hours (to return to the day care)."

Hand, foot and mouth disease is a common viral illness affecting mostly infants and children under 5 years old.

It's caused by the Coxsackievirus, said LSU Health Shreveport assistant professor of pediatrics Sarah Alvarez.

"We tend to see more cases this time of the year. This virus can manifest with a skin rash.," Alvarez said.

It's contagious and can spread from child to child or from child to adult. It's easily transmitted through close personal contact, or contact with feces or , contaminated surfaces or by coughing and sneezing. Alvarez said even if the virus has gone away, it still resides in a child's feces.

"For daycares, we worry about oral secretions having the virus in them and also in feces," she said. "We recommend that whenever there's an outbreak that daycares really practice good hand hygiene. We see it in younger kids, usually in the daycare age, because they're starting to teeth and put everything in their mouth. There's no way to prevent kids coming into contact with other kids' secretions."

Symptoms may include loss of appetite, a fever, sore throat, mouth sores, skin rashes and possible dehydration due to not being able to swallow.

Department of Health and Hospitals state epidemiologist, Raoult Ratard, said the sickness goes away after a week, but it could still be in the body.

"Make sure you're washing your hands because it could still be in the stool," he said. "Some daycare centers will exclude the children who are very sick. When everything is back to normal, it's still very important to wash after the bathroom."

Dennis said it can be hard to contain, since children touch everything. If the facility is aware of an outbreak, they'll inform all parents.

"We've never had a major outbreak where it was spreading all over the daycare," she said. "Any time a child runs a temperature,we call parents to come get them. Usually it starts with one little bump around the mouth. If we see any kind of bump, we call parents immediately."

A Shreveport parent, ReBecca Clark, said her 2-year-old son, Hunter, experienced severe hand, foot and mouth disease a few weeks ago. Her son was affected for two weeks, she said.

"My son had the worse case his doctor had ever seen," Clark said. "It was horrible, all he did was scream in pain and cry. All I could do was cry with him."

Her son wasn't able to eat anything for a while but did drink out of a straw. She warns to not let your children anywhere around someone with symptoms.

"He had sores all over his tongue mouth throat and face," she said. "Someone told me their kid was over it and I guess they (weren't) — that's how my son got it."