Recovery Time for Children with Hand, Foot, and Mouth Disease

Healing time

Dear Dr.
Pei,
I would like to ask you three questions:
(1) How many days should a child with enterovirus symptoms be isolated before they can have contact with others?
(2) If a child has a common cold, how many days should they be isolated before they can have contact with others?
(3) Regardless of whether the child has enterovirus or a common cold, if their uncomfortable symptoms have resolved, does that mean the child has fully recovered and can interact with others?
Thank you for taking the time to answer my questions.

Xiao Fen, 30~39 year old female. Ask Date: 2008/07/17

Dr. Pei Rensheng reply Pediatrics

Dear Xiaofen,
1.
Enteroviruses can be contagious 1 to 2 days before the onset of symptoms, with an incubation period of approximately 3 to 5 days.
Enteroviruses can be isolated from the respiratory secretions of infected individuals for up to 1 month, and from feces for up to 2 months.
However, during the early stages of the illness, especially when fever is present, the viral load is higher, making it more contagious.
After the fever subsides, the contagiousness is extremely low.
2.
According to the Centers for Disease Control's recommendations regarding enterovirus, it is advised to take leave from school or work for 1 to 2 weeks.
Additionally, it is best to avoid close contact for up to 2 months.
3.
For a common cold, where the virus is primarily concentrated in the respiratory tract, a week of isolation should be sufficient.
If the uncomfortable symptoms have resolved, it indicates that the child has recovered.
However, based on the aforementioned principles, it is still advisable to avoid contact with others for a period after recovery.
Wishing you health and happiness!
Sincerely,
Dr.
Pei Rensheng
Director of Pediatrics, Taoyuan Hospital, Department of Health

Reply Date: 2008/07/17

More Info

Hello! Thank you for your questions regarding recovery time and isolation protocols for children with Hand, Foot, and Mouth Disease (HFMD) and other viral infections. I will address each of your queries in detail.

1. Isolation Duration for Hand, Foot, and Mouth Disease: Children diagnosed with HFMD, which is often caused by enteroviruses (most commonly Coxsackievirus), should be kept at home and away from other children until their symptoms have resolved. Typically, this means that once the child has no fever and the sores in the mouth and on the skin have healed, they can return to school or daycare. This usually takes about 7 to 10 days from the onset of symptoms. However, it is essential to note that the virus can still be present in the stool for several weeks after symptoms have resolved, so good hygiene practices should be maintained to prevent transmission.

2. Isolation Duration for Common Cold: For a common cold, which is usually caused by rhinoviruses, the isolation period is less stringent. Generally, children can return to school or daycare once they feel well enough to participate in activities and do not have a fever. This is often within 3 to 5 days after the onset of symptoms. However, if the child is still coughing or has a runny nose, it is advisable to keep them home to prevent spreading the virus to others.

3. Symptom Resolution and Return to Contact: The absence of symptoms does not always guarantee that a child is no longer contagious. For both HFMD and common colds, children should be symptom-free for at least 24 hours without the use of fever-reducing medications before returning to contact with others. It's also important to consider that some children may still carry the virus even after symptoms have disappeared, particularly in the case of HFMD. Therefore, practicing good hygiene, such as frequent handwashing and avoiding close contact, is crucial during the recovery phase.

In summary, while symptom resolution is a good indicator of recovery, it is essential to consider the type of virus involved and the potential for ongoing contagiousness. For HFMD, a more extended isolation period is typically necessary compared to a common cold. Always consult with a healthcare provider for personalized advice, especially if you have concerns about your child's health or the appropriate time for them to return to social settings.

In addition to these considerations, it is vital to ensure that children maintain a healthy diet and stay hydrated during their recovery. Nutrient-rich foods can help support their immune system and overall recovery. Foods rich in vitamins A, C, and zinc, such as fruits, vegetables, lean proteins, and whole grains, can be beneficial.
If you have further questions or concerns, please feel free to reach out. Thank you for your inquiry, and I wish you and your child good health!

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