Chicken Pox vs Hand, Foot and Mouth Disease: Key Differences

Chicken Pox vs Hand, Foot and Mouth Disease

Chicken pox and hand, foot and mouth disease are two common contagious viral infections. They primarily impact young children but can occasionally affect adults as well. While their names sound similar, they are caused by different viruses and produce distinct symptoms.

Causes and Transmission

Chicken pox results from initial infection with the varicella zoster virus. Hand, foot and mouth disease stems from viruses in the enterovirus group, most commonly coxsackievirus 16.

Both conditions spread through direct contact with the viruses shed in saliva, mucus, fluid from blisters, or stool from an infected person. Droplet transmission from coughing or sneezing also transmits the viruses. Items like toys, bathroom surfaces, and kitchen utensils can harbor viruses and lead to infection upon use as well.

After initial infection, the viruses remain dormant in the body and can reactivate later in life. The varicella virus reemerges as shingles, while enteroviruses rarely cause recurring symptoms.

Vulnerable Populations

The highest risk groups include:

Children under age 10
Unvaccinated individuals
Pregnant women (chicken pox only)
Those with weakened immune systems

Adults account for less than 5% of hand, foot and mouth cases and 10-15% of chicken pox cases. Due to childhood vaccination, chicken pox infection rates continue declining while hand, foot and mouth disease persistently circulates.

Comparison of Symptoms

Despite somewhat similar names and modes of transmission, key differences distinguish chicken pox and hand, foot and mouth disease upon symptom onset.

Incubation Timeline

Following exposure to either virus, it takes:

Chicken pox: 10-21 days for symptoms to first appear
Hand, foot and mouth disease: 3-7 days before symptoms emerge

In both cases, infected people become contagious 1-2 days before symptoms start. The short hand, foot and mouth incubation period allows the virus to spread rapidly to classmates and playmates.

General Symptoms

Common general symptoms include:

Chicken pox: Fever, headache, fatigue
Hand, foot and mouth disease: Fever, sore throat, headache, body ache

Adults with either condition experience more severe and longer-lasting general symptoms compared to children.

Characteristic Skin Symptoms

The viruses elicit distinct skin manifestations:

Chicken pox: Itchy blister rash develops first on the trunk then spreads across the entire body
Hand, foot and mouth disease: Painful mouth ulcers accompanied by a blistery rash only on the palms, soles of feet, and sometimes buttocks

The varicella blisters fill with fluid before crusting over with new ones continuously emerging over 5-10 days.

Other Common Symptoms

Some other differences to note:

Chicken pox: Headache, cough
Hand, foot and mouth disease: Sore throat, mouth pain, loss of appetite, vomiting, diarrhea

Gastrointestinal issues can accompany hand, foot and mouth disease as the viruses multiply in the intestines and shed in stool.

Diagnosing Chicken Pox vs Hand, Foot and Mouth

Doctors can typically distinguish chicken pox from hand, foot and mouth through visual assessment of the characteristic rashes. However, lab tests help confirm diagnoses in ambiguous presentations.

Physical Examination

During exams, doctors assess:

Rash location, appearance and progression
Presence of fever, sore throat or other symptoms
Exposure risk
Vaccination status

The widespread varicella rash helps differentiate chicken pox from the localized blisters of hand, foot and mouth disease.

Lab Tests

If the distinction remains unclear, samples of fluid from blisters or lesions, throat or nose swabs, stool or blood can confirm which virus is causing symptoms through:

Viral culture
Polymerase chain reaction (PCR) assays
Serology blood tests

PCR rapidly detects viruses in body fluids or swab samples. Blood tests measure antibodies produced in response to specific viruses.

Co-testing for Other Conditions

Doctors may simultaneously test for:

Measles
Rubella
Mononucleosis
Allergic reactions

These tests help rule out diagnoses with potential symptom overlap before confirming chicken pox or hand, foot and mouth disease.

Risk Factors and Complications

While most cases of chicken pox and hand, foot and mouth disease resolve without incident, severe or recurring issues can develop under certain circumstances.

Populations at Risk

Those vulnerable for complications include:

Newborns infected from mothers before birth
Children under age 5
Adults, especially pregnant women with chicken pox
Immunocompromised individuals

In rare cases, previously healthy older children and adults also experience more severe symptoms and illness duration.

Common Complications

Typical complications involve:

Bacterial skin infections from scratching blisters
Dehydration from profuse blistering and fluid loss
Encephalitis from varicella virus invading the brain
Meningitis from virus-prompted inflammation

Those with weakened immune systems face the highest risk of hospitalization from pneumonia, sepsis, hemorrhage or complications of supportive treatments.

Long-Term Consequences

In some cases, permanent issues linger after initial infection:

Shingles from reactivated dormant varicella virus
Neurologic conditions from varicella brain impacts
Muscle weakness and paralysis from enteroviruses
Diabetes risk from enterovirus pancreas infection

Cutaneous disseminated varicella infection during pregnancy can prompt fetal defects or demise as well.

Treatment Approaches

As viral conditions, neither chicken pox or hand, foot and mouth disease respond to antibiotic therapy. Thus treatment aims to ease symptoms and prevent complications.

Home Care Basics

Managing mild infections at home involves:

Acetaminophen/ibuprofen for fever
Antihistamines to reduce itching
Topical treatments like calamine lotion for rashes
Adequate fluid intake
Proper hand hygiene

Cool baths, soft fabrics and keeping fingernails trimmed prevents skin damage from scratching. Over-the-counter numbing gels, throat lozenges and oral pain relievers ease mouth discomfort.

Medical Interventions

Those with severe infection may need:

Antiviral medication
Intravenous fluids
Supplemental oxygen
Intensive hospital care

Pregnant women benefit from specialized fetal monitoring and prenatal injections to reduce transmission and complications in newborns.

Isolation Essentials

To prevent viral spread, critical measures include:

Exclude infected children from school/daycare until no longer contagious
Cover skin rashes until fully healed
Practice cough etiquette
Disinfect frequently touched objects and surfaces
Wash hands before eating or touching others

In hospital settings, contact isolation protocols prevent staff and visitor transmission.

Preventing Infection and Recurrence

Beyond treatment, proactive strategies help prevent initial chicken pox and hand, foot and mouth infections. Certain steps also minimize recurrence risks.

Childhood Vaccination

Getting children vaccinated early provides protection with very high effectiveness:

Chicken pox vaccine: Over 90% effective at preventing infection
Hand, foot and mouth vaccines: None currently available

The CDC recommends routine childhood chicken pox vaccination along with staying up to date on other routine immunizations.

Reducing Transmission

To limit viral spread to vulnerable individuals:

Keep sick children home from school and activities
Avoid contact with pregnant women if infected
Be vigilant with hand hygiene when outbreaks occur
Sanitize surfaces, toys, utensils
Avoid exposure through indirect contact

Precautions for Recurrence

Steps to avoid viral reactivation down the road include:

Sun protection to prevent shingles rash
Stress reduction techniques
Healthy diet and lifestyle
Careful hygiene near those with active infection

While less common, adults should avoid close contact with children showing signs of hand, foot and mouth disease to prevent reinfection from circulating enteroviruses.

The Bottom Line

Chicken pox results from the varicella zoster virus while coxsackievirus causes hand, foot and mouth disease. They share some transmission methods, symptoms and risk groups. However, distinct incubation periods coupled with signature skin findings help differentiate between these two common childhood viral infections.

Understanding the unique and overlapping facets aids rapid identification. While self-limiting in most cases, prevention and prompt treatment provide the best opportunity to avoid lasting consequences.

FAQs

What causes chicken pox vs hand, foot and mouth?

Chicken pox stems from initial infection with the varicella zoster virus. Hand, foot and mouth disease originates from viruses in the enterovirus group, usually coxsackievirus 16.

Is chicken pox related to hand, foot and mouth disease?

No, chicken pox and hand, foot and mouth disease are caused by completely different viruses. Their names may sound similar, but they are distinct viral infections.

Can adults get chicken pox or HFMD?

Yes, while children under age 10 are most commonly affected, adults can develop chicken pox and, less frequently, hand, foot and mouth disease as well. Adult cases tend to cause more severe symptoms.

How do you confirm chicken pox vs HFMD?

Doctors can usually distinguish the diseases through physical examination of the characteristic rashes. Widespread varicella blisters signal chicken pox, while painful mouth ulcers with blisters on the palms, soles and buttocks indicate hand, foot and mouth. Lab tests can confirm diagnoses.

Chicken Pox vs Hand, Foot and Mouth Disease: Key Differences