Hand, Foot, and Mouth Disease

    This article provides information about the common virus infection causing Hand, Foot, and Mouth disease.

    Updated at October 27th, 2023

    Disclaimer [ENGLISH]

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    DisclaimerThis material is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it. It is not intended to provide medical advice, diagnosis or treatment, nor does it replace the advice or counsel of a doctor or health care professional. Reference to a specific commercial product or service does not imply endorsement or recommendation of that product or service by CPCMG.

     

    What is hand, foot, and mouth disease?

    • A virus infection.
    • Most common in children aged 6 months to 4 years, but anyone can get the infection at any age.
    • Outbreaks occur most often in the summer and fall. 

    What causes hand, foot, and mouth disease?

    • Many different viruses can cause it, one of the most common is the Coxsackie A-16 virus. 
    • It is NOT the same as foot-and-mouth disease (also called hoof-and-mouth disease), which affects cows, sheep, goats, and pigs.
    • Humans do not get the animal disease, and animals do not get the human disease.

    What are the symptoms of hand, foot, and mouth disease?

    Symptoms can include

    • Sores in the mouth
      • They can be small, but they can be very painful.
      • Sores can be anywhere in the mouth or along the throat.
      • The most common complication is dehydration.  The mouth sores sometimes cause enough pain that your child may refuse to drink. 
      • Most children don’t want to eat much either, but drinking is more important.
    • Rash
      • Usually, small blisters or red bumps on the hands and feet
      • Often, small blisters or red bumps on the buttocks or diaper area.
      • Sometimes, throughout the whole body.
    • Fever
    • Irritability 
    • Some children have changes to their hands and feet several weeks after the illness which get better on their own in 1-2 months. These might include:
      • Nails falling off.
      • Nails looking yellow or discolored.
      • Peeling of fingers or toes.
     
     

    Length of symptoms

    • The fever and discomfort are usually gone in 3 or 4 days. 
    • The mouth ulcers usually heal in about 7 days.
    • The rash on the hands and feet can last 10 days. 
     
     

    How is hand, foot, and mouth disease diagnosed?

    • You child’s provider will diagnose this based on your answers to questions about your child and their physical examination.

    How can I prevent hand, foot, and mouth disease?

    This infection is contagious, and it is very hard to keep it from spreading

    • The virus can be found in saliva, nasal mucous, stool, and fluid from the blisters.
    • Most children are contagious from 2 days before to 2 days after the rash develops.
    • People can still spread the virus to others for days or weeks after symptoms go away, or even if they have no symptoms at all.
    • It is usually 3 to 6 days between exposure to the virus and developing symptoms.  
     
     

    Good hygiene practices can help reduce the chance of spreading these virus

    • Good hand-washing habits. Learn more about hand-washing here
    • Avoid touching your eyes, nose, and mouth with unwashed hands.
    • Avoid close contact (kissing, hugging, sharing cups, and eating utensils) with people who have hand, foot, and mouth disease.
    • Clean frequently touched surfaces.
     
     

    How is this treated?

    • There are no treatments specific for hand, foot, and mouth disease. 
    • Since this is caused by a virus, antibiotics are not helpful. 
    • The most important thing is to help your child stay comfortable and hydrated. 

    Pain relief

    • You can give acetaminophen and/or ibuprofen  if needed.
    • Coat the mouth with a mixture of liquid antacid solution (one example is Maalox) prior to eating or drinking. 
      • Older children can use this like a mouthwash to “swish and spit”.
      • For younger children, parents can apply this with a cotton swab to the inside of the mouth.
     
     

    Drinks

    • Encourage your child to drink plenty of fluids to stay hydrated. 
    • Cool drinks might feel good in their mouth. 
    • Other ideas include popsicles, yogurt, pudding, ice cream, milkshakes, and smoothies.
    • Avoid citrus drinks like orange juice or lemonade since they might hurt.
     
     

    Food

    • Your child might not want to eat much during this illness. 
    • Avoid food that can hurt inside the mouth, like citrus, salty, or spicy foods. 
    • Offer soft and cool foods instead.
     
     

    Rash

    • There is no treatment for the rash. 
    • The rash will go away on it’s own. 
    • If your child complains the rash is itchy, or you see them scratching at it you can try:
      • Applying cool compresses – like a cool washcloth or ice pack.
      • Patting instead of scratching.
      • Keeping it covered with clothing so your child can’t reach it.
      • You can keep your child’s skin hydrated with lotions or creams.
     
     

     

    When can my child return to day care or school? 

    • When your child is:
      • Having no fever without the use of any medications.
      • Not drooling excessively because of the mouth sores.
      • Able to participate in regular activities. 
    • Sometimes the school or childcare has other criteria for keeping your child home. Check with your child’s school or childcare facility for specific guidelines.
     
     

    When to call your doctor:

    • Your child is not able to drink normally, and you’re worried they might be getting dehydrated.
    • Your child’s fever lasts longer than 3 days.
    • There is pus coming from the rash.
    • Your child is getting worse.
    • You have other questions or concerns.

    This publication was adapted from information from American Academy of Pediatrics patient education materials and the Centers for Disease Control and Prevention.

    Reviewed by: AR D.O., TT D.O. | 09/2023