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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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