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Hand, foot and mouth disease

hand; foot; mouth; blisters; child; infectious; diseases; virus; coxsackie; ulcers;;

Hand, foot and mouth disease is very common, and usually is a mild illness. It is not related to the disease of a similar name that affects cattle, sheep, goats, pigs and other 'cloven-hooved' animals.

SA Health (South Australia), ‘You’ve got what?’  "Hand, foot and mouth disease"  

Contents

What is hand, foot and mouth disease?

  • Hand, foot and mouth disease is caused by a virus (usually Coxsackie virus A16).
  • It causes blisters on the hands, feet, in the mouth. Blisters can also be in the nappy area of young children.
  • Hand, foot and mouth disease can be caused by several other viruses.


  • It mostly occurs in warmer weather, and tends to spread easily where a lot of young children are together, such as in a child care setting.
  • Once a child has had the infection he or she is not likely to get it again, but because the same rash can be caused by several different viruses it can appear that a child is having the same infection again.

Signs and symptoms

  • A child who has the infection may have a fever, be unwilling to eat or drink because of ulcers in the mouth, have a runny nose and sore throat, and not have much energy. The fever can be high, but often is mild.
  • Blisters on the hands and feet, and ulcers or blisters in the mouth appear 1-2 days after the first symptoms and may last for 2 – 7 days.
  • The blisters often appear in the nappy (genital) area and sometimes also on the upper arms, upper legs and bottoms of children.
  • Because of the sore mouth, the child may refuse to take some foods and drinks.
  • Most adults will have had the infection in childhood, but if they catch it they will usually have the ulcers in their mouth, but less commonly have the rash.

How long does it take to develop?

It takes 3 to 5 days after first being in contact with the virus for the disease to develop.

How long is it infectious? 

  • A person with the disease is infectious until the blisters dry up. There are viruses in the fluid of the blisters, and they can also be spread by coughing, sneezing and putting objects in the mouth.
  • The virus is found in the child's poo, and can still be there for several weeks after the child has recovered. Careful hygiene practices are always needed in child care centres and at home.
  • Children with hand foot and mouth disease should not attend school or child care until all the blisters have dried up.

What parents can do

  • There is no treatment which will make hand, foot and mouth disease go away more quickly.
  • Give paracetamol for fever if needed (see the topic Using paracetamol or ibuprofen).
  • Offer plenty of drinks. Avoid drinks like orange juice, which is acidic and can cause pain if the mouth has ulcers. Your child may prefer cold drinks, including cold milk drinks, or ice blocks (these can be made with milk). It does not matter if children do not eat for a day or so if they are having some drinks.
  • See your doctor if your child is unwell, or has a bad headache that persists, or a high fever.
  • Allow blisters to dry naturally.
  • There is no immunisation against hand, foot and mouth disease.

The topic Feeling sick has suggestions for caring for a sick child.

References

SA Health, 'Hand, Foot and Mouth Disease - symptoms, treatment and prevention'.

Centers for Disease Control and Prevention. 'Hand, foot and mouth disease',
http://www.cdc.gov/hand-foot-mouth/index.html

Trefts CE, ‘Hand, foot and mouth disease’ in 'Pediatric Clinical Advisor', Garfunkel LC, Kaczorowski J, and Christy C (Ed.), Mosby 2007.

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The information on this site should not be used as an alternative to professional care. If you have a particular problem, see a doctor, or ring the Parent Helpline on 1300 364 100 (local call cost from anywhere in South Australia).

This topic may use 'he' and 'she' in turn - please change to suit your child's sex.

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