Hand, foot, and mouth disease

What is hand, foot, and mouth disease?

Hand, foot, and mouth disease (HFMD) is a common and contagious childhood illness, caused by the coxsackievirus. The disease is easy to spot because of its classic symptoms — sores or blisters inside and outside the mouth, as well as a rash (red spots) or sores on the palms of the hands and soles of the feet. Infants and children younger than age 5 are more likely to get the virus. On rare occasions, adults can get it. A mild outbreak of the disease commonly occurs during summer and early fall. The disease should not be confused with foot-and-mouth disease, which affects sheep, cattle, and pigs.

Symptoms of hand, foot, and mouth disease

If your child has hand, foot, and mouth disease, he or she may first develop a fever (which can be high), headache, poor appetite, sore throat, and feel overly tired. Sores or blisters around the mouth, hands, and feet are the last symptoms to appear. Symptoms usually appear three to seven days after coming into contact with someone with the disease. However, not every person gets the full set of symptoms. The classic sores or blisters appear one to two days after the start of the fever. They can be tender and mildly painful when touched or pressed. Sores inside the mouth (cheeks, gums, and throat) can develop. A rash will develop on the soles of the feet and palms of the hand. They can become blisters or sores. In rare cases, sores or blisters can appear on the elbow, knees, genitals, or bottom.

Further symptoms can develop from complications. Because the sores make it painful to swallow, children and adults can become dehydrated. High fevers can cause seizures.

What causes hand, foot, and mouth disease?

Hand, foot and mouth disease is caused by the coxsackievirus. It is part of a family of viruses known as enteroviruses. It is found in the digestive tract (the mouth, esophagus, stomach, small intestine, large intestine, rectum, and anus).

How is hand, foot, and mouth disease diagnosed?

Your child’s doctor will review your child’s recent signs of illness (fever, poor appetite, headache, sore throat), his or her age, and examine your child’s sores or blisters to diagnose hand, foot, and mouth disease. In rare cases, you child’s doctor may swab the back of your child’s throat to send to a lab, or ask that you collect a stool sample from your child for your doctor to send to a lab. The lab can test for the virus and rule out other possible causes of the symptoms.

Can hand, foot, and mouth disease be prevented or avoided?

Hand, foot, and mouth disease is contagious, so it’s important to avoid contact with anyone who has it. One way that hand, foot, and mouth disease spreads is through the tiny droplets that exit a person’s nose or mouth when they cough or sneeze. The virus enters your body when you touch your nose or mouth after touching something contaminated by the virus (the droplets, doorknobs, diapers, the fluid from the sores or blisters). You or your child won’t always know when another person has the virus (in the early stages), so it’s important for your entire family to practice good hand washing.

Hand, foot, and mouth disease treatment

Unfortunately, antibiotics cannot treat a virus, so your doctor will not prescribe them. Your doctor will recommend several tips to relieve the discomfort of your child’s symptoms. For example, you can give your child acetaminophen and ibuprofen (over-the-counter pain relievers) to treat fever and sore throat. Check the back of the box or consult your doctor on dosage. Sore throat pain also can be relieved by gargling salt water (combine ½ teaspoon salt with 1 glass of warm water and stir). Finally, make sure your child is getting plenty of fluids. Cold milk products are better than juice or soda. The acidity in juice and soda can irritate mouth sores and cause a burning sensation. If your child is having difficulty swallowing, try giving them non-juice popsicles. Your child should recover completely in 5 to 7 days.

Do not give your child aspirin for pain if your child is younger than age 18. Aspirin (especially when used for viruses, such as the flu or chickenpox) has been tied to Reye’s syndrome. Reye’s syndrome is a serious but rare condition that causes your liver and brain to swell. It can be deadly without early treatment. Call your doctor if your child appears confused, is having seizures, or has lost consciousness.

Living with hand, foot, and mouth disease

Living with hand, foot, and mouth disease is a short-term challenge since the virus passes after about a week. As a parent caring for a child who has the virus, your primary goals are to keep your child comfortable, at home to rest and away from situations that will infect others.

Questions to ask your doctor

  • Does the virus spread by touching the sores or blisters?
  • Can you apply an ointment to the sores to relieve the pain?
  • Do the sores or blisters leave long-term scars?
  • Do the sores inside your mouth take longer to heal than the sores on your hands and feet?
  • How long is my child contagious?