Hand, Foot and Mouth Disease

What is hand, foot and mouth disease?

Hand, foot and mouth disease (HFMD) is a very contagious illness caused by a virus. The disease gets its name from the blister-like rash that forms on your child’s hands and feet and painful sores that develop in their mouth. The rash can actually appear anywhere on their body, including their chest, back, arms, legs, genitals and buttocks.

Infants and children younger than 5 are most likely to get hand, foot and mouth disease. It tends to spread quickly among children in daycare and schools. Still, older children and even adults can get it. Because several viruses can cause the disease, it’s possible to get HFMD multiple times.

Hand, foot and mouth disease is typically mild and usually clears up on its own within seven to 10 days.

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

Hand, foot and mouth disease symptoms typically appear in two stages. When the illness starts, your child might have flu-like symptoms, such as:

• Mild fever.
• Sore throat.
• Runny nose.
• Stomachache.
• Loss of appetite.

After a couple of days, these symptoms will go away and new symptoms will develop, including:

• An itchy rash on the palms of your child’s hands, soles of their feet, elbows, knees, genitals or buttocks.
• Painful mouth sores, which can develop anywhere in and around their mouth, including their tongue. The sores usually start as bright pink spots or tiny bumps that eventually turn into blisters.
• Swollen lymph nodes in their neck.

Symptoms of hand, foot and mouth disease usually clear within seven to 10 days. However, it can take children younger than 2 years old a little longer for their bodies to clear the virus.

What causes hand, foot and mouth disease?

Viruses belonging to the coxsackievirus and enterovirus families cause hand, foot and mouth disease. These viruses can be found in your child’s digestive tract, including their:

• Mouth.
• Esophagus.
• Stomach.
• Small intestine.
• Large intestine.
• Rectum.
• Anus (butthole).

Is hand, foot and mouth disease contagious?

Hand, foot and mouth disease is contagious. Your child is most contagious during the first few days of the illness, often before the rash appears. The blisters usually dry up in about 10 days. Your child is less likely to spread it to others once the blisters dry up. However, the virus can live in their stool (poop) for weeks after the rash goes away.

How is hand, foot and mouth disease spread?

The disease is highly contagious and spreads through:

• Airborne droplets when a person who’s infected sneezes or coughs.
• Contact with an infected person’s saliva or stool and then touching your mouth, eyes or nose.
• Direct contact with an infected person’s blisters.
• Kissing or hugging someone who has the virus.
• Sharing eating utensils, cups, towels or clothing.
• Touching contaminated toys, surfaces, doorknobs or other items and then touching your eyes, nose or mouth.

What are the risk factors for this condition?

Babies and children under the age of 5 are most likely to get hand, foot and mouth disease. Infants and children in daycare and schools are more likely to get the disease.

What are the complications of this condition?

Complications from hand, foot and mouth disease are rare. Occasionally, these problems occur:

• Dehydration: Mouth sores can make drinking and eating painful. It’s important to drink enough fluids to prevent dehydration.
• Nail loss: Some people lose a few fingernails or toenails after having the virus. The nails grow back.
• Viral meningitis and encephalitis: A very small number of people with hand, foot and mouth disease develop meningitis and encephalitis. These rare conditions cause dangerous swelling of the brain (encephalitis) and brain and spinal cord membrane (meningitis).

How does hand, foot and mouth disease affect pregnancy?

The virus rarely causes issues during pregnancy. Still, you should notify your healthcare provider if you’re expecting and are exposed to the virus.

How is hand, foot and mouth disease diagnosed?

A healthcare provider can diagnose hand, foot and mouth disease by looking at your child’s blisters. Occasionally, they’ll test for the virus by sending throat swab samples, or samples taken from blisters or stool (poop), to a lab.

If you know your child has been exposed to the virus, alert their provider before scheduling an exam. To protect the health of others, your provider may want to conduct a virtual visit and make treatment suggestions over the phone/computer.

How is hand, foot and mouth disease treated?

There’s no medication for hand, foot and mouth disease. Antibiotics won’t work because they don’t treat viruses. Fortunately, symptoms of HFMD are typically mild. Most people improve in a week or two with minimal at-home care. Hand, foot and mouth disease treatment may include:

• Over-the-counter (OTC) pain relievers for fever and pain, such as acetaminophen (Tylenol®) and ibuprofen (Advil®, Motrin®). Don’t give your child aspirin, which can cause Reye’s syndrome.
• Children who are old enough can try gargling with saltwater to reduce sore throat pain.
• Adults can use a numbing spray or mouthwash to relieve the pain.

Other tips for at-home treatment include:

• Avoid eating spicy or acidic foods that can make your mouth sores more painful.
• Drink cold liquids. Warm and hot beverages may make your mouth sores more painful.
• Keep your child hydrated with cold liquids or ice pops.

Can hand, foot and mouth disease be prevented?

The viruses that cause hand, foot and mouth disease are highly contagious. The infection often spreads before a person realizes they’re sick. You can slow or stop the spread of the illness through these good hygiene steps:

• Cough and/or sneeze into your elbow.
• Disinfect high-touch items, such as toys, countertops and doorknobs.
• Don’t share eating utensils, cups, towels, blankets or clothing.
• Keep infected children away from healthy children.
• Wash your child’s clothing, bedding and any other soiled items.
• Wash your hands often with soap and water for at least 20 seconds.

What should I expect if my child gets hand, foot and mouth disease?

While hand, foot and mouth disease is uncomfortable, it rarely causes long-term issues. Most children recover in less than two weeks with minimal treatment. It’s possible to have hand, foot and mouth disease multiple times.

How long does hand, foot and mouth disease last?

Most children with hand, foot and mouth disease will recover on their own within seven to 10 days.

When can my child go back to school?

Your child can return to school or daycare when:

• They feel well enough to participate.
• They don’t have a fever.
• Their blisters have dried up.

If you’re not sure if your child should return, ask their pediatrician.

How do I take care of my child if they have hand, foot and mouth disease?

Fortunately, the symptoms of HFMD are typically mild and go away on their own in about a week. As a parent caring for a child with hand, foot and mouth disease, your main goal is keeping your child hydrated and comfortable. Keep the fluids coming, encourage handwashing and keep your child away from situations where they could infect others.

What can/can’t my child eat/drink with this condition?

Painful mouth sores can make it uncomfortable to drink. Make sure your child stays hydrated by offering cold liquids such as water, milk or Pedialyte®. Avoid juice — the acidity can aggravate your child’s sores. You can also offer your child ice pops. Avoid spicy or acidic foods, as well as warm beverages, which can make their mouth sores more painful.

When should my child see their healthcare provider?

You should call a healthcare provider if your child:

• Isn’t drinking enough liquids to prevent dehydration.
• Has a fever that lasts for more than three days.
• Doesn’t seem to be improving after 10 days.
• Has severe itching or blistering.
• Has a weakened immune system.

What questions should I ask my child’s healthcare provider?

If your child has hand, foot and mouth disease, you may want to ask their provider:

• How long are they contagious?
• How long should my child stay home from school?
• Should I notify my child’s school about the infection?
• What steps can I take to ensure other family members don’t get infected?
• What can I do to make my child more comfortable?
• What can I do to alleviate symptoms like an itchy rash or mouth pain?
• What’s the best cream for hand, foot and mouth disease?
• How long will the rash last?
• Can the infection come back?
• What steps can I take to prevent getting hand, foot and mouth disease again?
• Should I look out for any signs of complications?

Can adults get hand, foot and mouth disease?

Yes. Hand, foot and mouth disease can occur in adults and older children, but it’s less common. Most adults who get HFMD don’t develop symptoms. When they do, the symptoms are the same as those that children get.

Is hand, foot and mouth disease the same as foot-and-mouth disease?

No. Foot-and-mouth disease is also known as hoof-and-mouth disease because it only affects livestock with hooves. Cows, sheep, goats and pigs can get it, but humans can’t. Different viruses cause the two diseases. While many people worry they can get hand, foot and mouth disease from a pet, you can’t. Animals can’t get HFMD.

Hand, foot and mouth disease vs. monkeypox — what’s the difference?

Hand, foot and mouth disease and monkeypox (now called mpox) are both viral infections that cause flu-like symptoms and rash. The difference is in the type of virus. A virus in the orthopoxvirus family causes mpox, whereas a virus in the coxsackievirus family causes hand, foot and mouth disease.

Hand, foot and mouth disease vs. herpangina — what’s the difference?

A virus in the coxsackievirus family causes both hand, foot and mouth disease and herpangina. The difference between the two diseases is that herpangina causes blisters or sores to form in your child’s mouth and throat only. It doesn’t cause a rash on their hands and feet as hand, foot and mouth disease does.