Hand, foot & mouth disease

What is hand, foot & mouth disease?

Hand, foot, and mouth disease (HFMD) is a common childhood illness that causes fever, as well as its signature symptoms—blister-like sores in the mouth and/or a skin rash on the palms of hands and soles of feet. The most common cause of HFMD is the coxsackievirus A16, though it can also be caused by other enteroviruses. HFMD is more common in young children under the age of 5 years old.

HFMD spreads easily through contact with an infected person, either through running noses or secretions from sneezes and coughs, fluid from the blisters, or the stool of an infected person. Children are most contagious during the first week that they are ill, but they can still infect others for weeks after the signs and symptoms have disappeared. 

Also, don't confuse HFMD with foot-and-mouth disease (FMD)—also known as hoof-and-mouth disease—which affects cattle, sheep, and pigs. Humans do not get FMD. 

What are the symptoms of HFMD? 

The first signs of HFMD include fever, loss of appetite, and/or sore throat. Your child may generally "act sick." Within 1–2 days after the onset of fever, he may begin to develop painful sores on his tongue, gums, and the inside of his cheeks. The sores begin as red spots that blister and often become ulcers. A rash, which does not itch, typically develops for 1–2 days on the palms of the hands or the soles of the feet (and may also appear on the buttocks or genitalia). In some cases, however, someone who has HFMD may have only the rash or only the sores. 

How is HFMD treated? 

Unfortunately, like other viruses, there is no specific treatment for HFMD—it simply needs to run its course. In the meantime, parents can treat the symptoms to make their child more comfortable. Give over-the-counter medications, such as ibuprofen or acetaminophen, to relieve pain and fever. (Check with your child's pediatrician if you are unsure about dosing, which is best calculated according to your child's weight.) For mouth pain, numbing mouthwashes or sprays may also provide relief.

How can HFMD be prevented? 

Although there isn’t a vaccine to prevent HFMD, good hygiene practices go a long way toward reducing your child’s risk of infection. 

  • Wash hands often, especially before eating.
  • If soap and water aren’t available, clean hands with hand sanitizer (containing at least 60% alcohol).
  • Encourage your child to avoid touching their eyes, nose, or mouth (unless their hands are clean).
  • Teach them to cover their mouth and nose with a tissue or their sleeve (not hands) when coughing or sneezing.
  • Try to avoid close contact, such as kissing, hugging, or sharing eating utensils or cups with people who are sick.

Contaminated surfaces and items should also be disinfected. The CDC recommends you first wash items with soap and water, then disinfect them with a solution of chlorine bleach (made by mixing 1 tablespoon of bleach with 4 cups of water) or a cleaning product that contains bleach.

When should I call a doctor? 

Parents should seek medical attention if the sores in their child’s mouth (or a sore throat) prevent the child from drinking fluids or if the child’s symptoms worsen after a few days.

Last updated January 1, 2022

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