What is hand, foot, and mouth disease?

Hand, foot, and mouth disease is an infection caused by a virus. It’s common in young children under the age of 5 years but older children and adults may also get it. This disease is not the same as hoof and mouth disease in animals.

What is the cause?

Hand, foot, and mouth disease is usually caused by the coxsackievirus. When someone is infected, the virus lives in mucus and saliva and can spread from person to person through coughing and sneezing. It can also be spread by unwashed hands or contact with fluid from skin blisters or bowel movements.

A child is most likely to spread the virus to others during the first week that they have symptoms. However, the virus may be spread for days or even weeks after symptoms go away. Children can spread the virus in their bowel movements for several weeks.

What are the symptoms?

Symptoms start about 1 week after a child comes into contact with the virus. At first, symptoms may include:

• Fever
• Sore throat
• Stomach pain
• Headache

After 1 or 2 days, your child may have:

• Small red spots in the mouth that can turn into blisters or sores. Because of the sores, your child may drool or may not want to eat or drink because the sores make it painful to swallow.
• A skin rash that looks like flat or raised red spots, sometimes with small blisters. The rash may appear on the palms of the hands and soles of the feet, between the fingers and toes, or on the buttocks.

Some children have blisters or sores in their mouth but don’t get a rash on their hands or feet. When the infection affects just the mouth, the illness is called herpangina or stomatitis.

The fever and illness may last up to 5 days but the mouth and skin blisters may last up to 10 days.

How is it diagnosed?

Your child’s healthcare provider will ask about your child’s symptoms and medical history and examine your child. Lab tests are usually not needed.

How is it treated?

There is no specific treatment for hand, foot, and mouth disease. Since it is caused by a virus, antibiotics do not help. However, there are some things you can do to help your child feel better:

Your child’s healthcare provider may recommend medicines, such as:

• Acetaminophen or ibuprofen for fever and discomfort.
  • Nonsteroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen and aspirin, may cause stomach bleeding and other problems. Read the label and give as directed. Unless recommended by your healthcare provider, your child should not take the medicine for more than 10 days.
  • Do not give any medicine that contains aspirin or salicylates to a child or teen. This includes medicines like baby aspirin, some cold medicines, and Pepto-Bismol. Children and teens who take aspirin are at risk for a serious illness called Reye’s syndrome.
• Prescription mouthwash to coat and soothe your child’s mouth
• Nonprescription numbing spray to help your child’s mouth feel better.

Some other things you can do for pain caused by sores in the mouth include:

• Give your child frequent sips of cool liquids. Avoid sodas and citrus drinks like orange juice that might irritate the sores.
• Give your child cold foods like ice cream and ice pops.
• If your baby does not want to breastfeed or suck on a bottle, feed your child with a dropper, spoon, or sippy cup.
• Offer soft, bland foods like mashed potatoes, pudding, applesauce, and macaroni and cheese. Avoid acidic, salty, or spicy foods like tomatoes, pretzels, and tacos.

If your child has blisters on the skin:

• Keep the blisters clean, dry, and uncovered. You may wash them with mild soap and water.
• If blisters open, put a small amount of antibiotic ointment on them.
• Wear latex or rubber gloves when you are caring for the blisters. Wash your hands well when you are done.

Ask your child’s healthcare provider:

• How long it will take to recover.
• What activities your child should avoid and when your child can return to normal activities.
• How to take care of your child at home.
• What symptoms or problems you should watch for and what to do if your child has them.

Make sure you know when your child should come back for a checkup.

How can I help prevent hand, foot, and mouth disease?

There is no shot that can prevent this disease. To prevent spread of the infection to others, keep your child home while he or she is ill. Your healthcare provider can tell you when your child can go back to daycare or school. This is usually when your child has no fever or open skin blisters and your child feels better.

Other things you can do to help prevent the spread of the infection include:

• Wash your child’s hands often with soap and water.
• Make sure everyone who cares for your child washes their hands. This is especially important after changing diapers or touching the blisters.
• Clean toys and surfaces that your child touches with soap and water. Then clean them again with a solution of 1 tablespoon of bleach mixed with 4 cups of water.
• Teach your child to cough and sneeze into a tissue or into the bend in his elbow. Throw away used tissues right away.
• Don’t let your child share items like toys, cups, and spoons.
• Keep your child from hugging, kissing, or having close contact with others.