Hand-Foot-Mouth Disease

911 warning

Hand-Foot-And-Mouth Disease

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A viral infection that causes mouth ulcers and tiny blisters on the hands and feet

Symptoms

Small painful ulcers in the mouth, especially on tongue and sides of mouth (in all children)
Small, thick-walled water blisters (like chickenpox) or red spots located on the palms, soles, and webs between the fingers and toes (70%)
1 to 5 water blisters per hand or foot
Small blisters or red spots on the buttocks (30%)
Low-grade fever less than 102° F (39° C)
Mainly occurs in children age 6 months to 4 years

Cause

Return to School

Can return to child care or school after the fever is gone (usually 2 to 3 days). The rash is not contagious.

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	Call Your Doctor Now (night or day) If
	Your child looks or acts very sick Signs of dehydration (e.g., very dry mouth, no tears, no urine in more than 8 hours) Stiff neck, severe headache or acting confused (delirious) You think your child needs to be seen urgently
	Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If
	You think your child needs to be seen, but not urgently Red, swollen and tender gums Ulcers and sores also present on outer lip Fever present for more than 3 days
	Call Your Doctor During Weekday Office Hours If
	You have other questions or concerns
	Parent Care at Home If
	Probable hand-foot-mouth disease and you don't think your child needs to be seen

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Reassurance: Hand-foot-mouth disease is a harmless viral rash.
Liquid Antacid for Mouth Pain:
- Use a liquid antacid 4 times per day.
- For younger children, put ½ teaspoon (2 ml) in the front of the mouth 4 times per day after meals.
- Children over age 4 can use 1 teaspoon (5 ml) as a mouthwash after meals.
Soft Diet:
- Encourage favorite fluids to prevent dehydration.
- Cold drinks, milkshakes, popsicles, slushes, and sherbet are good choices.
- Avoid citrus, salty, or spicy foods.
- For infants, give fluids by cup, spoon or syringe rather than a bottle. (Reason: The nipple can cause pain.)
- Solid food intake is not important.
Fever Medicine: Give acetaminophen (e.g., Tylenol) or ibuprofen for fever above 102° F (39° C) or severe mouth pain.
Contagiousness:
- Quite contagious but a mild and harmless disease.
- Incubation period is 3-6 days.
- Can return to child care or school after the fever is gone (usually 2 to 3 days).
- The rash is not contagious.
Expected Course:
- Fever lasts 2 or 3 days.
- Mouth ulcers resolve by 7 days.
- Rash on the hands and feet lasts 10 days. The rash on the hands and feet may then peel.
Call Your Doctor If:
- Signs of dehydration develop
- Fever present over 3 days
- Your child becomes worse

Updated:

March 22, 2017