Hand, Foot, and Mouth Disease

You may have heard about an outbreak of hand, foot and mouth disease at your daycare center or school recently and had many questions.  Hand, foot, and mouth disease is an infection that causes painful sores to form in your child’s mouth, and on the hands, feet, buttocks, and sometimes the genetalia.  The sores can make it painful for your child to swallow, handle objects, or walk. 

Hand, foot, and mouth disease is a common illness that most often affects infants and children younger than 5 years old, but can affect adults as well.  Children are more susceptible to the disease due to a multitude of factors.  Your child’s immune system is still developing the resistance needed to fight off infection and disease and hence will contract viruses much more easily.  Children are also often involved in daycare or school and are exposed to a greater number of disease carrying individuals.  Also, children as you know put everything in their mouths, which provides an excellent transport medium for viruses from child to child.  Hand, foot, and mouth disease is caused by an enterovirus called coxsackievirus. Cosackievirus A-16 is the most common cause of hand, foot, and mouth but others have also been proven to cause the disease. 

Children who contract the disease are often requested to stay home from daycare or school because the coxsackie virus is highly contagious.  Hand, foot, and mouth can be spread in a variety of ways.  The disease can be spread by nose and throat secretions (such as saliva, sputum, or nasal mucus), blister fluid, and feces (stool).  The disease may be contracted by close personal contact, the air (by coughing or sneezing), contact with contaminated objects and surfaces (such as toys), and contact with feces (such as changing a diaper).  Your child is most contagious with the virus during the first week. 

Your child will start experiencing symptoms of the disease 3 to 6 days after being exposed to the virus.  The initial symptoms of hand, foot, and mouth disease include:

  • a prodromal fever around 101 degrees to 103 degrees
  • malaise 
  • decreased appetite
  • sore throat

 One or two days after the fever begins, painful sores or blisters will present in the mouth.  These sores are called herpangina.  They begin as sore red spots that often turn into ulcers.  The sores are often in the back of the mouth as well.  The sores may also present on the hands, feet and occasionally the buttocks.  A skin rash may also appear.        

A healthcare provider can diagnose the disease based on looking at the blisters and sores. Tests are available but are not typically necessary to diagnose the disease.

Hand, foot, and mouth disease is treated with supportive care.  Since it is a virus, antibiotics will not cure the disease.  Offering your child plenty of cold fluids such as ice pops and ice cream may help alleviate the discomfort.  Spicy foods and drinks such as orange juice may make the sores more painful and should be avoided.  Over the counter pain relievers such as acetaminophen (Tylenol) and ibuprofen (Motrin) may be used to treat discomfort and fever.  Aspirin should not be utilized as it may cause a serious disease known as Reye’s syndrome. 

Hand, foot, and mouth disease is a short lived disease.  The fever and discomfort are usually gone in 3 to 4 days.  The mouth blisters and sores will health in about a week.  The rash on the hands and feet may last longer, up to 10 days. 

Complications related to hand, foot, and mouth disease are rare and occur due to the pain caused by the sores in the mouth.  Dehydration can occur due to the child refusing to drink fluids because of the discomfort.  You should contact a health care provider if your child has not urinated for more than 8 hours or the child is acting very sick. 

You can help prevent your child from contracting the disease by washing your hands often and encouraging them to frequently wash their hands.  Disinfecting toys, tabletops, and other items your child may touch will also help prevent the spread of the disease.  If your child does contract the disease, they should be kept away from other people during the first week of the disease to help prevent transmission to others. 


  • Center for Disease and Prevention.  (2013).  Hand, foot, and mouth disease.  Retrieved from www.cdc.gov/hand-foot-mouth/index.html 
  • Hay, W. W., Levin, M. J., Deterding, R. R., & Abzug, M. J.  (2014).  Current diagnosis & treatment:  Pediatrics (22nd edition).  New York: McGraw Hill Education.
  • Modlin, J. F.  (2014).  Patient information: Hand, foot and mouth disease (The Basics).  UpToDate.  Retrieved from www.uptodate.com
  • Schmitt, B. D.  (2004).  Hand, foot, and mouth disease.  McKesson Health Solutions, LLC. 
  • WebMD.  (2012).  Hand-foot-mouth disease.  Retrieved from www.webmd.com/children/guide/hand-foot-and-mouth-disease-topic-overview