While the name might sound scary, hand, foot, and mouth disease is a very common childhood illness that rarely causes any serious or lasting problems. Named for the rash that the virus causes on children’s hands and feet, this disease is very contagious and spreads easily, especially during the summer and fall in children under five.
Keeping track of all of the viruses and infections your child might be exposed to can be overwhelming for parents and caregivers. As viruses and childhood illnesses go, hand, foot, and mouth disease is not one to lose sleep over. It is relatively mild, short-lived, and easily prevented with many of the same behaviors we learned during the COVID-19 pandemic.
What causes hand, foot, and mouth disease?
Most often, a group of viruses called the coxsackie viruses cause hand, foot, and mouth disease. It’s not the same disease that infects livestock and other animals (sometimes called hoof-and-mouth disease). Humans can’t get the animal disease and animals can’t get the human disease.
Just like colds and the flu, there are different versions or types of the virus that can cause hand, foot, and mouth disease. This means you can get it more than once – all the more reason to learn how to prevent it.
The viruses that cause hand, foot, and mouth disease can be spread in saliva and droplets in the mouth, nose, and throat, as well as through stool (if you don’t wash your hands completely after changing your child’s diaper, for example). The virus can be spread by sharing drinking cups, putting toys in your mouth, kissing, and talking closely with someone who’s infected.
What are the symptoms?
Symptoms usually appear 3 to 6 days after the initial infection (exposure to another person with hand-foot-mouth disease). The first symptoms parents usually notice are loss of appetite, generally not feeling well, and then developing a fever and sore throat. Other symptoms include:
- Sores or painful blisters in the mouth (on gums, tongue, and inside of cheeks)
- Rash on the palms of the hand or soles of feet
- Rash on buttocks (less common)
- Sore throat
- Feeling sick
- Loss of appetite
- Fussiness or irritability in babies and toddlers
As with most viruses, your child may only have some but not all of these symptoms. Different children may have different symptoms, and some may get sicker than others. Hand, foot, mouth disease is usually a minor illness; your child should start feeling better within a few days. Peeling skin can occur during recovery, and although it looks strange it’s not painful or worrisome.
How do I treat the virus?
Like other viruses, there aren’t any medications or antibiotics to treat or cure hand, foot, and mouth disease. There are some medications and treatments to try that can help your child feel better if they do get infected, including:
- Over-the-counter pain medications, such as ibuprofen (Advil) or acetaminophen (Tylenol) if your child is running a fever or has painful mouth sores; follow packaging dosing instructions by age and weight
- Aloe skin gel if the skin rash is itchy or uncomfortable
- Drinking plenty of fluids to stay hydrated.
- Soft foods, soups, yogurts, popsicles, and smoothies may help soothe a sore mouth.
- Avoid drinks and foods that could irritate the mouth sores (acidic drinks like orange juice, salty, spicy, or hot foods).
- If your child is old enough, have them rinse their mouth with warm water after eating.
Should I see my healthcare provider?
No. In general, you do not need to see a healthcare provider. This is especially true if you know that they might have been in close contact with someone who has the virus. There are a few cases where you might want to see a healthcare provider, such as:
- Your child is younger than six months.
- Your child has a weakened immune system.
- Your child has mouth sores or a sore throat that makes it painful to drink fluids.
- Your child’s symptoms don’t improve after 10 days.
- Your child’s fever lasts longer than 3 days.
- You need help diagnosing your child’s illness.
Can I get hand, foot, and mouth disease from my child?
Yes, although not easily. Adults generally have stronger immune systems, so are less likely to get infected. We also are better at washing our hands and don’t put as much in our mouths as toddlers do. Nevertheless, it is a good idea to step up your hand-washing routine, especially when caring for your child and after changing diapers.
Do I have to keep my child out of daycare, school, or other activities?
Maybe. Each school, daycare, or caregiver may have its own policies, but in general, as long as your child doesn’t have a fever, can control their drool/avoid putting things in their mouth, and seems to be feeling well, they can head back to school or be around other children. We know that children can spread hand, foot, and mouth disease starting the day before the rash shows up and for several days after the rash appears, but don’t know exactly when they are no longer contagious.
How can I prevent my child from getting sick?
- Frequent handwashing (long enough to be able to sing “Happy Birthday,” using enough soap to cover all surfaces of your hands and wrists, lathering and scrubbing all surfaces of your hands, fingertips, fingernails, and wrists).
- Avoiding close contact (observe the six feet or an adult bike’s length apart rule ) with anyone with hand-foot-mouth disease.
Because hand, foot, and mouth disease is so contagious, it’s important you tell other people and children that your child has been around that your child has hand, foot, and mouth disease. This includes your child’s other caregivers, daycare, or school.
You should not feel ashamed that your child has hand, foot, and mouth disease, it’s incredibly contagious and hard to avoid. Learning more about how mild and common this childhood illness is and how to prevent its spread by reading this information sheet will help you talk more confidently with other parents or caregivers.
“Hand-foot-and-mouth-disease.” Mayo Clinic. Mayo Clinic. August 16, 2022. https://www.mayoclinic.org/diseases-conditions/hand-foot-and-mouth-disease/symptoms-causes/syc-20353035
“Hand-foot-and-mouth-disease (HFMD).” CDC. CDC. February 2, 2021. https://www.cdc.gov/hand-foot-mouth/index.html
“What to do if your child has hand, foot, and mouth disease?” Children’s Hospital of Philadelphia. Children’s Hospital of Philadelphia. May 17, 2022. https://www.chop.edu/news/health-tip/hand-foot-and-mouth-disease-what-you-need-know