Hand, foot, and mouth disease is a common childhood virus that typically occurs in children under 5 years old. Mouth sores, a rash on the hands and feet, and fever can all be symptoms of hand, foot, and mouth. The main risk is dehydration from fevers and painful sores in the mouth that may make drinking difficult.

It takes 3-6 days from exposure for symptoms to show up. Usually, a fever, sore throat, or cold symptoms like a runny nose come first. Then, a rash with small blisters may appear on the lips, gums, and inside of the mouth. The rash may also appear on the soles of feet, palms of hands, buttocks, and thighs.

Some children may only get mouth sores. If you notice your child is not wanting to drink or eat as much, or seems more fussy and irritable, it could be a sign of sores in the throat or mouth.

Symptoms worsen within the first few days and last up to a week. It is common for the rash to peel on the fingers and toes 1-2 weeks after symptoms have resolved.

How to manage symptoms

Keeping your child from picking or itching at their rash or sores is important. You also want to make sure they're drinking enough fluids. If they are in pain from the sores or have fevers, try giving Tylenol or ibuprofen.

For children with mouth sores, try giving cool drinks, smoothies, or popsicles. Avoid giving anything hot, spicy, or citrus.

Keep the blisters on the hands and feet clean and uncovered. You can wash the areas with lukewarm water and soap, then pat dry. If the blister pops, apply a small amount of antibiotic ointment, and cover with a bandaid.

Prevent the spread

Did you know that hand, foot, and mouth disease can spread from contact with fecal matter (poop)? It also spreads from a sneeze or cough. Transmission occurs via the respiratory and fecal-oral routes. Hand, foot, and mouth is typically caused by the coxsackievirus.

Prevent the spread by teaching your child to wash their hands after coughing, sneezing, and using the bathroom. Wash toys that have been in contact with your child's saliva, and separate the child with hand, foot, and mouth from other children in the household. Hand washing is the best method for reducing contagiousness.

The spread of hand, foot, and mouth disease is possible for up to 3 weeks after the infection begins, but it is most contagious during the first week. Children can usually return to school or daycare when fevers have resolved (are fever-free for 24 hours), sores have healed, and they feel better. It's still important to inform your childcare provider or school if your child has hand, foot, and mouth so they can track the spread and monitor symptoms in other staff or families.

Call your pediatrician if your child's fever lasts more than 3 days or if they are not drinking fluids.

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This article was written by Katie Taibl, BSN, RN, CPN. Katie has over nine years of experience working in pediatrics, with a background in travel nursing and clinical writing. As the Patient and Family Outreach Educator at Roslindale Pediatric Associates, she writes articles on relevant pediatric health topics to help RPA patients and their families access user-friendly health content.