Community Health Network

Hand-Foot-Mouth Disease
Back to Index

Symptom
Description

Should I
Call?

Care at
Home

Does this describe your child's symptoms?

Definition

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 102Â° F (39Â° C)
Mainly occurs in children age 6 months to 4 years

Cause

Coxsackie A-16 virus
Not related to animal disease

Return to School

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

If not, see these topics

Only has mouth ulcers, see MOUTH ULCERS (Exception: exposed to HFM)
Only has a rash, see RASH - WIDESPREAD AND CAUSE UNKNOWN

Should I
Call?

Care at
Home

When to Call Your Doctor

	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)
	Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If
	You think your child needs to be seen Red, swollen and tender gums 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

Symptom
Description

Care at
Home

HOME CARE ADVICE FOR HAND-FOOT-MOUTH DISEASE

Reassurance: Hand-foot-mouth disease is a harmless viral rash.
Liquid Antacid for Mouth Pain: Â
- Use a liquid antacid 4 times per day.
- For younger children, put Â½ teaspoon in the front of the mouth 4 times per day after meals.
- Children over age 4 can use 1 teaspoon 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 102Â° F (39Â° C) or severe mouth pain.
Contagiousness: Â Quite contagious but a mild and harmless disease. Incubation period is 3-6 days. Â Can return to daycare or school after the fever is gone (usually 2 to 3 days). The rash is not contagious.
Expected Course: Â The fever lasts 2 or 3 days. Â The mouth ulcers resolve by 7 days. The rash on the hands and feet lasts 10 days.
Call Your Doctor If:
- Signs of dehydration develop
- Fever present over 3 days
- Your child becomes worse

And remember, contact your doctor if your child develops any of the "Call Your Doctor" symptoms.

Symptom
Description

Should I
Call?

Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

Author and Senior Reviewer: Barton D. Schmitt, M.D.

Last Reviewed: 1/19/2009

Last Revised: 10/1/2006

Content Set: Pediatric HouseCalls Online