Hand-Foot-Mouth Disease

Main 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% of skin area)
  • 1 to 5 water blisters per hand or foot
  • Small blisters or red spots on the buttocks (30% of skin area)
  • Low-grade fever 100° to 102°F (37.8° to 39°C)
  • Mainly occurs in children age 6 months to 4 years
  • Cause: Coxsackie A-16 virus

See More Appropriate Topic

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 > 8 hours)
  • Stiff neck, severe headache or acting confused

Call Your Doctor Within 24 Hours (between 9 and 4) If

  • You think your child needs to be seen
  • Red, swollen and tender gums
  • Fever persists > 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

Home Care Advice for Hand, Foot and Mouth Disease

  1. Antacid for Mouth Pain: Use a liquid antacid 4 times per day.
    • For younger children, put 1/2 teaspoon in the front of the mouth 4 times per day after meals.
    • Children over age 4 can use 1 teaspoon as a mouth wash after meals.
  2. 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 rather than a bottle. (Reason: The nipple can cause pain)
  3. Fever Medicine: Give acetaminophen or ibuprofen for fever > 102°F (39°C) or severe mouth pain
  4. Contagiousness: Quite contagious but a mild and harmless disease. Incubation period is 3-6 days. Can return to daycare or school after the fever is gone (usually 1 to 3 days)
  5. Expected Course: The fever lasts 2 or 3 days. The mouth ulcers resolve by 7 days. The rash on the hands and feet lasts 10 days
  6. Call Your Doctor If
    • Signs of dehydration develop
    • Fever lasts > 3 days
    • Your child becomes worse or develops any of the “Call Your Doctor” symptoms