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

• If only has mouth ulcers, see Mouth Ulcers
• If only has a rash, see Widespread Rashes with Unknown Cause

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