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%).
  • 1 to 5 water blisters per hand or foot.
  • Small blisters or red spots on the buttocks (30%).
  • 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.

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WHEN TO CALL YOUR DOCTOR FOR HAND, FOOT AND MOUTH DISEASE

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.

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

  • You think your child needs to be seen.
  • Red, swollen and tender gums.  
  • Fever persists 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.
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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 ½ 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.
  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, 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 102°F (39°C) or severe mouth pain.
  1. 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).
  2. 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.
  3. Call Your Doctor If:
    • Signs of dehydration develop.
    • Fever lasts for more than 3 days.
    • Your child becomes worse or develops any of the "Call Your Doctor" symptoms.
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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.

Pediatric HouseCalls Online. Copyright © 2000-2004 Barton Schmitt, M.D. FAAP

Reviewed 8/2004

Revised 7/2004

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