Healthy Kids

Hot Topic: Hand, Foot, and Mouth Disease

What is hand, foot, and mouth disease?

Hand, foot, and mouth disease (HFMD) is a common childhood illness that causes mouth sores and tiny blisters on the hands and feet. It is caused by types of the Coxsackie A virus and should not be confused with foot-and-mouth or hoof-and-mouth disease, which does not occur in humans.

What are the symptoms?

• Small painful sores in the mouth, especially on the tongue and sides of the mouth.
• Low-grade fever (less than 102°F).
• Small, thick-walled water blisters or red spots located on the palms of the hands, soles of the feet, and webs between the fingers and toes (in about 70% of children). The blisters may look similar to chickenpox.
• The new strain is causing a more widespread rash that can spread across the arms, legs, buttocks, torso, and face.
• In some new cases, the virus causes fingernails or toenails to fall off 10 to 14 days after infection.

Is it contagious?

Yes, HFMD spreads from person to person. Symptoms often do not appear until 3 to 6 days after exposure to the virus.

When can my child go back to school?

Your child can return to school or childcare after the fever is gone.

How can I care for my child at home?

Encourage your child to rest if he or she is not feeling well. If your child is uncomfortable, you can treat the symptoms:

For Mouth Pain:

1. Rinse mouth with water.
2. For more severe mouth pain, use a liquid antacid 4 times per day. For younger children, put ½ teaspoon (2 ml) in the front of the mouth 4 times per day after meals. Children over age 4 can use 1 teaspoon (5 ml) as a mouthwash after meals (spit out after rinsing).

For Fever:

If your child is uncomfortable, give acetaminophen (e.g., Tylenol) or ibuprofen for fever or severe mouth pain. Do not give ibuprofen to infants under 6 months.

Diet:

• Encourage drinking fluids (water, milk) to prevent dehydration.
• For infants, give fluids by cup, spoon, or syringe rather than a bottle.
• Avoid citrus, salty, or spicy foods, which can hurt your child’s mouth.

When should I call Kaiser Permanente?

Call us right away if your child: 

• Shows signs of dehydration (very dry mouth, no tears, no urine in more than 8 hours).
• Has a stiff neck, severe headache, or is acting confused.
• Becomes worse.
• Looks or acts very sick.

Call us within 24 hours if your child has these symptoms:

• Red, swollen, and tender gums.
• Sores on outer lip.
• A fever for more than 3 days.

Please call us if you are concerned about your child’s symptoms.

For more information, review our HFMD article on My Doctor Online.