What is hand, foot and mouth disease?

Hand, foot and mouth disease is a common viral illness that mainly affects children under 10 years old, but can sometimes affect older children and adults. It is usually caused by infection with the coxsackie virus. Hand, foot and mouth disease is not the same as foot-and-mouth disease, which affects farm animals.

Hand, foot and mouth disease is highly contagious. It’s especially common in childcare and kindergartens.

What are the symptoms of hand, foot and mouth disease?

The most common symptoms of hand, foot and mouth disease are:

• fever
• tiny blisters in and around the mouth and on the hands and feet, and sometimes in the nappy area in infants, OR a red skin rash with a brown scale on the outer arms, hands, legs, feet, around the mouth and upper buttocks
• sore throat and mouth, which may make eating or drinking difficult
• runny nose
• cough
• loss of appetite
• tiredness

The symptoms of hand, foot and mouth disease usually start to appear 3 to 7 days after a person is infected, and typically last for 7 to 10 days.

Blisters inside the mouth are often the most troublesome symptom, because they can make eating and drinking quite painful. However, in some cases — especially in adults — symptoms are so mild that they are not noticeable.

In very rare cases hand, foot and mouth disease can cause serious illnesses that affect the heart, brain, lungs or eyes.

When should I see my doctor?

Young children are at higher risk of serious infection than older children, teenagers and adults.

Signs that a person might have a more serious form of hand, foot and mouth disease include any of the following:

• persistent fever (38°C or above for 72 hours or more)
• abnormal movements / jerking movements
• rapid breathing
• excessive tiredness, drowsiness
• excessive irritability
• difficulty walking
• showing signs of being dehydrated (such as not passing urine as often as usual)
• symptoms that are getting worse after a few days
• moving jerkily or can't walk properly

If any of these signs are present, see your doctor urgently.

What causes hand, foot and mouth disease?

Hand, foot and mouth disease is usually caused by infection with the coxsackie virus. It’s often spread through contact with the fluid within the blisters, as well as in fluids from the nose, mouth and lungs.

It can also be spread through the air by coughing, sneezing and talking.

How is hand, foot and mouth disease diagnosed?

Your doctor can usually diagnose hand, foot and mouth disease based on age, symptoms and the appearance of sores.

Laboratory tests, such as blood tests, are not usually needed.

How is hand, foot and mouth disease treated?

There is no specific treatment for the coxsackie virus that causes hand, foot and mouth disease. Antibiotics do not work.

It’s possible to make your child feel more comfortable by treating the symptoms:

• Paracetamol can ease pain and fever. Ask your doctor or pharmacist for advice on the right product and dose for your child.
• Give your child plenty to drink. Sips of water or oral rehydration fluid can stop them becoming dehydrated. Ice blocks or jelly can soothe a sore mouth.
• Give your child soft foods. Avoid tangy or acidic food that could sting a sore mouth.
• Encourage your child to rest. Keep them home from day care or school until their blisters dry up.

Allow blisters to dry out naturally. The blisters should not be deliberately burst because the fluid inside them is infectious.

See a doctor if symptoms are severe.

Can hand, foot and mouth disease be prevented?

The best way to prevent hand, foot and mouth disease from spreading is to practise good hygiene. This includes:

• washing hands thoroughly after touching fluids from an infected person
• making sure children don’t share items such as drinking cups
• teaching children how to wash their hands, how to cover their mouth when they cough, and how to cover their nose and mouth when they sneeze
• thoroughly washing any soiled clothing and any surfaces or toys that may have been contaminated

It’s important to keep children with the infection away from others as much as possible.