How to Spot Hand-Foot-and-Mouth Symptoms

Learn how to spot symptoms of hand-foot-and-mouth disease.

With immune systems that are still maturing, kids get sick — and often. So it’s not surprising when children come home from school, daycare or even a day at the playground with a runny nose, cough or fever. But a rash or sores appearing on their hands and feet?

No need to panic. It could be a sign of a common, highly contagious viral infection known as hand-foot-and-mouth disease.

“There’s nothing more stressful for a parent than seeing an open sore or rash,” says Allison Schuessler, DO, a pediatrician at Geisinger. “Luckily, hand-foot-and-mouth disease is a mild virus that often heals itself, even without medication.”

Hand-foot-and-mouth, usually caused by the coxsackievirus, is passed through contact with an infected person’s bodily fluids, including saliva from coughs or sneezes, nasal secretions or feces. Though it has a similar name, it’s not related to the foot and mouth disease found in animals.

Adults can contract hand-foot-and-mouth disease, but kids under age 7 are most at risk. The infection is common in childcare settings, as many young children are together over the course of frequent diaper changes. And at this age, children put just about everything into their mouths.

Knowing the common signs of the condition can help you rest easy and get your child the care they need.

Hand-foot-and-mouth disease symptoms

Hand-foot-and-mouth disease symptoms typically appear three to five days after exposure and can last up to 10 days. Kids may have some or all of these symptoms:

Fever and muscle aches
Sore throat
Nausea and a general ill feeling
Loss of appetite
Painful, red blisters on the tongue, gums and inside of the cheeks
A red, white or gray skin rash on the palms, soles and diaper area. The sores look like flat or slightly raised red spots that can blister. They can also be itchy and uncomfortable.

In most cases, kids start with a fever and sore throat, and then the rash and painful blisters appear one to two days later. Kids are most contagious during the first week of having hand-foot-and-mouth disease.

“Babies and very young children can become irritable, fussy and may sleep more often,” says Dr. Schuessler. “They may even drool more than usual due to painful swallowing.”

Hand-foot-and-mouth disease treatments

The good news? Hand-foot-and-mouth disease is mild and most kids begin to feel better in seven to 10 days. Because it’s a virus, there is no specific medical treatment, but you can manage your child’s symptoms at home.

Offer plenty of fluids to keep kids hydrated and make sure they’re getting lots of rest. Soothe your child’s sore throat and mouth by offering cold foods, such as smoothies and popsicles. Just be sure to avoid hot drinks and acidic fruit juice, such as orange juice, because they can make the pain worse.

You can also reduce fever and discomfort with non-aspirin medicine, such as acetaminophen. If your child is older than 6 months, you can try ibuprofen. Do not give children over-the-counter aspirin or cough and cold medicine. They can be dangerous for young children.

Keep the blisters clean and uncovered, and avoid touching them. Fluid in the blister can’t spread the virus and isn’t contagious.

Call your pediatrician if your child:

Is younger than 6 months of age
Has a weakened immune system
Has a fever that lasts longer than three days
Has trouble drinking fluids due to painful mouth sores
Has symptoms that don’t improve after 10 days

“In extremely rare cases, hand-foot-and-mouth disease can cause complications, including viral meningitis (swelling around the brain and spinal cord) and encephalitis (swelling of the brain),” says Dr. Schuessler. “Children under age 5 and people with weakened immune systems are at a higher risk of complications.”

Seek immediate medical attention if your child has:

A severe headache
A stiff neck
Back pain
Seizures
Extreme tiredness or changes in consciousness

Hand-foot-and-mouth disease prevention

Steps you can take to help prevent your child from contracting hand-foot-and-mouth disease include:

Frequent handwashing. Teach kids to wash their hands often with soap and warm water for at least 20 seconds, especially after going to the bathroom or blowing their noses. When soap and water isn’t available, hand sanitizer is the next best thing.
Avoiding shared items. Make sure children don’t share drinking cups, utensils or towels.
Disinfecting common surfaces. Use a disinfectant to clean high-traffic areas and shared surfaces, such as doorknobs, tables and toys. The virus can live on surfaces for a few days.
Avoiding close contact. Since hand-foot-and-mouth disease is highly contagious, it’s best to keep children home until they’re fever-free and off fever-reducing medications for 24 hours. Because the rash itself isn’t contagious, they may return to school or childcare before the rash is gone.

“If kids are old enough, explain to them why it’s best not to put their fingers or toys in their mouths,” says Dr. Schuessler, adding that it’s possible to contract the virus more than once, but symptoms will be less severe. “Remember, good hygiene habits are equally important for kids and parents, as adults carry the infection even when their own immune system fights it off.”