Hand, Foot, and Mouth Disease

Signs and Symptoms

HFM disease (not to be confused with hoof and mouth disease, a totally unrelated illness that affects barnyard animals and livestock) causes painful blisters in the throat, tongue, gums, hard palate, or inside the cheeks. Blisters are red with a small bubble of fluid on top and often turn into ulcers. The soles of the feet and the palms of the hands also may be affected with a rash that can look like flat red spots or red blisters.

Occasionally, a pink rash may be seen on other parts of the body, such as the buttocks and thighs. However, some children with HFM disease develop no symptoms, or if they do, may only have sores in the back of the throat.

It can be hard for a parent to tell if a child (especially a preverbal child) has HFM disease if sores are only inside the mouth or throat. Very young kids may not be able to complain of a sore throat, but if a child stops eating or drinking, or wants to eat or drink less often, it's a signal to parents that something is wrong.

A child also might:

• develop fever, muscle aches, or other flu-like symptoms
• become irritable or sleep more than usual
• begin drooling (due to painful swallowing)
• gravitate toward cold fluids

Treatment

If your child is continually irritable or refusing food or drink, it's time to see the doctor. While there is no medical cure for HFM disease (the illness needs to run its course), the doctor might recommend home health remedies to make your child more comfortable during recovery.

Acetaminophen or ibuprofen can be given to console a child who is achy or irritable or ease painful mouth sores or discomfort associated with fever. Do not give aspirin to children or teens as it may cause a rare but serious illness called Reye syndrome.

A child who has difficulty swallowing might be prescribed "magic mouthwash"— a mixture made by pharmacists that can be dabbed onto sores to alleviate pain. Cold foods like ice cream and popsicles ease pain by numbing the area, and will be a welcome treat for those who have difficulty swallowing (and even those who don't!).

Kids with blisters on their hands or feet should keep the areas clean (wash with lukewarm soap and water, pat dry) and uncovered. If a blister pops, dab on a bit of antibiotic ointment to help prevent infection and cover it with a small bandage.

It is very important to make sure your child drinks plenty of fluids to prevent dehydration. Call your doctor if your child remains very irritable; can't be consoled; is lethargic; or has signs of dehydration such as dry tongue, sunken eyes, or decreased urine output; or if symptoms worsen.

HFM disease usually resolves within several days to a week and kids recover completely. Very rarely it can lead to complications such as viral meningitis (infection of the fluid around the brain and spinal cord) or encephalitis (infections and inflammation of the brain)

Preventing the Spread

There is no vaccine to prevent HFM disease or any other similar infection. HFM is contagious and can spread through contact with feces, saliva, mucus from the nose, or fluid from the blisters. Even after recovery, kids can pass the virus in their stool for several weeks, so still can spread the infection to others even though they're no longer sick.

Hand washing is the best protection. Remind everyone in your family to wash their hands frequently, particularly after using the toilet, changing a diaper, before meals, and before preparing food. Shared toys in childcare centers should be cleaned often with a disinfectant because these viruses can live on objects for several days.

Keep kids home from school and childcare while they have a fever or open blisters on the skin and mouth.

Reviewed by: Yamini Durani, MD
Date reviewed: June 2011