Hand, Foot and Mouth Disease

Caused by infection with coxsackie virus, hand, foot and mouth disease (HFMD) is a common disease of childhood.

Children with HFMD are quite contagious with the virus spreading readily by contact with infected body fluids (mostly saliva). The spread is most readily controlled by good hand hygiene, especially before eating.

HFMD most commonly presents with a variable number of blister-like spots which may affect the hands, feet or mouth. Sometimes one or more of these areas have no spots at all. The spots are often painful and in severe cases cause a lot of distress. Most children will have a temperature for a few days and many will be sore and miserable. Abdominal discomfort, cough and malaise are also common.

There is no cure for HFMD but it is useful to have the diagnosis confirmed by a doctor, especially if your child seems to be in pain or unwell in any way. Treatment is symptomatic - painkillers, Bonjela may help mouth ulcers but is poorly tolerated and for children who can use a mouthwash, Difflam spray or oral rinse may help.

It does not matter if normally healthy children do not want to eat for a day or two but all children should be encouraged to drink fluids. Ice blocks may be soothing and it may be appropriate to allow sugary sports drinks - they are not so sore on the mouth!

The sores usually take 5-7 days to heal in the mouth and 7-10 days elsewhere.

This picture shows a severe case of HFMD affecting the mouth of a small child. The tip of the tounge and both lips had very painful sores. The sores have a red margin which does not show well on this picture.

Fortunately, one infection usually leads to lifelong immunity (although there are always exceptions as more than one type of coxsackie virus causes HFMD) so the illness is relatively rare in adults.

Children with HFMD can be infectious for an extended period of time (weeks to months) but the risk of infection being passed on is very small unless there is a high temperature. Please keep children away from others whilst they have a temperature and until the sores have healed. The usual incubation period is 3-6 days.

Although HFMD is generally a mild condition, there are a few cases every year where the illness is more severe. If your child is more than mildly unwell please take them to a doctor. Difficulty in breathing or irritability which does not settle quickly with medication would be cause for immediate concern.

This image shows the classic spots of HFMD on a foot. At first glance they look similar to varicella (chickenpox), but this latter condition usually occurs on the chest first. These spots were not particularly painful, although many children find them most uncomfortable.