Hand, foot and mouth disease

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Hand Foot and Mouth is a common childhood illness, caused by a virus called Coxsackie. It is usually a mild infection that does not need specific treatment and will usually get better on its own. Antibiotics will not help.

It commonly affects children under 5 years of age, and initial symptoms can include a high temperature, sore throat, reduced appetite and generally feeling unwell.

After a few days mouth ulcers and a rash will appear.

Ulcers appear in the mouth and on the tongue. These can be painful and make it difficult to eat or drink.

Red spots, which develop into blisters, usually appear on the hands and feet.

The blisters are grey in the centre and can be painful.

It's possible to get hand, foot and mouth disease more than once.

If you are not sure it is Hand Foot and Mouth disease look at other childhood rashes here.

When should you worry?

If your child has any of the following:

Has a rash that does not go away with pressure (the ‘Glass Test’)
Swollen lips or tongue and struggling to breathe
Breathing very fast, too breathless to talk, eat or drink
Working hard to breathe, drawing in of the muscles below the ribs, or noisy breathing (grunting)
Breathing that stops or pauses
Is pale, blue, mottled or feels unusually cold to touch
Difficult to wake up, very sleepy or confused
Weak, high-pitched cry or can’t be settled
Has a fit (seizure)
Is under 3 months old with temperature more than 38°C or under 36°C (unless fever in the 48 hours following vaccinations and no other red features)

You need urgent help.

Go to the nearest Hospital Emergency (A&E) Department or phone 999

If your child has any of the following:

Increasing pain and redness between the spots
Symptoms do not improve after 10 days
Breathing a bit faster than normal or working a bit harder to breathe
Dry skin, lips or tongue
Not had a wee or wet nappy in last 8 hours
Poor feeding in babies (less than half of their usual amount)
Irritable (unable to settle them with toys, TV, food or hugs even after their fever has come down)
Is 3-6 months old with temperature 39°C or above (unless fever in the 48 hours following vaccinations and no other red or amber features)
Temperature of 38°C or above for more than 5 days or shivering with fever (rigors)
Temperature less than 36°C in those over 3 months
Getting worse and you are worried

You need to contact a doctor or nurse today.

Please ring your GP surgery or call NHS 111 - dial 111

If symptoms persist for 4 hours or more and you have not been able to speak to either a member of staff from your GP practice or to NHS 111 staff, recheck that your child has not developed any red features.

If none of the above features present

Most children with fever and rash can be safely managed at home
Watch them closely for any change and look out for any red or amber symptoms
Additional advice is also available to young families for coping with crying of well babies
If your child has a long term condition or disability and you are worried please contact your regular team or follow any plans that they have given you.
If you think that this is a worsening of your child’s eczema, please look at the eczema page or contact your GP or practice nurse

Self care

Continue providing your child’s care at home. If you are still concerned about your child, speak to your health visitor, local pharmacist or call NHS 111– dial 111

Children and young people who are unwell and have a high temperature should stay at home. They can go back to school, college or childcare when they no longer have a high temperature, and are well enough to attend.

What should you do?

Seeing your child unwell with hand foot and mouth disease can be very distressing for a parent and while there is no treatment for the virus itself there are simple things you can do to make your child more comfortable:

Get them to drink plenty of fluids and try ice lollies if your child is not drinking much
Try soft foods like soup, yoghurt or ice cream – avoid hot and spicy foods as these may be painful on ulcers in the mouth
Speak with a pharmacist for advice about treatments, such as mouth ulcer gels, sprays and mouthwashes to relieve pain.
Paracetamol or ibuprofen for temperature / pain
While there is normally no risk to pregnant people it is best to avoid close contact if possible

You can't take antibiotics or medicines to cure hand, foot and mouth disease – it has to run its course. It usually gets better in 7 to 10 days.

How long will your child’s symptoms last?

Hand foot and mouth disaease usually lasts 7-10 days
It is easy to spread for first 5 days (it is spread in sneezes, coughing and poo)
Wash your hands often and avoid sharing towels at home
You should keep your child off school of nursery while they are feeling unwell
Once they are feeling better they can go back and there is no need to wait until all the blisters have healed. It is best to let the school or nursery know.