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Hand-Foot-And-Mouth Disease

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Does this describe your child's symptoms?


  • A viral infection that causes mouth ulcers and tiny blisters on the hands and feet


  • Small painful ulcers in the mouth, especially on tongue and sides of mouth (in all children)

  • Small, thick-walled water blisters (like chickenpox) or red spots located on the palms, soles, and webs between the fingers and toes (70%)

  • 1 to 5 water blisters per hand or foot

  • Small blisters or red spots on the buttocks (30%)

  • Low-grade fever less than 102° F (39° C)

  • Mainly occurs in children age 6 months to 4 years


  • Coxsackie A-16 virus

  • Not related to animal disease

Return to School

  • Can return to child care or school after the fever is gone (usually 2 to 3 days). The rash is not contagious.

If not, see these topics


When to Call Your Doctor

call now

Call Your Doctor Now (night or day) If

  • Your child looks or acts very sick

  • Signs of dehydration (e.g., very dry mouth, no tears, no urine in more than 8 hours)

  • Stiff neck, severe headache or acting confused (delirious)

  • You think your child needs to be seen urgently

call within 24 hours

Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If

  • You think your child needs to be seen, but not urgently

  • Red, swollen and tender gums

  • Ulcers and sores also present on outer lip

  • Fever present for more than 3 days

call within 24 hours

Call Your Doctor During Weekday Office Hours If

  • You have other questions or concerns

home care

Parent Care at Home If

  • Probable hand-foot-mouth disease and you don't think your child needs to be seen



  1. Reassurance: Hand-foot-mouth disease is a harmless viral rash.

  2. Liquid Antacid for Mouth Pain:  

    • Use a liquid antacid 4 times per day.

    • For younger children, put ½ teaspoon (2 ml) in the front of the mouth 4 times per day after meals.

    • Children over age 4 can use 1 teaspoon (5 ml) as a mouthwash after meals.

  3. Soft Diet:

    • Encourage favorite fluids to prevent dehydration.

    • Cold drinks, milkshakes, popsicles, slushes, and sherbet are good choices.

    • Avoid citrus, salty, or spicy foods.

    • For infants, give fluids by cup, spoon or syringe rather than a bottle. (Reason: The nipple can cause pain.)

    • Solid food intake is not important.

  4. Fever Medicine: Give acetaminophen (e.g., Tylenol) or ibuprofen for fever above 102° F (39° C) or severe mouth pain.

  5. Contagiousness:  

    • Quite contagious but a mild and harmless disease.

    • Incubation period is 3-6 days.  

    • Can return to child care or school after the fever is gone (usually 2 to 3 days).

    • The rash is not contagious.

  6. Expected Course:  

    • Fever lasts 2 or 3 days.

    • Mouth ulcers resolve by 7 days.

    • Rash on the hands and feet lasts 10 days. The rash on the hands and feet may then peel.

  7. Call Your Doctor If:

    • Signs of dehydration develop

    • Fever present over 3 days

    • Your child becomes worse

And remember, contact your doctor if your child develops any of the "Call Your Doctor" symptoms.

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