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Hand, Foot and Mouth Disease
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| Hand, foot and mouth disease is usually a short mild illness that mainly affects children. Most children fully recover within a week. Serious complications occur rarely. This disease is NOT related to the disease with a similar name which affects animals. |
What is hand, foot and mouth disease and what causes it?
Hand, foot and mouth disease is an infection that is usually caused by a virus called the coxsackie A virus. Some cases are caused by coxsackie B virus and enterovirus 71.
What are the symptoms of hand, foot and mouth disease?
Like many virus infections, the illness often starts with a feeling of being unwell for a day or so. This might include a high temperature (fever). After this a sore throat commonly occurs, quickly followed by small spots that develop inside the mouth. These soon progress into small mouth ulcers.
In about 3 in 4 cases, spots develop on the skin. This is typically a day or so after the mouth ulcers develop. The spots are small lumps that are a few millimetres in diameter and usually appear on the hands and feet. Spots sometimes also appear on the buttocks, legs and genitals. They rarely develop on other parts of the body. The spots are similar to chickenpox, but are smaller. Unlike chickenpox, they are not usually itchy but can be quite tender.
For a list of websites that contain pictures of skin conditions including hand, foot and mouth disease see www.patient.co.uk/showdoc/1097/
Is hand, foot and mouth disease serious?
Usually not. The fever and spots usually clear within a few days. The mouth ulcers can be painful, and may last up to a week. The sore mouth may make a child miserable for a few days. In a very small number of cases, the virus affects the heart, lung or brain to cause a serious inflammation of the heart, lung or brain. But it has to be stressed - these complications are rare. There is some evidence that infection during pregnancy may cause miscarriage and poor growth of the unborn baby in some cases - but this also seems to be rare.
Is hand, foot and mouth disease infectious?
Yes. The incubation period is 3-6 days. This means it takes 3-6 days to develop symptoms after being infected from another person. Sometimes small outbreaks occur in nurseries and schools. It is mainly infectious until the spots and mouth ulcers have gone. However, children can still be mildly infectious for several weeks longer as the virus may be passed out with the faeces (stools) for several weeks after the symptoms have gone. It is impractical to exclude children from school or nursery once the symptoms have gone. However, it is sensible to maintain good hygiene to reduce the chance of passing on the virus. In particular, hand washing after going to the toilet.
What is the treatment for hand, foot and mouth disease?
There is no treatment that will take away the virus. The aim is to ease symptoms until the illness goes away (which it normally does within a week or so).
You can give paracetamol (Calpol®, Disprol®, etc) or ibuprofen if the child is uncomfortable with a high temperature or a sore mouth. Give plenty to drink. Cool sloppy foods such as yoghurt may be best for a day or so if the mouth is sore. Ice lollies may help to ease a sore mouth, and are also a way of giving a drink. Tell a doctor if a child stops drinking due to a sore mouth as, rarely, dehydration may develop. Also, see a doctor if you are concerned about any symptoms.
References
- Frydenberg A, Starr M; Hand, foot and mouth disease. Aust Fam Physician. 2003 Aug;32(8):594-5. [abstract]
- Nervi S, Schwartz RA, Kapila R, Johnson DH; Hand-Foot-and-Mouth Disease. eMedicine. Last Updated Mar 17, 2008.
The authors and editors of this article are employed to create accurate and up to date content reflecting reliable research evidence, guidance and best clinical practice. They are free from any commercial conflicts of interest. Find out more about updating.
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