Hand Foot and Mouth Disease

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.

It usually affects children under 10 years of age, but older children and adults are sometimes affected. Affected adults and older children tend to develop a milder form of the illness compared to younger children. 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.

A day or so later, small spots usually appear on the hands and feet. Spots sometimes also appear on the buttocks, legs and genitals, but rarely 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.

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 muscle or brain to cause a serious inflammation of the brain (meningoencephalitis) or heart (myocarditis) - but this is rare. There is some evidence that infection during pregnancy may cause miscarriage and poor growth of the unborn baby in some cases, but this seems to be rare.

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.

Give paracetamol (Calpol, Disprol, etc) or ibuprofen if the child has 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 or if you are concerned about any symptoms.

© EMIS and PIP 2006   Updated: October 2006