Hand-Foot and Mouth Disease

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 100° to 102° F (37.8^o to 39^o C).
Mainly occurs in children age 6 months to 4 years.

Cause:
Coxsackie A-16 virus.

See More Appropriate Topic (instead of this one):

If only has mouth ulcers, see Mouth Ulcers

If only has a rash, see Rashes, Widespread

When to Call for Hand-Foot and Mouth Disease

Call Us Now If:

Your child looks or acts very sick

Signs of dehydration (e.g. very dry mouth, no tears, no urine > 8 hours)

Stiff neck, severe headache or acting confused (delirious)

Call Us Within 24 Hours If:

You think your child needs to be seen

Red, swollen and tender gums

Fever persists > 3 days

Call Us During Weekday Office Hours If:

You have other questions or concerns

Home Care (Read "When to Call..." first):

Antacid Solution for Pain Relief: Use an antacid solution 4 times per day:

For younger children, put 1/2 teaspoon in the front of the mouth 4 times per day after meals
Children over age 4 can use 1 teaspoon as a mouth wash after meals

Fluids:

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

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

Contagiousness: Quite contagious but a mild and harmless disease. Incubation period is 3-6 days. Can return to daycare or school after the fever is gone (usually 1 to 3 days).

Expected Course: The fever lasts 2 or 3 days. The mouth ulcers resolve by 7 days. The rash on the hands and feet lasts 10 days.

Call Your Doctor If:

Signs of dehydration develop

Fever lasts > 3 days
Your child becomes worse or develops any of the "Call Your Doctor…" symptoms

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