What is hand, foot and mouth disease?

Hand, foot and mouth disease is a common viral illness that mainly affects children under 10 years old, but can sometimes affect older children and adults. It is caused by infection with a type of coxsackie virus. Hand, foot and mouth disease is not the same as foot-and-mouth disease, which affects farm animals.

Hand, foot and mouth disease is highly contagious (spreads easily from person to person). It’s especially common in childcare and kindergartens.

What are the symptoms of hand, foot and mouth disease?

The symptoms of hand, foot and mouth disease usually start 3 to 7 days after you’ve been infected, and typically last for 7 to 10 days.

The most common symptoms are small blisters inside your child’s mouth and on the palms of their hands and soles of their feet, and sometimes in the nappy area in infants. Your child may also have fever, tiredness and sore throat and mouth, making eating or drinking difficult.

In some cases, especially in adults, symptoms may be very mild.

What causes hand, foot and mouth disease?

Hand, foot and mouth disease is caused by infection with a type of coxsackie virus. It’s spread through:

• person to person contact
• contact with the faeces (poo) of an infected person
• contact with fluid from blisters
• contact with fluids from coughs and sneezes
• contact with objects or surfaces contaminated with the virus

Blisters typically appear between 3 to 5 days after contact with an infected person. The virus can remain in faeces for several weeks after the person has recovered.

How is hand, foot and mouth disease diagnosed?

Your doctor can usually diagnose hand, foot and mouth disease based on you or your child’s age, symptoms and the appearance of the rash.

You don’t usually need laboratory tests such as blood tests.

How is hand, foot and mouth disease treated?

There is no specific treatment for the coxsackie virus that causes hand, foot and mouth disease. Antibiotics do not work on viruses, and most people can be treated at home.

If your child has hand, foot and mouth disease, you can make them feel more comfortable by treating the symptoms:

• Paracetamol can ease pain and fever. Ask your doctor or pharmacist for advice on the right product and dose for your child.
• Give your child plenty to drink. Sips of water or oral rehydration fluid can stop them becoming dehydrated. Ice blocks or jelly can soothe a sore mouth or throat.
• Give your child soft foods. Avoid tangy or acidic food that could sting a sore mouth.
• Encourage your child to rest. Keep them home from day care or school until their blisters dry up.

Allow any blisters to dry out naturally. Don’t try to burst the blisters, as the fluid inside them is infectious.

When should I see my doctor?

Young children are at higher risk of serious infection than older children, teenagers and adults. See your doctor if symptoms are severe, if your child is very young, or if they haven’t improved after a few days.

Signs that you or your child might have a more serious form of hand, foot and mouth disease include:

• fever (38℃ or above) for 72 hours or more
• abnormal movements / jerking movements
• rapid breathing
• excessive tiredness, drowsiness or lethargy
• excessive irritability
• signs of dehydration (such as not passing urine as often as usual)
• difficulty walking or inability to walk properly

What are complications of hand, foot and mouth disease?

Hand, foot and mouth disease rarely causes further complications.

If your child has eczema, it can get worse and might become infected with bacteria.

Hand, foot and mouth disease may cause fingernail and toenail changes about 8 weeks after the infection. Lines may develop in the nail bed, or the nail may shed completely. The nails will grow back without treatment.

In very rare cases, hand, foot and mouth disease can cause serious illnesses that affect your heart, brain, lungs or eyes. See a doctor if symptoms are severe, or don’t improve after a few days.

Can I prevent hand, foot and mouth disease?

The best way to prevent hand, foot and mouth disease from spreading is to practise good hygiene:

• Wash your hands thoroughly after touching fluids from an infected person.
• Make sure your children don’t share items such as drinking cups, towels or clothing.
• Teach your children how to wash their hands, how to cover their mouth when they cough and how to cover their nose and mouth when they sneeze.
• Thoroughly wash any soiled clothing and any surfaces or toys that may be contaminated.

You should keep children with the infection away from others as much as possible.

Resources and support

• The Royal Children’s Hospital has fact sheets on:
• pain relief for children
• dehydration
• fever in children
• stopping the spread of germs.
• See your GP or Maternal and Child Health Nurse.
• Call healthdirect on 1800 022 222 at any time to speak to a registered nurse (known as NURSE-ON-CALL in Victoria) for more information and advice.