Hand, foot and mouth disease is an illness caused by a type of virus called an enterovirus. It's highly contagious.
The illness is common in children under 10 years old. It can spread quite quickly in schools and childcare settings. Adolescents and adults can also be affected, although most adults are immune.
Hand, foot and mouth disease is not the same as foot and mouth disease, which affects farm animals such as cattle, sheep and pigs.
The two infections are unrelated. You can't catch hand, foot and mouth disease from animals.
Once your child has become infected with hand, foot and mouth disease, it can take 3 to 5 days for them to show any symptoms.
Symptoms can include:
- fever (a temperature higher than 38°C)
- feeling generally unwell
- sore throat
- loss of appetite (not wanting to eat)
After a few days your child may develop:
- mouth ulcers
- a rash - this is usually not itchy and is made up of red spots on their palms and soles of the feet. The spots can turn into blisters.
Symptoms are usually mild and go away after 7 to 10 days. Some people will experience no symptoms at all.
How your child can catch it
A person with the virus can spread it when they cough or sneeze. The virus can also spread in poo.
You can become infected if you touch the blisters, poo, or saliva of someone with hand foot and mouth.
Stop the spread
The best way to avoid catching and spreading hand, foot and mouth disease is to avoid contact with infected people.
You should also practice good hygiene. You can practice good hygiene by:
- washing your hands after going to the toilet and handling nappies
- washing your hands before preparing food
- not sharing cups or cutlery with your child and stopping them from sharing with other people
- not putting your child's soother in your mouth - for example, if it falls to the ground
- not sharing eating utensils or cups
For older children
Teach your child to cough and sneeze into a tissue. Throw away the tissue immediately. Get your child to wash and dry their hands after this. Wash and dry your own hands too.
Attending school or crèche
There is no need to keep your child out of school or crèche if they have hand, foot and mouth disease. This is because they probably have already passed on the virus to other children.
Hand, foot and mouth disease is likely to be contagious even before symptoms appear. So there is no real benefit in keeping your child at home unless they are unwell.
If they are unwell or feeling miserable you should keep them at home until they feel well enough to return.
Diagnosing hand, foot and mouth disease
If there's an outbreak of the virus at your child's school or crèche, it's likely they've caught the virus. You will probably know this without needing to bring your child to a GP.
You should bring your child to the GP if:
- You are not sure whether it is hand, foot and mouth or something else.
- You are worried about your child.
- Your child is not drinking or is showing signs of dehydration.
- You are finding it difficult to control your child’s temperature.
- They do not improve after 7 days.
You should phone ahead to let the GP know you think your child might have hand, foot and mouth. As this virus is contagious, they may arrange to see you at a time when the surgery is quiet. This is to prevent the infection from spreading to other patients.
If your GP or paediatrician is not sure if your child has hand, foot and mouth disease, they may need to do other tests.
These could include:
- a swab - where they rub the back of your child's throat with a swab (this looks like a long cotton bud)
- a poo sample
These samples will be sent to the lab for testing.
There's no treatment for hand, foot and mouth disease. It's a viral infection and cannot be treated with antibiotics.
You can treat the symptoms of hand, foot and mouth disease. You can reduce symptoms by resting and drinking plenty of fluids.
Paracetamol (or children’s paracetamol) can be taken to reduce fever and throat soreness.
Aspirin should not be given to children under 16 years of age
Mouth ulcers can be numbed with anaesthetic mouthwashes or sprays.
Ask your pharmacist about suitable medications for you or your child
Fever and pain
You can give your child liquid children's paracetamol or ibuprofen to reduce fever and pain. This should help any pain they experience around their mouth. It can be a good idea to give them paracetamol about 30 minutes before they eat. This might help them to eat.
You should give your child plenty of fluids to drink. This will help them feel better. It will also prevent dehydration.
If their mouths are sore they may not want to drink. So giving them paracetamol or ibuprofen regularly can help with this. It might help to give them sips of fluid, using a straw.
If your child is breastfeeding, offer them regular breastfeeds. This will help them stay hydrated. It will also comfort them too.
Treating their sore mouth
Soft foods will be easier for your child to eat. Soft foods include mashed potatoes and veg, smoothies and even ice-cream.
Salty or spicy foods might sting your child's mouth. Acidic foods like tomatoes and citrus fruits might sting too.
Older children might find it helpful to rinse their mouth with warm, salty water and spit it out. Only give this to your child if they are old enough to spit it out.
Talk to your pharmacist as you may be able to get an anesthetic mouthwash, gel or spray for your child. If your child stops drinking because of the sore mouth bring them to your GP. They could become dehydrated.
Complications from hand, foot and mouth disease
Mouth ulcers caused by hand foot and mouth disease can be painful and make it hard for your child to eat and drink. More common complications can include:
- skin infection
Throat and mouth sores can make it difficult for your child to drink and swallow. This can cause dehydration. It's important that they drink plenty of fluids.
If you or your child become severely dehydrated, you may have to be treated in hospital and be given fluids through a drip. A drip is a small tube placed into a vein in your child's hand or arm.
If the skin around any of your child's blisters becomes very red, or if pus starts oozing out of the blisters, this could be signs of infection.
Talk to your GP if this happens.
If you are pregnant
Hand, foot and mouth disease does not usually cause complications in pregnancy. But high temperatures in the first three months of pregnancy can increase your risk of miscarriage.
Try not to worry. Adults are less likely to become infected than children.
If you are pregnant and you come into contact with hand, foot and mouth, talk to your GP or midwife. If you catch the illness close to your due date, there is a small risk of passing the infection to your baby.
Serious complications due to hand, foot and mouth disease are very rare.
In rare cases the virus can cause inflammation of the heart, the brain or the lung. In very rare cases, death can occur from these complications.
But remember that serious complications are rare.
Bring your child to your nearest hospital emergency department (A&E) that treats children if your child develops the following symptoms:
- Dislike of bright lights.
- Stiffness in their neck.
- Drowsy (you find it hard to wake them)
- Difficulty breathing.
Content supplied by the NHS and adapted for Ireland by the HSE.