Hand Foot and Mouth Disease in Children

Out, Damned Spot!

Hand, Foot and Mouth Disease (HFMD) a contagious viral infection - that is, an infection that is easily spread, and caused by a virus rather than bacteria. It is an illness charaterised by sores on or in the mouth, and on the hands and feet.

It is more common in children, with pre-schoolers (under 5) often being more unwell than those who are older. Adults and those who are immunosuppressed may also catch HFMD - it is often milder in adults, but can be extremely itchy.

Once you have had HFMD - you are then immune to the virus and cannot get this disease again.

Not Dribble Rash

Lesions caused by Hand Foot and Mouth Disease in an 11mth old male.
Lesions caused by Hand Foot and Mouth Disease in an 11mth old male. | Source

What Are The Symptoms of HFMD?

It usually takes 3-5 days for symptoms to appear once a child/person has be exposed to the virus that causes HFMD

The symptoms of HFMD are:

  • A mild fever usually develops first
  • Red spots that develop into fluid filled blisters, starting in the mouth, progressing to hands and feet.
  • Loss of appetite
  • Sore throat
  • Malaise - general weakness or tiredness
  • Occasionally spots may also be present on the bottom and legs (but not all over)

It is usually mild and should only last 3-7 days - though most of the symptoms will subside earlier - the spots take a little longer to disappear. They usually do not leave a scar.

It is occasionally mistaken for Chickenpox, cold sores, or in our case, dribble/teething rash! Chickenpox is usually a full body rash.

A personal example of symptom progression:

Our 9mth old was grizzly, off her food and a slight temp - we thought "teething" - used pain relief and she settled to sleep.
Following morning - a spot on her chin, and one near her lip, looked like dribble/teething rash.Still off her food, a little 'off' but not sick.
A call from daycare a few hrs later - unsettled ++ (NOT like her), more spots on chin, and one on hand, other cases at daycare of HFMD.

Treatment For HFMD

HFMD does not have a vaccine to prevent it's spread, unlike the virus that causes chickenpox.

Treatment for HFMD mostly involves treating the symptoms, and 'riding it out'.

Treatments include:

  • Paracetamol or Ibuprofen for the temp - NEVER give Aspirin to a child.
  • Plenty of fluids
  • Rest
  • Salt water rinses for the blisters in the mouth (not suitable for babies)

Infants may be very clingy, grizzly, generally listless, and weak.

Personal Experience:
After being picked up from daycare (30mins after call) and brought home - Our 9mth old was very clingy, off her food, grizzly - alternated between a 'whinge' that was almost constant, to a wail - completely miserable little one, and generally tired. Crawling seemed to be a strain on her - previous commando-crawling at speed just days prior. We spent the day on the couch, having lots of cuddles, paracetamol 4-6hourly, encouraging fluids and fruity purees.

Causes of HFMD, and How It is Spread

HFMD is caused by a group of viruses called enteroviruses. The most common virus that causes HFMD is called Coxsackie A16.

It is highly infectious, and is spread easily through contact with bodily fluids that contain the virus, or poor hygiene. This includes:

  • Saliva - coughing, sneezing and dribbling
  • Fluid from the blisters
  • Contact with faeces/poo - nappy changing being high risk
  • Poor hand washing technique

Anyone with HFMD is most infectious in the first week after symptoms appear, and while the blisters are filled with fluid.

Spots! And More Spots

HFMD spots on the hands and feet of a 36yr old male
HFMD spots on the hands and feet of a 36yr old male | Source


Have you or your child ever had HFMD?

  • No
  • Yes
  • It's not related to Foot and Mouth is it?
See results without voting

Rare, But Serious Illnesses Related to HFMD

HFMD is usually a mild illness, unpleasant for a few days but recovered from quickly. However, for some people HFMD may be dangerous, or cause other illnesses that are serious and even life-threatening, so it pays to be aware of these.

A small number of people in an epidemic outbreak of HFMD may develop Encephalitis (inflammation of the brain) or Pneumonitis (inflammation of the lung tissue). SIgns of these illnesses include (in addition to those symptoms of HFMD):


  • vomiting
  • light sensitivity
  • stiff neck
  • difficult to wake
  • problems with walking


  • Trouble breathing
  • High fever

If you, or your child have any of these symptoms - please seek urgent medical attention.

Pregnancy is situation where contracting HFMD can be dangerous - to the unborn child.

Whilst even rarer than encephalitis and pneumonitis, if HFMD is contracted in the third trimester of pregnancy it can cause the baby to become very unwell once delivered with illnesses including inflammation of the liver, thrombocytopenia (low platelets in the blood - causes bleeding), inflammation of the brain and membranes, and disease of the heart muscle.

If you have contracted HFMD whilst pregnant - please advise your doctor so that you can be monitored appropriately.

Spots, Damn Spots!

Spots on hand of adult - HFMD
Spots on hand of adult - HFMD | Source

Prevention of HFMD

HFMD is highly contagious/infectious, but there are a few simple ways that you can slow or prevent the spread of this common childhood illness.

Proper hand hygiene - regularly washing your hands, particularly after changing nappies, dealing with sick children, before food preparation, after using the toilet - can prevent the spread of many illnesses including HFMD. Childcare workers are recommended to wear gloves if caring for a sick child (while waiting for parent to collect), as well as proper hand washing.

Avoid sharing food or drinks - both with a sick person, and in general everyday life - there are many illnesses spread through saliva, and sharing food or drink bottles promotes the spread of both HFMD and these other diseases.

Avoid sharing toys - particularly if the children are small enough that toys are also 'chew thing', but recommended even in older children, as faecal matter on children's hands can cause the spread of HFMD also.

Good cough 'etiquette" - hand or tissue over your mouth when you cough or sneeze, proper disposal of used tissues, and proper handwashing will also help to contain the spread of the disease - as well as containing the spread of the common cold!

Keeping sick children home from school, childcare - children are generally contagious for 7-10days, so keeping them home from school or daycare can prevent the illness from spreading further. Children who do not have mouth sores, and who's hands and feet only have a few sores that can be covered may attend school/daycare.

HFMD is Common, but Not Usually Serious

HFMD is a common, viral childhood illness, that is highly contagious. Often seen in children younger than 10, it is often more severe in pre-school aged children (under 5 yrs), and can be caught by adults at times as well. Once you have had HFMD once, you cannot get sick with it again.

There is no preventative vaccine for HFMD, and treatment consists mainly of paracetamol/ibuprofen for temperatures and pain relief, fluids and plenty of rest. Preventative measures such as good hand washing, and covering your mouth when you cough or sneeze are useful in preventing the spread of this disease, as well as many others.

Here's to a speedy recovery for any and all of you suffering with HFMD, or caring for a sick child with HFMD - whilst a mild illness, it is not a pleasant one to be struck down with, particularly as an infant!


DJ Anderson 21 months ago

Jacqui, this is most interesting, but thankfully me or mine have never

suffered this malady.

Can children have a re-infestation or is an anti-body built up after having had HFMD. If re-infestation occurs from others children at

a child care facility, this could be an on-going problem.

Hope your wee one is better.


jlpark profile image

jlpark 21 months ago from New Zealand Author

Thanks for your comment DJ. She is all back to normal - no evidence of any spots even!

Thanks for the question - I meant to go back and add the answer last night before I publish - HFMD is a once only disease - once you've had it, you become immune to it so cannot get it again.

MsDora profile image

MsDora 21 months ago from The Caribbean

Thanks for writing about this. I had never heard of it, before my grandson was diagnosed; his must have been a slight case. (I smile at a prescription of rest for a child.) Good presentation!

jlpark profile image

jlpark 21 months ago from New Zealand Author

Thanks MsDora. I smiled too about the rest - but I remember popping her on the floor (as she seemed to want to crawl) and she'd crawl a wee way, then stop and cry so I think she was exhausted by the virus.

DeborahDian profile image

DeborahDian 17 months ago from Orange County, California

How scary! I had no idea that children could get this disease!

jlpark profile image

jlpark 17 months ago from New Zealand Author

Thanks for your comment, Deborah. I didn't either - poor wee kid.

peachpurple profile image

peachpurple 16 months ago from Home Sweet Home

My son had this problem when he was 6 yrs old.It repeated again when he was 7. I think he got it from school

Happy Moment profile image

Happy Moment 12 months ago from The Eastern Bypass

Yeah, the disease is highly contagious. The problem is you cannot prevent your kids from interacting with others

on immunity 9 months ago

There are actually multiple viruses that cause HFMD. Once you have had one, you are indeed immune to a recurrence of that one for life, but not the others.

jlpark profile image

jlpark 9 months ago from New Zealand Author

Good to know! Yes, my daughter has now had it twice!

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