Definition

• Small ulcers in the mouth
• A mildly painful mouth
• Small water blisters or red spots located on the palms and soles and on the webs between the fingers and toes
• Five or fewer blisters per limb
• Sometimes, small blisters or red spots on the buttocks
• Low-grade fever between 100° and 102°F (37.8° and 38.9° C)
• Mainly occurs in children 6 months to 4 years of age

Cause

Hand, foot, and mouth disease is always caused by Coxsackie A-16 virus. It has no relationship to hoof and mouth disease of cattle.

Expected Course

The fever and discomfort are usually gone by day 3 or 4. The mouth ulcers resolve in 7 days, but the rash on the hands and feet can last 10 days. The only complication seen with any frequency is dehydration from refusing fluids.

Home Care

Antacid Solution

Use an antacid solution for pain relief. For younger children, put ½ teaspoon antacid solution in the front of their mouth 4 times a day after meals.

Diet

Change to a soft diet for a few days and encourage plenty of clear fluids. Cold drinks, Popsicles, and sherbert are often well received. For a younger child, give fluids by cup rather than from a bottle. Avoid giving your child citrus, salty, or spicy foods. Also avoid foods that need much chewing.

Fever

Acetaminophen or ibuprofen may be given for a few days for severe mouth pain or a fever above 102°F (38.9°C).

Contagiousness

Hand, foot, and mouth disease is quite contagious and usually some of your child’s playmates will develop it at about the same time. The incubation period after contact is 3 to 6 days. Because the spread of infection is extremely difficult to prevent and the condition is harmless, these children do not need to be isolated. They can return to day care or school when the fever returns to normal range. Although most children care contagious from 2 days before to 2 days after the rash, avoidance of other children is unnecessary.

Call our office immediately if:

• Your child has not urinated for more than 8 hours
• Your child starts acting very sick

During regular hours if:

• The fever last more than 3 days
• The mouth pain becomes severe
• You have other concerns or questions