Hand, foot and mouth disease

Hand, foot and mouth disease is a common childhood viral illness. It causes blisters on your hands and feet, and ulcers in your mouth. While it may be unpleasant, it’s generally mild, and you usually recover within a week or two.

It has no relation to foot and mouth disease, which only affects farm animals like cattle, sheep and pigs.

About hand, foot and mouth disease

Hand, foot and mouth disease is most common in children under 10, especially those under 4. But people of any age can get it, including adults. However, most adults will have had contact with the disease as a child and are immune. In the UK, it shows a seasonal pattern, occurring most often in the late summer and early autumn. There are cases year-round though.

Symptoms of hand, foot and mouth disease

Symptoms usually appear three to seven days after becoming infected (this is the incubation period). Symptoms generally last for around 7 to 10 days.

Let’s look at the general stages of hand, foot and mouth disease. For the first few days, you may feel generally unwell with:

• fever
• a sore throat
• loss of appetite
• pain in your abdomen (tummy)
• a cough

These early symptoms are similar to many other viral infections. But within a few days, you may start to develop symptoms more typical of hand, foot and mouth disease, including:

• blisters or ulcers in your mouth
• spots or blisters on your hands and feet

Mouth ulcers and blisters usually develop within a couple of days after you start feeling unwell. They’re most common on the roof of your mouth, the inside of your cheek and your tongue, which can make eating and drinking painful.

Spots and blisters on your hands and feet tend to develop soon after the blisters in your mouth. They tend to come up on the backs of your hands, the sides of your fingers, and the heels of your feet. Although less common, they may also appear on the palms of the hands and soles of the feet. Blisters often ulcerate (break down) and crust over. They can also be painful or itchy.

The rash tends to be more widespread in younger children and babies. And they are more likely to get the rash on the buttocks and groin. Older children may just have spots and blisters in and around their mouths, or just on their palms and soles.

You won’t need to see your GP if symptoms are mild because you can usually manage them at home. If you or your child becomes more unwell – for example with reduced feeding, increased irritability, or a fever that does not respond to paracetamol or ibuprofen – contact your GP surgery for advice.

Hand foot and mouth blisters on hand, and mouth ulcers

Treatment for hand, foot and mouth disease

You don’t usually need to see your GP for hand, foot and mouth disease, especially if you know it’s been going round your child’s school or nursery. But if your child is becoming more unwell or if you’re not sure what’s causing their symptoms, contact your GP surgery for advice.

Your GP will usually be able to tell if you have hand, foot and mouth disease by checking the spots or blisters on your body and ulcers in your mouth. There isn’t any specific hand, foot and mouth disease treatment. The infection usually clears up on its own after around 7 to 10 days. Antibiotics won’t work because the infection is caused by a virus, not bacteria.

Treatment is supportive, meaning it focuses on symptom relief. This includes having regular fluids, taking pain relief such as paracetamol or ibuprofen, and soothing treatments for mouth discomfort, such as teething gel.

Complications of hand, foot and mouth disease

Hand, foot and mouth disease is usually a mild infection. But occasionally it can lead to more serious problems.

• Dehydration is the most common complication. Blisters in your mouth might make drinking painful – so you may not drink enough. Young children may find it easier to drink through a straw. Ice lollies can be a useful way to increase hydration.
• Blisters on your skin can become infected, especially if you scratch them. If one or more areas of your skin becomes very red and you get a high temperature, see your doctor. You may need antibiotics for a secondary bacterial infection.

Young children are especially prone to dehydration. Signs that you or your child may be dehydrated include feeling thirsty, having a dry mouth, and not passing urine as often. You should contact your doctor if you think your child is dehydrated. Offer them fluids frequently in small amounts. If it’s severe, babies or young children may need to go to hospital to have fluids through a drip.

More serious complications are much rarer, and are generally related to a more severe type of hand, foot and mouth disease caused by enterovirus 71 (EV71). Most people in the UK won’t have this form of the disease.

If you or your child become more unwell or don’t get better after a week or so, contact your doctor for advice.

Prevention of hand, foot and mouth disease

Hand, foot and mouth disease spreads very easily. Take the following measures to reduce the risk of spreading it,you should:

• wash your hands well with soap and water before you eat and after going to the toilet
• cover your mouth and nose when you cough or sneeze – use a tissue and wash your hands afterwards
• clean surfaces that may have been in contact with saliva or poo with cleaning products containing bleach. (If you use bleach on a changing mat, rinse it off afterwards.)
• dispose of used tissues and nappies properly after changing your baby
• wash soiled clothing, towels, and bedding on a hot machine wash with laundry bleach
• don’t share cups, utensils, or towels with people who are infected
• the virus is in the spots and blisters, so don’t deliberately squeeze or pierce them
• try to avoid contact with other people – particularly pregnant women – as much as you can while you have hand, foot and mouth disease symptoms
• remember that the virus can be found in poo for a number of weeks after you’ve had the infection, so take extra care after using the toilet

The following video shows how to wash your hands effectively in 20 seconds.