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Hand Foot Mouth Disease

If you’ve had a little one in daycare or school, then you’ve likely heard about “hand-foot-mouth disease”. This is a common, highly contagious illness caused by a family of viruses known as coxsackie virus, which is from a bigger family of viruses called enterovirus. The virus causes the following symptoms:

  • Fever, usually 100-102 degrees F.
  • Ulcers in the back of the mouth that can range from mild to highly painful
  • Red rash that usually includes the arms, legs, buttocks, palms, and soles. The rash can be flat or bumpy with small red blisters and is sometimes itchy or painful.
  • Occasionally diarrhea and vomiting
  • Runny nose

The fever generally resolves by day 4 but the ulcers, diarrhea, and rash can last longer. The rash is usually the last symptom to disappear around day 10. Treatment is supportive care with mainstays including Tylenol and Motrin for the fever and oral pain. Additionally, a mixture of Maalox and Benadryl can be used to swish and spit several times a day for oral pain, but always check with us first whether your child is old enough to use this combination.

Hand-foot-mouth is highly contagious and is transmitted via respiratory droplets, exchange of saliva, and via fecal-oral contamination. Be sure to practice the following:

  • Hand washing, especially when returning from public places and before meals
  • Keep your child home from daycare or school until they have been without fever (99 F or more) for > 24 hours to prevent spread of illness
  • Keep your child home until the rash is not spreading (i.e. no new lesions are appearing). It is not necessary to remain home the entire time the rash is present

Warning signs to look out for include:

  • Mouth pain preventing your child from staying hydrated
  • Decreased wet diapers
  • Significant vomiting
  • Fever lasting for more than 3 days
  • Weakness of the arms or legs
  • Severe headache or neck stiffness

Article written by Dr. Elizabeth Adams

Originally from Richardson, Texas. Graduated Texas A&M
Graduated from UT Southwestern Medical School, residency at Children’s Medical Center Dallas.