Patient education: Hand, foot, and mouth disease and herpangina (The Basics)

What is hand, foot, and mouth disease? — Hand, foot, and mouth disease is an infection that causes sores in the mouth and on the hands, feet, and buttocks. It most often affects young children, but older children and adults can get it, too.

A related infection, called "herpangina," causes sores just in the mouth and throat.

This article is mostly about hand, foot, and mouth disease. But herpangina has similar symptoms and is treated in the same way.

Hand, foot, and mouth disease usually goes away on its own within a week or so. But there are things that you can do to help relieve symptoms.

What are the symptoms of hand, foot, and mouth disease? — The main symptom is sores in the mouth and on the hands, feet, and buttocks. They can look like small spots, bumps, or blisters (picture 1 and picture 2). The sores in the mouth can make swallowing painful. The sores on the hands and feet might be painful. It is possible to get the sores only in some areas. Not every person gets them on their hands, feet, and mouth.

Herpangina can also cause sores inside the throat.

Hand, foot, and mouth disease sometimes causes a fever. People with herpangina usually get a high fever that starts suddenly.

How does hand, foot, and mouth disease spread? — The virus that causes hand, foot, and mouth disease can live in body fluids of an infected person. For example, the virus can be found in:

●Mucus from the nose

●Saliva

●Fluid from the sores

●Traces of bowel movements

People with hand, foot, and mouth disease are most likely to spread the infection during the first week of their illness. But the virus can live in their body for weeks or even months after the symptoms have gone away.

Is there a test for hand, foot, and mouth disease? — Yes, but it is not usually needed. A doctor or nurse should be able to tell if a child has it by learning about their symptoms and doing an exam.

How can I care for my child at home? — Hand, foot, and mouth disease usually goes away on its own within about a week. It does not need specific treatment.

To help your child feel better, you can:

●Give non-prescription medicines such as acetaminophen (sample brand name: Tylenol) or ibuprofen (sample brand names: Advil, Motrin) to relieve pain. Never give aspirin to a child younger than 18 years. In children, aspirin can cause a serious problem called Reye syndrome.

●Offer the child plenty of fluids. The sores in the mouth can make swallowing painful, so some children might not want to eat or drink. Make sure that children get enough fluids so that they don't get dehydrated. Cold foods, like popsicles and ice cream, can help to numb the pain. Soft foods, like pudding and gelatin, might be easier to swallow.

●If your child is older than 6 years, have them rinse their mouth with salt water. This might help with pain. To do this, mix 1/4 to 1/2 teaspoon of salt into 8 ounces of warm water. Your child can swish the water in their mouth, then spit it out. They should not swallow it. They can do this 2 or 3 times a day.

Treatment for herpangina is the same as for hand, foot, and mouth disease.

Can hand, foot, and mouth disease be prevented? — Yes. The best thing that you can do to prevent the spread of this infection is to wash your hands often with soap and water, even after the child is feeling better. Teach children to wash their hands often, especially after using the bathroom (figure 1). Younger children might need help with this.

It's also important to disinfect tabletops, toys, and other things that a child might touch.

If a child has hand, foot, and mouth disease or herpangina, keep them out of school or day care if they have a fever or if they don't feel well enough to go. You should also keep the child home if they are drooling a lot or have open sores. Do not let them pick at their sores.

When should I call the doctor? — Call for advice if your child:

●Has signs that their sores are infected – These include:

•Swelling, redness, or warmth around the sore

•Pain when touching the area

•Yellow, green, or bloody discharge

•Bad smell from the sore

●Has a lot of trouble eating or drinking

●Is not urinating often enough:

•For babies and young children, call if they have not had a wet diaper in 4 to 6 hours.

•For older children, call if they have not urinated for 6 to 8 hours (while awake).

●Does not start feeling better after 2 to 3 days, or is feeling worse