Hand, Foot and Mouth Disease


What is it?

Hand foot and mouth disease is caused by a virus. It usually affects children under 10 years but can occur in adults. Hand, foot, and mouth disease (HFMD) is a common illness of infants and children. It is characterized by fever, sores in the mouth, and a rash with blisters. HFMD begins with a mild fever, poor appetite, malaise (“feeling sick”), and frequently a sore throat. One or 2 days after the fever begins, sores develop in the mouth. They begin as small red spots that blister and then often become ulcers. They are usually located on the tongue, gums, and inside of the cheeks. The skin rash develops over 1 to 2 days with flat or raised red spots, some with blisters. The rash does not itch, and it is usually located on the palms of the hands and soles of the feet. It may also appear on the buttocks. A person with HFMD may have only the rash or the mouth ulcers.

How do I know if someone has it?

The illness usually starts suddenly with a sore throat, temperature (fever) and blisters develop in the inside of the mouth and throat. Blisters may also appear on the palms, fingers and soles.

Is it infectious?

The infection can be spread when a person has direct or close contact with discharges from the nose or throat of a person who is in the acute stage of illness. The faeces (motions, stools) are also infectious during the illness and may continue to be infectious for several weeks even after the person feels well.

What is the incubation period?

Illness usually appears 3 to 5 days after a person has been in close contact with an infected person.

Is there any treatment?

There is no specific treatment for the infection. The infected person will get better on their own without treatment. The blisters in the mouth usually clear within 4 to 6 days and the blisters on the body usually last for 7 to 10 days.

What should I do if someone has the illness?

  • A child who has a temperature (fever) should be kept cool by a fan and by reducing the amount of clothing/bedding. If advised by a doctor or nurse, give paracetamol to children in the dose prescribed for the child’s age.
  • Make sure the handkerchiefs are washed well in a washing machine or in hot soapy water. Always wash your hands well after handling them.
  • Make sure that a person with the illness washes his/her hands with warm soapy water after using the toilet and before handling or eating food. Special care should be taken with this for some time after the illness.
  • Make sure the toilet is kept clean. Use diluted bleach (one part bleach to nine parts water) to clean the toilet making sure you clean the handle as well as the seat. If worried seek advice from your GP.
  • How soon can someone with the illness return to school/work? A person should stay away from work/school while they feel ill and have obvious blisters or as long as advised by the GP.


Anyone can get hand, foot, and mouth disease

Young children are primarily affected, but it may be seen in adults. Most cases occur in the summer and early fall. Outbreaks may occur among groups of children especially in day care centers or nursery schools. The incubation period is usually 3-5 days.

Hand, foot, and mouth disease is usually spread through person-to-person contact

The virus is spread primarily from the feces of infected persons to the mouth of the next person. It is spread also by the respiratory tract from mouth or respiratory secretions, by person-to-person contact, and from saliva on hands or toys. Direct contact with the skin blisters may also spread the virus.

Hand, foot, and mouth disease can be shed for several weeks

People can spread the disease when they are shedding the virus. The primary means of transmission is from the feces. The virus can be shed for several weeks after the onset of infection. The virus is also shed from the mouth and throat when a person has cold-like symptoms. The virus has also been found in the fluid from the skin blisters. Greatest communicability is during the acute phase/stage of illness when people are feeling ill.

There is no specific treatment for the virus that causes hand, foot, and mouth disease

Help prevent and control the spread of hand, foot, and mouth disease by:

  • Washing hands well, especially after going to the bathroom, changing diapers and handling diapers or other stool-soiled material
  • Covering the mouth and nose when coughing or sneezing
  • Washing toys and other surfaces that have saliva on them
  • Children should be excluded from child care or school settings if there is a fever and/or ulcers in the mouth, that is, when the child may be feeling ill
  • If blisters/lesions are open and weeping, children should be excluded from child care settings until the blisters are dried and crusted