Hand, foot and mouth disease

About hand, foot and mouth disease

Hand, foot and mouth disease is most common in children under 10, but you can get it at any age. The disease often spreads among groups of children, particularly in nurseries and schools. In the UK, it most frequently occurs in the summer months and early autumn.

Hand, foot and mouth disease isn’t the same as foot and mouth disease, which is a disease of cattle, sheep and pigs.

Symptoms of hand, foot and mouth disease

You may not have any symptoms of hand, foot and mouth disease. If you do have symptoms, you’re likely to:

  • have a fever
  • have a sore throat
  • lose your appetite
  • generally feel unwell
  • have pain in your abdomen (tummy)
  • have blisters or ulcers in your mouth – often on the inside of your cheek, gums or on your tongue, which can make eating and drinking painful
  • develop spots or blisters, about 2 to 5mm wide with red edges, on your hands, soles of the feet, buttocks, knees or elbows – these aren’t usually itchy

Your symptoms will usually appear three to five days after you’re infected with the virus and may last for around seven to 10 days.

You probably won’t need to see your GP if you have these symptoms as you can usually manage them at home, and the condition doesn’t need to be notified to the health authorities. However, you should see your GP if symptoms get worse, for example, if you aren’t drinking fluids, are vomiting or you’re drowsy or irritable, as this could indicate a complication of the condition.

Complications of hand, foot and mouth disease

Hand, foot and mouth disease is usually a mild infection. Very rarely, it may lead to more serious problems such as those listed below.

  • Dehydration. It may be painful for you to drink but if you don’t drink enough fluids you may need to go to hospital to have fluids through a drip.
  • Inflammation of your brain (viral meningitis). Symptoms include a headache, stiff neck and vomiting.
  • Swelling of your brain (encephalitis). Symptoms include confusion, becoming irritable and seizures (fits).
  • Paralysis (unable to move your muscles).

If you have any of these symptoms, seek urgent medical attention.

Causes of hand, foot and mouth disease

Hand, foot and mouth disease is caused by the enterovirus group of viruses, which includes the coxsackie virus A16 – the most common cause of the disease. Hand, foot and mouth disease can also be caused by the coxsackie B virus and the enterovirus 71 virus. These viruses can remain in your body for weeks after your symptoms have gone, so you can pass the disease on to others even if you feel and appear well.

Hand, foot and mouth disease is very contagious and you can catch and spread it easily. The viruses that cause the disease are often spread in droplets of mucus or saliva. You can breathe in infected droplets if someone with hand, foot and mouth disease coughs or sneezes near to you.

The viruses can also be spread in faeces. For example, you may catch it if your child has hand, foot and mouth disease and you touch your mouth after handling his or her dirty nappy. It's important to wash your hands (with soap and water) after you go to the toilet, or after touching tissues or nappies from someone who has recently had hand, foot and mouth disease.

You can also get infected with hand, foot and mouth disease if you have contact with fluid from the blisters of a person infected with the virus.

If you have hand, foot and mouth disease and have developed blisters, avoid bursting the blisters and try not to share towels, clothes or eating utensils with other people. Wash soiled clothing, towels and bedding at a hot temperature.

Diagnosis of hand, foot and mouth disease

You don’t usually need to see your GP if you think you have hand, foot and mouth disease. However, if your symptoms get worse, see your GP for advice.

Your GP will ask about your symptoms and examine you. He or she may also ask you about your medical history. Your GP will confirm if you have hand, foot and mouth disease by looking at the spots or blisters on your body and ulcers in your mouth. He or she may also take into account other factors such as your age and if you have been in contact with anyone else who has hand, foot and mouth disease.

Treatment of hand, foot and mouth disease

There isn't a specific treatment for hand, foot and mouth disease; it usually clears up on its own after around seven to 10 days. However, there are a number of things you can do to help relieve your symptoms.

  • Drink enough fluids to prevent yourself from becoming dehydrated.
  • If you need pain relief, take over-the-counter painkillers such as paracetamol or ibuprofen.
  • If you have pain from mouth ulcers, use benzydamine hydrochloride mouthwash or spray (eg Difflam). If you prefer, you can use choline salicylate gel (eg Bonjela) to relieve your pain.

There are age restrictions on some of these treatments. For example, benzydamine mouthwash is only suitable for children over 12, and the spray for children over five. You can give Bonjela to children 16 or older.

You shouldn’t give ibuprofen to children or adults who are sensitive to the medicine or to other non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin. Always read the patient information that comes with your medicine and if you have any questions, ask your pharmacist for advice.

Special considerations

If you're pregnant

Hand, foot and mouth disease causes a mild illness in pregnant women. There is no clear evidence that more serious problems can occur while you're pregnant. However, if you get hand, foot and mouth disease shortly before you give birth, you may give it to your newborn baby. This will usually be a mild illness and it's very unlikely your baby will develop complications.

To prevent yourself from catching the virus, try not to have direct contact with people who have hand, foot and mouth disease. If you become infected during your pregnancy, or just before your child's birth, see your GP.

Prevention of hand, foot and mouth disease

There isn't a vaccine that will prevent you from getting hand, foot and mouth disease.

You can reduce your risk of catching and spreading hand, foot and mouth disease by taking the following personal hygiene precautions.

  • Wash your hands with soap and water after you touch any infected blisters or sores, especially before you eat and after you go to the toilet.
  • Clean contaminated surfaces with chlorine-containing bleach.
  • Dispose properly of used tissues and nappies after changing your baby.
  • Don’t kiss, hug or share utensils with people who are infected.
  • Stay away from public places to prevent spreading the infection to others – wait until your blisters have dried and you’re feeling better.

Should my child stay off school if he has got hand, foot and mouth disease?

Answer

Your child doesn’t need to stay off school unless he or she is unwell.

Explanation

The hand, foot and mouth disease infection is generally mild and symptoms will usually disappear within seven to 10 days. The Health Protection Agency recommends that a child may go to school if they are well enough to attend.

Hand, foot and mouth looks like chickenpox. How do I tell the difference?

Answer

The main difference is where the rash is on your body.

Explanation

If you have hand, foot and mouth disease you may have red spots on your hands, feet, buttocks, knees or elbows, and blisters or ulcers in your mouth. If you have chickenpox, you will usually get spots on your face and scalp as well as your chest, arms and legs. You may also get spots inside your mouth and nose.

The blisters that you get with hand, foot and mouth disease are generally smaller than those that develop in chickenpox. Chickenpox blisters are also usually very itchy.

Can I catch hand, foot and mouth disease more than once?

Answer

Yes.

Explanation

As hand, foot and mouth disease can be caused by different types of enterovirus, you may be able to catch it more than once. However, you won't develop the disease if you become infected with the same type of virus you were infected with before. When you recover from hand, foot and mouth disease, you will develop immunity to the specific type of virus you were infected with.