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, buttocks, and sometimes genitals.

A related infection, called "herpangina," causes sores just in the mouth and throat. Both infections most often affect children, but adults can get them, too. 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 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, buttocks, and sometimes genitals. 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 in the throat.

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

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

●Mucus from the nose

●Saliva

●Fluid from one of 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 necessary. The doctor or nurse should be able to tell if a child has it by learning about their symptoms and doing an exam.

Should the child see a doctor or nurse? — You should call the doctor or nurse if the child is drinking less than usual and hasn't had a wet diaper for 4 to 6 hours (for babies and young children) or hasn't needed to urinate in the past 6 to 8 hours (for older children). You should also call if the child seems to be getting worse or isn't getting better after a few days.

How is hand, foot, and mouth disease treated? — The infection itself is not treated. It usually goes away on its own within about a week. But children who are in pain can take nonprescription 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.

The sores in the mouth can make swallowing painful, so some children might not want to eat or drink. It is important to 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.

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

Can hand, foot, and mouth disease be prevented? — Yes. The most important thing 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 (table 1).

It's also important to keep your home clean and 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 don't feel well enough to go. You should also keep the child home if they are drooling a lot or have open sores.