Hand, Foot, and Mouth Disease: Recognizing Symptoms, Preventing Spread, and Relieving Symptoms

Sudden fever, loss of appetite, and small blisters in the mouth: If red spots or blisters appear on the hands and feet shortly afterward, hand, foot, and mouth disease may be the cause. This contagious viral illness primarily affects babies, toddlers, and preschool-aged children. However, adolescents and adults can also contract it.

In most cases, hand, foot, and mouth disease is mild and resolves on its own. For affected children, however, the painful lesions in the mouth can be very uncomfortable. It is therefore especially important to ensure adequate fluid intake, good hygiene, and early recognition of possible warning signs.

In this guide, you’ll learn how hand, foot, and mouth disease presents itself, how it’s transmitted, and how you can reduce the risk of infection in your family’s daily life.

What is hand, foot, and mouth disease?

Hand, foot, and mouth disease is an infectious disease caused by various enteroviruses. The possible pathogens include, in particular, Coxsackieviruses and other human enteroviruses.

The disease occurs year-round. However, outbreaks are particularly common in late summer and fall. It mostly affects children under the age of ten because the viruses can spread easily in preschools, daycare centers, and other communal settings.

Despite the similar name, hand, foot, and mouth disease has nothing to do with foot-and-mouth disease in animals.

What are the typical symptoms?

The first symptoms usually appear a few days after infection. At first, the symptoms often resemble those of a common infection.

Possible early signs include:

• mild to moderate fever
• sore throat
• Fatigue and general malaise
• loss of appetite
• Headache or body aches
• Irritable and tearful behavior in young children

After a short time, characteristic changes may develop in the mouth and on the skin.

Blisters and sores in the mouth

Small red spots first appear in the mouth, which can develop into blisters or painful areas on the mucous membranes. They are often found:

• on the tongue
• on the gums
• on the inside of the cheeks
• on the roof of the mouth
• around the mouth

The sores can make eating, drinking, and swallowing difficult. As a result, young children sometimes refuse food or fluids.

Skin rash on the hands and feet

Red spots or small blisters on the palms of the hands and soles of the feet are typical. The rash may also appear in the following areas:

• Fingers and toes
• Knees and elbows
• Buttocks
• Diaper area
• Arms and legs

Not every person affected develops all of the typical symptoms. Some infections are very mild or even occur without any noticeable symptoms.

How is hand, foot, and mouth disease transmitted?

The viruses are highly contagious and can spread from person to person in various ways.

Direct contact

Transmission is possible through direct contact with saliva, nasal secretions, or the fluid from skin blisters. This can happen, for example, while cuddling, kissing, or playing together.

Droplets and secretions

Coughing, sneezing, or speaking can spread secretions containing the virus. Close contact therefore facilitates the spread within a family or group of children.

Surface transmission

Enteroviruses can get onto hands, toys, doorknobs, tables, and other frequently touched objects. If the mouth, nose, or eyes are touched afterward, the pathogens can be ingested.

Transmission via feces

The viruses can still be shed in the stool for several weeks after symptoms have subsided. That is why thorough handwashing after using the restroom and after changing diapers is especially important.

The risk of infection is particularly high during the first week of illness and when fresh blisters appear. However, transmission can also occur through people who experience few or no symptoms themselves.

How long does hand, foot, and mouth disease last?

In most cases, symptoms improve within seven to ten days. The blisters gradually dry out, and the rash usually disappears without leaving scars.

Occasionally, a few weeks after the illness, fingernails or toenails may change in appearance or partially detach. This can look alarming, but it is often temporary. The nails usually grow back. If you are unsure, you should consult a pediatrician or dermatologist.

How is hand, foot, and mouth disease treated?

There is usually no specific treatment for the viruses that cause the disease. Treatment focuses on relieving symptoms and preventing dehydration.

Drink plenty of fluids

Painful sores in the mouth can cause children to drink less. Therefore, offer small amounts of fluid regularly.

Good options include:

• cool water
• unsweetened tea
• chilled beverages
• small sips at short intervals
• Ice pops for temporary relief

Acidic juices, very hot beverages, and highly carbonated drinks can further irritate the inflamed oral mucosa.

Offer soft and mild foods

Good choices include foods that are easy to swallow and do not further irritate the sore areas, such as:

• Yogurt
• Porridge
• Mashed potatoes
• Soft pasta
• cooled soups
• Mild, soft foods

Spicy, salty, sour, or very hot foods should be avoided temporarily.

Monitoring Fever

Fever is one of the possible initial symptoms. A reliable clinical thermometer can be used to regularly monitor and record body temperature.

Fever-reducing or pain-relieving medications should only be given to children based on their age and weight, in accordance with the package insert, or after consulting a doctor.

Ensure Rest

Sick children need plenty of sleep and rest. Strenuous activities should be avoided as long as fever, pain, or a significantly impaired general condition persists.

Hygiene for Hand, Foot, and Mouth Disease: What Matters

Consistent hygiene can reduce the risk of infection. However, it cannot completely prevent transmission in every case.

Wash hands thoroughly

Wash your hands regularly with soap and water—especially:

• after changing a diaper
• after using the restroom
• before preparing food
• before eating
• after coming into contact with saliva or nasal secretions
• after treating skin blisters
• after cleaning contaminated surfaces

Hands should be completely lathered with soap, thoroughly rinsed, and then carefully dried. Help young children wash their hands.

For specific hygiene situations, Altruan also offers a selection of hand sanitizers. However, in the case of hand, foot, and mouth disease, hand sanitizer is not a substitute for thorough washing with soap and water. In addition, the product in question must explicitly have a suitable spectrum of activity against non-enveloped viruses.

Clean frequently touched surfaces

Doorknobs, changing tables, toilets, faucets, and frequently used toys should be cleaned regularly. Visible dirt must first be completely removed.

If targeted disinfection is necessary, a suitable product should be used. The Altruan Collection of hand and surface disinfectants offers a variety of solutions, concentrates, and disinfectant wipes.

When selecting a product, always ensure:

• the intended area of application
• the stated spectrum of activity
• the prescribed concentration
• the contact time
• material compatibility
• the manufacturer’s instructions for use

Since the pathogens that cause hand, foot, and mouth disease are non-enveloped viruses, not every disinfectant should be considered suitable across the board. The specific manufacturer’s information regarding viral efficacy is decisive.

Disposable gloves for changing diapers and cleaning

In cases of direct contact with feces, bodily fluids, or contaminated materials, disposable gloves can support hygienic work procedures. They may be useful, for example:

• when changing diapers
• when applying medically recommended skin care products
• when cleaning heavily soiled surfaces
• when handling excrement
• when treating burst blisters

Disposable gloves must be discarded after each task. Hands should then be washed thoroughly. Gloves are not a substitute for handwashing or proper surface cleaning.

Do not share personal items

People who are sick should use their own personal items whenever possible. These include:

• Towels
• Washcloths
• Drinking cups
• Cutlery
• Toothbrushes
• Pacifiers
• Bedding

Textiles should be washed according to the care instructions. Soiled laundry should not be shaken out if possible, so that particles containing pathogens are not spread unnecessarily.

Can the child go to daycare or school?

Children with a fever, severe pain, or a significantly impaired general condition should stay home. Fresh, weeping blisters also increase the risk of transmission.

When a child can return to daycare or school depends on the child’s condition and the guidelines of the respective facility. Parents should therefore consult with the daycare center, school, and, if applicable, the child’s pediatrician’s office.

In many cases, a return is possible if:

• the fever has subsided
• the child is eating and drinking sufficiently again
• the child’s general condition is good
• the acute symptoms have significantly subsided
• there are no longer any heavily weeping skin areas

Complete elimination of the viruses is not to be expected at this point, as they can continue to be shed in the stool for some time. Consistent hand hygiene therefore remains important even after recovery.

Can adults get sick?

Yes. Adults can also become infected with the causative enteroviruses. The infection often proceeds without symptoms or with only mild symptoms.

However, more severe cases are also possible. Adults may develop the following symptoms, among others:

• Fever
• severe sore throat
• sores in the mouth
• Rash on the hands and feet
• severe malaise
• Pain or itching in the affected areas

Parents, educators, and healthcare and nursing professionals, in particular, come into contact with potential sources of infection more frequently. Thorough handwashing is therefore crucial not only for children but also for the adults caring for them.

Is hand, foot, and mouth disease dangerous during pregnancy?

Pregnant women should minimize close contact with infected individuals whenever possible and pay particular attention to hand hygiene. Most infections are mild, even during pregnancy.

If a pregnant woman develops symptoms or has been in close contact with an infected person shortly before giving birth, she should notify her OB/GYN’s office as a precaution. There, her individual risk can be assessed and the next steps discussed.

When should you see a doctor?

Hand, foot, and mouth disease usually resolves on its own. However, it’s important to seek medical advice if the child appears unusually ill or is unable to drink enough fluids.

Visit a doctor’s office if:

• there is a high or prolonged fever
• severe pain occurs
• the child is barely drinking
• the number of wet diapers decreases significantly
• their mouth seems very dry
• the child is unusually sleepy or lethargic
• the symptoms do not improve after several days
• areas of skin become severely inflamed
• there is a relevant pre-existing condition or immune deficiency
• you are unsure whether it is actually hand, foot, and mouth disease

Immediate medical attention is required if:

• Altered consciousness
• Seizures
• Stiff neck
• Breathing difficulties
• marked lethargy
• Clear signs of dehydration

Serious complications are rare but should be detected early.

Checklist for Families

• Check body temperature regularly
• Offer small amounts of fluid frequently
• Choose mild and soft foods
• Wash hands thoroughly after changing diapers and using the restroom
• Do not share towels or drinking cups
• Clean pacifiers and frequently used toys
• Keep doorknobs and changing areas clean
• Wear disposable gloves when handling feces, if necessary
• Check the spectrum of activity for disinfectants
• Cover burst blisters as cleanly as possible
• Carefully monitor the person’s overall condition
• Seek medical help if warning signs appear

Appropriate Hygiene and Care Products

The following product categories can be helpful for maintaining hygiene during an illness:

• Clinical thermometers for monitoring body temperature
• Disposable gloves for changing diapers and cleaning
• Hand sanitizer for appropriate situations
• Hand and surface disinfectants
• Hygiene products for the home, personal care, and patient care

Disinfectants and medical devices should always be used in accordance with their intended purpose and the manufacturer’s instructions. They are not a substitute for medical diagnosis or treatment.

Conclusion: Good hygiene protects the whole family

Hand, foot, and mouth disease is a common and highly contagious viral illness that primarily affects young children. Typical symptoms include fever, painful sores in the mouth, and a rash on the hands and feet.

In most cases, the illness resolves on its own within a few days. It is important to ensure the child stays well-hydrated, eats bland foods, gets plenty of rest, and is closely monitored. Thorough handwashing, regular cleaning of frequently touched objects, and proper hygiene when handling diapers and bodily fluids can help break the chain of infection.

If the child has a high fever, refuses to drink, is extremely tired, or has other concerning symptoms, they should be examined by a doctor. This allows for the early detection of potential complications and the ruling out of other illnesses.

Note: This article is intended for general information purposes only and is not a substitute for individual medical advice, diagnosis, or treatment.