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Clinical Reference Systems: Pediatric Advisor 10.0
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Hand, Foot, and Mouth Disease


  • small, painful ulcers in the mouth
  • small water blisters or red spots located on the palms and soles, and on the webs between the fingers and toes
  • five or fewer blisters per hand or foot
  • sometimes, small blisters or red spots on the buttocks
  • low-grade fever between 100 and 102 degrees F (37.8 and 38.9 degrees C)
  • mainly occurs in children age 6 months to 4 years.


Hand, foot, and mouth disease is always caused by the Coxsackie A-16 virus. It has no relationship to hoof and mouth disease of cattle.


The fever and discomfort are usually gone by day 3 or 4. The mouth ulcers resolve in 7 days, but the rash on the hands and feet can last 10 days. The only complication seen with any frequency is dehydration from refusing fluids.


  1. Antacid solution for pain relief

    For very young children, put 1/2 teaspoon antacid solution in the front of the mouth four times a day after meals. Children over age 4 can use 1 teaspoon of an antacid solution as a mouthwash after meals.

  2. Diet

    Offer a soft diet. Use a cup instead of a bottle to give fluids to very young children. Cold drinks, milkshakes, Popsicles, and sherbet are good choices. Avoid citrus, salty, or spicy foods.

  3. Medication

    Give acetaminophen or ibuprofen for severe mouth pain or fever over 102 degrees F (38.9 degrees C).

  4. Contagiousness

    Hand, foot, and mouth disease is quite contagious. Usually some of your child's playmates will develop it at about the same time. The incubation period after contact is 3 to to 6 days. Because the spread of infection is extremely difficult to prevent and the condition is harmless, these children do not need to be isolated. They can return to day care or school when the fever returns to normal. While most children are contagious from 2 days before to 2 days after the rash, avoiding other children is unnecessary.


  • Your child has not urinated for more than 8 hours.
  • Your child starts acting very sick.


  • The fever lasts more than 3 days.
  • You have other concerns or questions.

Written by B.D. Schmitt, M.D., author of "Your Child's Health," Bantam Books.
Copyright 1999 Clinical Reference Systems