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Hand, foot and mouth disease

Hand, foot and mouth disease is a mild infection caused by a virus. It causes spots or blisters to appear on your hands, your feet and/or in your mouth.

It is most common in children under 10, but you can get it at any age. It occurs more often in the summer months and early autumn.

  • About hand, foot and mouth disease
  • Symptoms
  • Causes
  • Diagnosis
  • Treatment
  • Hand, foot and mouth disease and pregnancy
  • Prevention
  • Further information
  • Sources
  • Related topics

About hand, foot and mouth disease

Hand, foot and mouth disease is very infectious. This means it's passed between people very easily. In young children, every child will usually get hand, foot and mouth disease if they have come into contact with someone with the disease. It's generally a mild infection.

Symptoms

You may have hand, foot and mouth disease and have no symptoms. If you do have symptoms, you will usually have them about four to six days after getting the hand, foot and mouth disease virus. Symptoms include:

  • fever
  • sore throat
  • blisters or ulcers in your mouth - often on the inside of your cheek, your gums or on your tongue
  • spots or blisters with red edges on the back or palms of your hands and feet
  • spots or blisters on your buttocks
  • loss of appetite
  • generally feeling unwell

Symptoms may last for about five to seven days. The blisters usually go after one week.

Complications

Hand, foot and mouth disease is usually a mild infection. Complications can occur in some people but they are rare. These include:

  • inflammation of the heart (myocarditis)
  • bleeding in the lungs
  • inflammation of the brain (meningitis)
  • paralysis (being unable to move your muscles)

Causes

Hand, foot and mouth disease is mainly caused by the coxsackievirus A16 or enterovirus 71. Some other enteroviruses can also cause hand, foot and mouth disease.

You can get the virus if you breathe in the droplets of infected mucus or saliva suspended in the air when a person with hand, foot and mouth coughs or sneezes. You can also get hand, foot and mouth disease if you are in close contact or touch someone with the virus. This is via saliva, mucus and fluid from the blisters. The virus is also found in faeces and can be passed if you touch your mouth after being in contact with infected faeces. For example, after handling dirty nappies and not washing your hands.

You are able to pass the virus to someone else through coughs and sneezes or by touching them for about seven days. The virus can be found in the faeces for up to four weeks so you may spread the virus this way.

Diagnosis

Blisters or ulcers in the mouth are a symptom of many diseases or infections. Your GP will examine you and ask you about your symptoms. This may include asking your age, what your symptoms are and when they started and by looking at the blisters or spots.

Treatment

There isn't a specific treatment for hand, foot and mouth disease. Taking the painkiller you would normally take for a headache will help to ease symptoms. Before taking any medicines ask your pharmacist for advice. Follow the instructions in the patient information leaflet that comes with the medicine.

It's important to drink plenty of fluids to stop you from becoming dehydrated, this is particularly important in young children.

Benzydamine hydrochloride (eg Difflam) mouthwash or spray may be helpful to relieve pain from mouth ulcers. You may need to dilute this with an equal amount of water to prevent stinging. Flurbiprofen lozenges (eg Strefen) may reduce pain from mouth ulcers in adults and children over 12 years old. You can use choline salicylate gel (eg Bonjela) to help relieve ulcer pain in young children over four months old.

For more information on treating fevers in children, please see Related topics.

Hand, foot and mouth disease and pregnancy

Hand, foot and mouth disease causes a mild illness in pregnant women. There is no clear evidence that more serious problems can occur while pregnant. Pregnant women often have viruses during pregnancy. It may though be advisable to not have any contact with people who have the infection so you can avoid getting the virus.

Mothers can give the virus to newborn babies if you are infected before delivery. This usually causes a mild illness in your baby but can cause infections in major organs such as the liver or heart and can be life threatening. This risk is higher during the first two weeks of life.


Prevention

There isn't a vaccine to prevent hand, foot and mouth disease.

You can help to prevent the infection by maintaining good hygiene standards, particularly if you are changing nappies or are a carer. You can also clean surfaces with chlorine-containing bleach to prevent infection. By not kissing, hugging or sharing utensils with people who have the infection, you can reduce the risk of getting hand, foot and mouth disease if someone close to you has it.

Further information

Health Protection Agency

Sources

  • British National Formulary (BNF) September 2007. BMJ Publishing Group, 2007, 54: 583
  • Guidelines on the management of communicable diseases in schools and nurseries: Hand, foot and mouth. Health Protection Agency. www.hpa.org.uk, accessed 31 October 2007.
  • Hand, foot, and mouth disease. Centers for Disease Control and Prevention (CDC). www.cdc.gov, accessed 31 October 2007
  • Kasper DL, Braunwald E, Fauci AS et al. Harrison's Principles of Internal Medicine. 16th ed. USA, McGraw-Hill, 2005:1146
  • Simon C, Everitt H, Kendrick T. Oxford Handbook of General Practice. 2nd ed. Oxford: Oxford University Press, 2005: 491

Related topics

Fever in children