What is hand, foot and mouth disease?
Hand, foot and mouth disease is generally a mild illness caused by a number of enteroviruses, including coxsackieviruses. It is usually not a serious illness, and occurs and is not related to the foot and mouth disease that affects cattle. It mainly occurs in children under 10 years of age but can also occur in older children and adults.
What are the symptoms?
Hand, foot and mouth disease starts with blisters that begin as small red dots which later become ulcers.
- Blisters appear inside the cheeks, gums, and on the sides of the tongue, as well as on the palms of the hands and soles of the feet. In infants, blisters can sometimes be seen in the nappy area. Blisters usually last for seven 7 to 10 days.
- Children can sometimes have a low fever, irritability, sore throat, tiredness, feel off colour and may be off their food for a day or two.
- Very rarely, enteroviruses can cause other illnesses that affect the heart, brain, lining of the brain (meningitis), lungs, or eyes.
How is it spread?
Hand, foot and mouth disease is usually spread by person-to-person contact. The virus is spread from the faeces of an infected person to the mouth of the next person by contaminated hands. It is also spread by secretions from the mouth or respiratory system, and by direct contact with the fluid from blisters .
It usually takes between three and five days after contact with an infected person before blisters appear. The viruses can remain in faeces for several weeks.
Who is at risk?
The viruses that cause hand, foot and mouth disease are common and particularly affect children.
Many adults, including pregnant women, are often exposed to them without symptoms. There is no clear evidence of risk to unborn babies from hand, foot and mouth disease. However, infected mothers can pass the infection onto newborn babies who rarely can have severe disease.
Outbreaks may occur in child-care settings.
How can it be prevented?
Good hygiene is the best protection:
- Wash hands with soap and water after going to the toilet, before eating, after wiping noses, and after changing nappies or soiled clothing.
- Avoid sharing cups, eating utensils, items of personal hygiene (for example: towels, washers and toothbrushes), and clothing (especially shoes and socks).
- Thoroughly wash any soiled clothing and any surfaces or toys that may have been contaminated.
- Teach children about cough and sneeze etiquette:
- Cover coughs and sneezes with a tissue. Coughing into an elbow is better than coughing into your hands.
- Dispose of used tissues in the bin straight away
- Wash your hands afterwards with soap and water
How is it diagnosed?
Your doctor can diagnose hand, foot and mouth disease based on the symptoms. Laboratory tests are not usually necessary.
How is it treated?
Usually no treatment is needed. Paracetamol will relieve fever and discomfort. Do not give children aspirin.
Allow blisters to dry out naturally. The blisters should not be deliberately burst because the fluid within them is infectious.
What are the signs of a serious infection?
Signs that an infant or older child might have a more serious form of hand, foot and mouth disease include any of the following:
- persistent fever (38°C or above for 72 hours or more)
- abnormal movements / jerking movements
- rapid breathing
- excessive tiredness, drowsiness
- excessive irritability
- difficulty walking.
If any of these signs are present then the child should be seen by a doctor urgently even if they have been checked earlier in the illness.
How long should children stay away from childcare and school?
Children with hand, foot and mouth disease should be excluded from school or childcare facilities until their blisters have dried-up, and any rash (if present) has gone and any fever has settled.
What is the public health response?
Hand, foot and mouth disease is not notifiable under the Public Health Act. However, to help prevent spread parents should report the illness to the director of the childcare centre or the school principal.
For further information please call your local public health unit on 1300 066 055.
Information for health professionals
See the Enteroviruses (non-polio) and human parechoviruses fact sheet - Information for clinicians.