- small, painful ulcers in the mouth
- small blisters or red spots located on the palms and soles, and on the webs between the fingers and toes
- 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. “Magic Mouthwash” for pain relief
Mix 1/2 teaspoon antacid solution (such as Maalox or Mylanta) with ½ teaspoon diphenhydramine
solution (liquid Benedryl). Apply some of this solution to the inside of the lips and mouth before
feeding, up to six times a day. Children over age 4 can use 1 teaspoon of this solution to swish and
Offer a soft diet. Cold drinks, milkshakes, Popsicles, and sherbet are good choices. Avoid citrus,
salty, or spicy foods.
Give acetaminophen or ibuprofen for severe mouth pain or fever over 102 degrees F (38.9 degrees C).
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.
Call your child’s physician immediately if:
• Your child has not urinated for more than 8 hours.
• Your child starts acting very sick.
Call your child’s physician during office hours if:
• The fever lasts more than 3 days.
• You have other concerns or questions
adapted from Clinical Reference Systems Pediatric Advisor ©2001