Beginning signs of hand, foot and mouth disease

The mouth changes may start as red spots on the tongue, gums or inside the cheeks and then become tender sores. A rash can follow on the palms and soles, and may also involve the buttocks, legs or arms. The spots are not always itchy.

This contagious viral illness is seen often in young children, although older children and adults can catch it. Similar-looking rashes have other causes, so the pattern alone does not confirm the diagnosis.

Offer frequent cool drinks and soft foods. Avoid acidic, salty or spicy items if mouth sores sting. A pharmacist or clinician can advise on a suitable pain or fever medicine for the person's age and health; do not give aspirin to a child.

Wash hands after toileting, nappy changes and contact with saliva. Do not share cups, cutlery or towels, and clean frequently touched surfaces. Keep blisters clean rather than deliberately breaking them.

Seek prompt medical advice if mouth pain prevents drinking, urine becomes noticeably less frequent, the mouth is dry, there are no tears when crying, or the person is unusually sleepy. A very young infant, a person with weakened immunity, severe symptoms, or symptoms that are worsening also needs clinical guidance.

Get urgent help for difficulty breathing, confusion, a seizure, marked weakness or inability to wake normally. These signs require assessment regardless of the suspected cause of the rash.

Ask whether the mouth and skin pattern fits hand, foot and mouth disease, how to maintain hydration, which symptom medicines are appropriate, and when the person may return to nursery, school or work under local guidance.