Cough with hand, foot and mouth disease: what should you know?

Hand, foot and mouth disease commonly causes fever, painful mouth sores, and spots or blisters on the hands and feet. Cough may occur as part of the same viral illness, or it may reflect a common cold, allergic rhinitis, or acute bronchitis occurring at the same time. The rash does not prove that the cough has the same cause.

Mouth pain can make drinking difficult, especially for young children. Watch for fewer wet nappies or trips to the toilet, dry lips, no tears, unusual sleepiness, or worsening weakness. A clinician should assess a child who cannot drink or whose breathing changes.

Offer frequent small sips of cool fluid and soft foods; avoid acidic or spicy choices that sting mouth sores. Keep the child home from close-contact activities while unwell and wash hands carefully after nappy changes or toilet use. Do not share cups, utensils, towels, or toothbrushes. Use only age- and weight-appropriate medicine after checking the label or asking a clinician.

Seek emergency help for struggling or noisy breathing, blue lips, severe drowsiness, a seizure, or inability to wake the child. Obtain prompt medical advice for dehydration, persistent high fever, severe headache, neck stiffness, repeated vomiting, rapidly worsening illness, or a cough that is becoming more severe. Infants and children with long-term conditions may need earlier review.

Ask whether the cough fits the viral illness or suggests a separate chest problem, how to maintain hydration with mouth sores, and which fever or pain medicine is suitable. Check how long to keep the child away from school or nursery and which changes require urgent review.