Coxsackie virus and hand, foot and mouth disease

A child may first seem tired or feverish, then develop painful spots or blisters in the mouth and a rash on the palms, soles, fingers, toes or buttocks. The rash can be mild and may not appear in every area. The virus spreads through saliva, coughs, stool and fluid from blisters, particularly in households and childcare settings. It is different from foot-and-mouth disease in animals.

Give regular drinks and offer soft, cool foods when mouth sores make eating uncomfortable. Encourage handwashing after toileting or nappy changes, clean frequently touched surfaces and avoid sharing cups or utensils. Keep blisters clean and avoid picking them. Use symptom medicines only as directed for the child's age and weight. A child health consultation can help when the diagnosis is uncertain or drinking is becoming difficult.

Arrange prompt care if the child refuses fluids, has a dry mouth, passes much less urine, is difficult to wake, develops breathing problems, has a seizure or appears increasingly unwell. Fever that concerns you, symptoms in a very young infant, or a child with reduced immunity also warrants medical advice.

Ask how to protect siblings, when the child can return to nursery, which pain-relief options are suitable, and what hydration signs should be monitored.