Early stages of hand, foot and mouth disease

This is a contagious viral illness that mainly affects young children, although older children and adults can catch it. Small painful ulcers may develop inside the mouth, making eating and drinking difficult. A rash or small blisters can then appear on the palms, soles, fingers, toes, or around the buttocks; the pattern varies between people.

The early symptoms can resemble other childhood infections. The appearance of mouth lesions and the distribution of the rash help a clinician assess the illness, but they do not replace an examination when a child is very unwell.

Offer frequent sips of cool water or milk and soft foods. Avoid acidic, spicy, or salty foods if mouth sores sting. Encourage rest, wash hands carefully, and do not share cups, cutlery, towels, or pacifiers. Clean commonly touched surfaces and keep the child away from group activities while fever or significant illness continues.

Arrange a Child Health Consultation if drinking is difficult, the diagnosis is uncertain, or symptoms are not improving. Use only age-appropriate medicines and doses advised by a healthcare professional.

Seek urgent help if the child cannot drink, has very little urine, no tears, a dry mouth, marked sleepiness, breathing difficulty, a seizure, severe headache, neck stiffness, or a rapidly worsening condition. Get prompt medical advice for a persistent Fever, severe mouth pain, or a child who is difficult to wake.

Ask how to protect hydration, which foods and medicines are suitable, when the child can return to nursery or school, how long close-contact precautions should continue, and which signs mean the child needs reassessment.