What should you know about hand foot and mouth disease more than once?

Hand, foot and mouth disease is caused by a group of enteroviruses. Recovery from one infection may not protect against every virus in that group. A later episode can therefore look similar without meaning that the first illness never cleared. Spots may appear in the mouth, on the hands, feet, bottom or other areas. Other conditions can also cause blisters or ulcers, so a repeat rash is worth checking if its pattern differs.

Encourage regular fluids and offer soft, cool foods when mouth sores hurt. Wash hands with soap after toileting, nappy changes and nose wiping. Clean frequently touched surfaces, avoid sharing cups and utensils, and wash soiled clothing and bedding. Do not send a feverish or clearly unwell child into group settings. Use only medicines and skin products recommended for the child’s age and situation.

Contact a clinician if episodes keep returning, symptoms are unusually severe, or the child has a new rash that does not resemble the earlier illness. Get prompt help for difficulty drinking, very little urine, marked drowsiness, breathing problems, severe headache, or a fever that persists or worries you. A clinician can examine the mouth and skin and consider other causes.

Does this episode fit hand, foot and mouth disease? Could another infection explain the repeat symptoms? How long should close-contact precautions continue? What fluid and pain-relief plan suits my child?