How hand, foot and mouth disease spreads

The virus can pass through coughs, sneezes, kissing, shared cups or cutlery, and contact with contaminated hands, toys or surfaces. Nappy changing and toilet use can spread it when handwashing is incomplete. A person is often most contagious while symptoms are active, but virus can remain in stool after recovery. People may spread it before they realise they are ill, so identifying every exposure is not always possible.

Wash hands with soap after using the toilet, changing nappies, wiping a nose or touching blisters, and before preparing food. Clean frequently touched surfaces and do not share towels, cups, cutlery or toothbrushes. Cover coughs and sneezes, keep blisters covered where practical, and wash soiled laundry separately or thoroughly. Stay home while feverish or too unwell for normal activities, following school or workplace advice.

Arrange advice if the person cannot drink, is passing much less urine, has persistent fever or seems to be worsening. Urgent care is needed for breathing problems, confusion, a seizure, a stiff neck or severe sleepiness. A [fever](/symptoms/fever/) may occur with the infection and should be considered with hydration and behaviour. Use a [Child Health Consultation](/treatments/consultations-and-assessment/child-health-consultation/) for guidance about attendance and household contacts.

Ask how long close contacts should be watched, when school or childcare is reasonable, how to clean shared items, and whether a household member needs assessment.