Is a hand, foot and mouth rash contagious?

Spread is more likely with close contact, shared cups or utensils, kissing, coughing, or contact with fluid from a blister. Germs can also reach hands and surfaces after a nappy change or using the toilet. A person may spread infection before the rash is obvious, and virus can remain in stool after the child starts to feel better. A rash by itself does not establish the diagnosis; Atopic Dermatitis, Contact Dermatitis, Drug Rash, Heat Rash, Intertrigo, Psoriasis, Ringworm, and Scabies are not interchangeable explanations.

Wash hands with soap and water after toileting, nappy changes, nose wiping, and touching lesions. Do the same before preparing food or eating. Clean toys and high-touch surfaces, launder soiled clothing and bedding, and avoid sharing towels, cups, cutlery, or toothbrushes. Keep blisters covered with clean clothing when practical, and keep a child away from close-contact activities while feverish or unwell. Follow local nursery or school guidance for returning.

Contact a clinician if the child is drinking poorly, has much less urine, or has mouth pain that makes fluids difficult. Seek urgent care for breathing problems, unusual difficulty waking, a stiff neck, severe headache, or a rapidly worsening skin infection with swelling, heat, pus, or spreading pain. Medical review is also sensible for a vulnerable infant or a person with reduced immunity.

How should we manage contact with siblings or pregnant household members? When is return to school or nursery reasonable? How long should extra hand hygiene continue? Which symptoms would mean the rash is infected rather than simply healing?