Hand, foot and mouth disease and a runny nose

Hand, foot and mouth disease is a viral infection that often causes fever, sore throat, reduced appetite, painful mouth ulcers, and spots or blisters on the palms, soles, or elsewhere. Nasal discharge may be part of the early viral illness, or the child may have a separate cold at the same time. Clear discharge, sneezing, and itchy eyes can also fit an allergy. A runny nose alone cannot identify the cause.

Offer frequent drinks and cool, soft foods if mouth sores make eating uncomfortable. Saline nose drops and gentle nose blowing can ease congestion; avoid smoke and strong fragrances around the child. Wash hands after wiping the nose, using the toilet, or changing nappies, and do not share cups, cutlery, towels, or pacifiers. Use only age-appropriate medicines and follow label or clinician advice. A pharmacist can help choose a suitable option for the child’s age.

Arrange medical advice if the child is drinking very little, passing much less urine, becoming unusually sleepy, or has fever that persists or returns. Seek urgent help for difficult breathing, inability to swallow fluids, severe weakness, a seizure, or a child who is difficult to wake. A runny nose lasting beyond the viral illness, facial pain, or thick discharge with worsening symptoms may need assessment for another problem.

Could the nasal symptoms be a separate cold or allergy? How can we protect sore areas in the mouth and keep drinks going? When can the child return to nursery or school? Which symptoms would mean the child needs same-day assessment?