How long is hand, foot and mouth disease contagious?

A child can spread the infection before the rash is fully recognised, while fever, mouth ulcers and active blisters are present, and after feeling better. The highest spread risk is generally early in the illness, when respiratory secretions and close contact are common. Virus can continue to leave the body in stool after other symptoms settle, which is why careful hand hygiene after toilet use or nappy changes matters.

There is no single day that suits every child for returning to group activities. The decision depends on overall health, fever, ability to drink and the rules of the nursery or school. A [Fever](/symptoms/fever/) that persists or returns deserves medical advice.

Wash hands with soap and water after every nappy change or toilet visit and before preparing food. Clean shared toys, taps, door handles and other frequently touched surfaces. Avoid sharing cups, cutlery, towels and toothbrushes. Cover coughs and sneezes, and dispose of tissues promptly.

Offer cool fluids and soft foods if mouth sores make eating uncomfortable. Keep the child home while they are unwell, then check local nursery or school guidance before return. A [Child Health Consultation](/treatments/consultations-and-assessment/child-health-consultation/) is useful when the child cannot drink well or the timing of return is unclear.

Seek prompt advice for reduced urination, a dry mouth, no tears, marked tiredness or difficulty drinking. These signs can point to dehydration. Get urgent help if the child has trouble breathing, a seizure, is difficult to wake or deteriorates quickly.

Contact a clinician when fever lasts longer than expected, symptoms are severe, the child is very young, or the rash does not look typical. Continued stool hygiene is sensible even after the skin has healed.

Ask when your child can safely return to nursery or school, whether the fever or rash needs review, how to manage painful mouth sores, how long to take extra care with nappy hygiene, and which warning signs should prompt urgent assessment.