What should you know about herpangina and hand foot mouth disease?

Herpangina often causes sudden fever, sore throat, and small painful blisters toward the back of the mouth and throat. Hand, foot and mouth disease can cause mouth sores plus spots or blisters on the hands, feet, and sometimes the nappy area or other skin. Children may refuse food or drink because swallowing hurts. The illnesses spread readily through close contact and respiratory or stool particles, so careful handwashing matters.

Offer frequent small drinks and soft, cool foods if tolerated. Avoid acidic, spicy, or rough foods that sting sores. Use children’s fever or pain medicine only according to the product instructions and the child’s age or clinician’s advice; never give aspirin to a child. Keep the child home while unwell, wash hands after toileting or nappy changes, and avoid sharing cups, cutlery, towels, or toothbrushes. A Child Health Consultation can help when the diagnosis or hydration plan is unclear.

Seek urgent medical help if a child cannot drink, passes very little urine, has a dry mouth with no tears, is unusually sleepy, confused, or difficult to wake, or has breathing difficulty. Contact a clinician for a young infant with Fever, fever that persists, severe pain, worsening rash, or a child who is not improving. Dehydration can develop when mouth pain prevents drinking.

Which illness best matches the mouth and skin findings? How can I keep my child drinking? When can they return to nursery or school? Which symptoms would mean the child needs reassessment?