What should you know about HFM without fever?

Hand, foot and mouth illness is often recognised by a combination of mouth ulcers and spots or blisters on the palms and soles. The rash may also appear on fingers, toes, or the nappy area. A person can have no fever and still pass the virus to others. Mild cases may cause little more than sore gums or a few tender spots, while mouth pain can affect eating even when the person appears bright.

Encourage small, frequent drinks and choose cool, bland foods if the mouth is tender. Avoid acidic juices and spicy foods that sting ulcers. Keep hands clean after toileting, nappy changes, and contact with saliva, and do not share drinking vessels or towels. Follow product instructions for any pain relief, and ask a pharmacist about options for a child who cannot swallow tablets.

Seek medical advice if the person refuses fluids, urinates less, develops worsening pain, or becomes unusually quiet or sleepy. Urgent care is needed for breathing difficulty, a seizure, new confusion, severe neck stiffness, or trouble waking. Arrange a review if blisters become hot, swollen, increasingly red, or produce discharge, since that can indicate a separate skin infection.

You can ask whether the rash is consistent with hand, foot and mouth illness, how long close-contact precautions should continue, and which symptoms would change the care plan.