What should you know about start of hand foot and mouth disease?

This usually affects young children, although older children and adults can also become infected. A sore throat, reduced appetite or fever may come first. Painful spots or ulcers can develop inside the mouth, followed by small red spots or blisters on the hands and feet; the nappy area, legs or arms may also be involved. The rash can be uncomfortable but is not always extensive.

The illness spreads readily through saliva, mucus, stool and fluid from blisters. A rash alone does not confirm the diagnosis, so consider other causes if the child looks very ill or the pattern is unusual.

Offer frequent small drinks and soft, cool foods if the mouth is sore. Monitor urination, tears and alertness for signs of adequate hydration. Use age-appropriate fever or pain relief only as directed on the product label or by a clinician; never give a child medicine intended for another person.

Wash hands after nappy changes and toileting, clean shared surfaces, and avoid sharing cups, cutlery or towels. Keep the child home while feverish or too unwell for normal activities, following local school or nursery guidance. A child health consultation can clarify diagnosis and comfort measures.

Seek urgent help if the child cannot drink, is passing very little urine, is unusually sleepy, has trouble breathing, develops a stiff neck, has a seizure, or has a rapidly worsening illness. Arrange prompt review for a very young infant with fever, persistent vomiting, severe pain or a rash that does not fade when pressed.

Ask how to maintain fluids, which pain-relief product is suitable, when the child can return to activities, and which signs should prompt reassessment.