August is the peak month for hand, foot and mouth disease (HFMD). I know more than I want to about this virus because I had it as a kid.  It was a terribly painful experience and I remember it was too painful to even swallow my own saliva. 

HFMD is caused by a virus and is very contagious. HFMD is spread by saliva and stool. HFMD is most common in children under five but can also affect adults.

The signs

  • After exposure, if you are going to get sick you will see symptoms in three to five days.
  • The most common symptoms are painful mouth sores and small, red, circular spots on the palms and soles.
  • The fever starts first and lasts about two days, during which time mouth sores and skin rashes are seen.
  • After day three there is usually general improvement, with symptoms lasting about five to seven days in total.

Caring for a child with HFMD

A child who is sick with HFMD should stay home from school, camp, and daycare. Also, avoid public pools, especially if the child is still in diapers. This should continue until the child feels better and is fever free for 24 hours without anti-fever medications.

Ibuprofen and/or acetaminophen can be used for fever and pain, however, there is no medication to cure or treat HFMD. The major risk with HFMD is dehydration due to the painful mouth sores. Encourage drinking 30 minutes after giving your child pain medication for best success.  In school-age children and older, using over the counter throat lozenges or numbing oral sprays can also help reduce the pain with swallowing.  

Things to remember

  • Staying hydrated is most important, especially since the peak season for HFMD is summer (and early fall) when the climate here in New England can be very hot.
  • The best way to avoid exposure to the virus is by regular hand washing and not sharing drinking glasses or other items that could have the virus from saliva. Of course, this is very hard to do with babies who put everything in their mouth.
  • Washing hands after a diaper change is necessary.
  • The mouth sores are typically on the tongue, cheek, throat, and sometimes lips.  If sores are only on the gums with bleeding or there is swelling/redness of the eyes, you should see your primary care giver as it could be something other than HFMD.

If you are concerned your child has HFMD talk with your child's primary care provider. To learn more about HFMD, visit the American Academy of Pediatrics website.

Michael Koster, MD

Dr. Michael Koster is a pediatric infectious diseases specialist and a hospitalist at Hasbro Children’s Hospital.