What are the symptoms of hand, foot, and mouth disease?

What it is and how it spreads

Hand, foot, and mouth disease is caused by viruses, most commonly coxsackievirus A16 in the United States. It is most common in infants and children younger than 5 and spreads easily in childcare and group settings.

The virus spreads through close contact, respiratory droplets, fluid from blisters, and stool. Children often develop fever and other flu-like symptoms about 3 to 5 days after they catch the virus.

The symptoms to watch for

Early symptoms often include fever, sore throat, reduced appetite, and a general feeling of being unwell. A day or two later, painful sores can appear in the mouth, starting as small red spots that blister.

A skin rash of flat red spots or blisters typically appears on the palms of the hands and soles of the feet. It can also show up on the buttocks, legs, and arms. Not every child gets every symptom, and some have only a few.

• Fever and feeling unwell
• Sore throat and reduced appetite
• Painful mouth sores that begin as red spots, then blister
• Rash on palms and soles, sometimes on buttocks, legs, and arms

Dehydration is the main concern

Because mouth sores can make swallowing painful, young children may drink and eat less and can become dehydrated. This is the main thing to watch for at home.

Offer cool fluids and soft, soothing foods, and watch for signs of dehydration such as drooling more than usual, very little urine, no tears when crying, or unusual sleepiness. Contact your pediatrician if your child cannot keep fluids down or shows these signs.

How long it lasts and contagiousness

Most children have mild symptoms and recover in about 7 to 10 days. Treatment focuses on comfort and fluids, since the illness is viral and not treated with antibiotics.

People are most contagious during the first week of illness. The virus can remain in the body and continue to spread for days or even weeks after symptoms go away, since it can persist in stool. Frequent handwashing, especially after diaper changes, helps limit spread.

Related questions

How long is hand, foot, and mouth disease contagious?

A child is most contagious during the first week of illness. However, the virus can remain in the body and continue to spread for days or even weeks after symptoms clear, because it can persist in stool. Frequent handwashing, especially after diaper changes and toileting, helps reduce spread.

How long does hand, foot, and mouth disease last?

Most children have mild symptoms and recover in about 7 to 10 days. The illness is viral, so care focuses on comfort and keeping your child hydrated rather than antibiotics. Contact your pediatrician if symptoms are severe, fever lasts more than a few days, or your child cannot drink enough fluids.

Where does the hand, foot, and mouth rash appear?

The rash usually appears on the palms of the hands and soles of the feet as flat red spots or blisters. It can also show up on the buttocks, legs, and arms. Painful sores commonly appear inside the mouth as well, starting as red spots that blister.

When should I call the doctor for hand, foot, and mouth disease?

Call your pediatrician if your child cannot keep fluids down, shows signs of dehydration such as very little urine or no tears, has a fever lasting more than a few days, seems unusually sleepy or unwell, or if symptoms get worse instead of better. Dehydration from painful mouth sores is the main concern.

Sources & further reading

1. CDC — Hand, Foot, and Mouth Disease Signs and Symptoms
2. CDC — About Hand, Foot, and Mouth Disease
3. CDC — Causes and Spread of Hand, Foot, and Mouth Disease

This article reflects current AAP, CDC, and other public-health guidance and is for educational purposes only. It does not constitute medical advice. ParentFlow is a wellness companion — not a substitute for your pediatrician. For any medical concern, contact your healthcare provider.