What is hand, foot and mouth disease?
It is a common childhood illness. The Centre for Health Protection states that it is usually caused by enteroviruses such as coxsackievirus and enterovirus 71.
It begins with fever, poor appetite, tiredness and sore throat, followed by ulcers in the mouth and a rash on the palms and soles. The Centre for Health Protection notes that most patients have mild symptoms and recover on their own within seven to ten days.
The Centre for Health Protection’s leaflet is more specific: one to two days after the fever, painful sores may appear in the mouth, starting as small red spots and blisters and then becoming ulcers, usually on the tongue, the gums and the insides of the cheeks. A rash — not itchy, sometimes with small blisters — appears on the palms and soles, and may extend to the buttocks and genitals.
Some children have no symptoms at all, or only the rash or only the mouth ulcers. After recovery the body carries antibodies to that particular enterovirus, but a child can still catch hand, foot and mouth disease caused by a different one — which is why the same child may have it more than once.
Among the enteroviruses, enterovirus 71 draws particular attention because it is more likely to cause serious complications — viral meningitis, encephalitis and polio-like paralysis, and in rare cases death. This is not the usual outcome, but it is why the warning signs below are set out.
How long is the incubation and contagious period?
The Centre for Health Protection puts the incubation period at about three to six days. A patient is most infectious during the first week of illness, and the virus can be shed in the faeces for several weeks.
| Stage | Timing | What it means for a parent |
|---|---|---|
| Incubation | About 3 to 6 days | No symptoms in the first few days after exposure does not mean the child is clear |
| Most infectious | The first week of illness | Keep the child at home during this week to avoid passing it on |
| Usual recovery | Recovers on its own within 7 to 10 days | Most cases are mild and need no specific medicine |
| Virus still shed | In the faeces for several weeks | Even after recovery, handwashing after nappy changes and the toilet still matters |
