Hand, Foot, and Mouth (HFM)

By: Katie Campbell, DNP, PNP-PC

You’ve probably heard of hand, foot and mouth disease (HFM) circulating around the community at one point or another and thought to yourself either “What’s that?” or “Oh no, not again!”. Whether HFM is a new term to you or there are a few questions you still have, you’ve come to the right place!

What causes HFM?

Hand, foot and mouth disease is a viral syndrome caused by enterovirus. There are multiple different serotypes (think subsets or strains) of enterovirus that can cause HFM but the coxsackievirus is the most common offender.

The viruses that cause HFM can be passed from person to person via:

  • Fecal-oral route: One of the many reasons why thorough hand washing after using the restroom or changing a diaper is so important!
  • Respiratory secretions: Coughs, sneezes, sharing food and drinks.
  • Contact with fluid inside blistered skin lesions.

What should I be on the lookout for?

Symptoms may vary from person to person which can make it quite tricky for parents to know what is going on with their little ones! HFM is most common in children under age 7, however people of any age can be affected (I know what you’re thinking parents- yes, even you!). Typically those with HFM will have a rash on their hands and feet but you may also notice those pesky spots popping up on the buttocks (or entire diaper area), stomach, upper thighs, arms, and face around the mouth. The rash may look different depending on the child, ranging from raised red spots to blisters. The rash does not itch but may be painful in some cases.

Oral ulcers are another lovely hallmark of HFM. Your child may complain of a sore throat or if they are too young to let you know, you may notice they are not eating or drinking as much. A fever between 100-102°F is common and may be your first sign that something is wrong before you even notice a rash. Keep in mind that although these are the most common ways HFM presents itself, not every symptom will show up on every child.

How long should I expect HFM to last?

The fever associated with HFM typically resolves after 3 to 4 days. Complete resolution of symptoms typically occurs within 7 to 10 days. Mouth ulcers should heal within 7 days but the skin lesions can take up to 10 days to resolve.

But let’s be honest, the real question here is, when can my child go back to their normal routine? Children are most contagious 2 days before eruption of the rash to 2 days after the rash has resolved. The virus is shed in the stool for weeks following HFM infection which is why hand hygiene is so important. Your child may return to daycare or school once they are no longer running a fever for 24 hours and they are feeling up to it (providing they do not have open and draining blisters that others could come into contact with). 

My child has HFM- what can I do to help them?

So now that you know what you’re dealing with, you’re probably wondering what can be done to help your child. The best step is to try and prevent them from getting HFM if possible (I know- much easier said than done but it’s worth a try!). Hand washing is your best bet and being mindful of the ways it spreads. If you’ve used all the hand sanitizer and soap in the world and your little one still managed to get HFM, do not fear! Ibuprofen and Tylenol can be helpful in relieving fever and pain from ulcers- here’s our handy dandy dosage chart to make things simple. Your main goal will be to keep your child as comfortable and hydrated as possible. This is a great time to pull out those popsicles you have stashed in your freezer and to stock up on your kiddo’s favorite drinks. Your child should be seen if they have had a fever for greater than 5 days or if they are not urinating at least once every 8 hours.

As always, we are here to help you! If you think your child might have HFM, please reach out to us and we will help guide you through the best course of action.

Until next time,

Katie Campbell

Parkside Provider, Florida Gator fan, and self proclaimed Uno champion

  • Toddler