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Hand, Foot and Mouth Disease

Information for Schools and Daycares

Hand, Foot, and Mouth Disease (HFMD) is a common, communicable viral disease that generally affects young children under age 5, causing painful mouth sores, fever and skin rashes. Adults and older children can also get the disease.

Because HFMD is easily spread from person to person, children with HFMD should be kept home from child care or school until their fever goes away and they are well enough to participate in normal activities. Adults with illness should stay home from work until symptoms resolve. Frequent hand washing and disinfecting of surfaces, including toys, are also important ways to prevent spread of HFMD.

What is hand, foot and mouth disease (HFMD)?

  • HFMD is a viral infection that causes fever, mouth sores, and a skin rash on the palms of the hands and soles of the feet. The rash may also appear on the knees, elbows, buttocks or genital area.
  • HFMD usually infects infants and children younger than 5 years old. However, it can sometimes occur in older children and adults.
  • HFMD is not the same as foot-and-mouth disease (also called hoof-and-mouth disease), which is a disease of cattle, sheep and swine. They are caused by different viruses. People cannot get the animal disease, and animals do not get the human disease.

What are the symptoms?

  • Fever, rash, mouth sores, poor appetite, a vague feeling of illness, and sore throat.
  • Painful sores in the mouth that may blister and become ulcers.
  • Flat or raised red spots that develop over 1 to 2 days.
  • Rash is usually on the palms of the hands and soles of the feet and may appear on the knees, elbows, bottom, or genital area.

How does HFMD spread?

  • HFMD spreads from person-to-person through contact with saliva, sputum, fluid in blisters, or stool.
  • HFMD can also spread indirectly by touching objects and surfaces touched by infected persons.
  • Infected persons are most contagious during the first week of illness, but can still pass the virus for weeks after symptoms have gone away.
  • Some people who are infected do not get sick.

How do I stop the spread of HFMD?

  • Everyone in the household of a person with HFMD, or in a facility where someone has HFMD, should wash their hands with soap and water carefully and frequently, especially after going to the bathroom, after changing diapers, and before preparing foods or beverages.
  • Disinfect surfaces and items, including toys. First wash the items with soap and water; then disinfect them with a fresh solution of 1 tablespoon of bleach and 4 cups of water.
  • Avoid close contact such as kissing, hugging, or sharing eating utensils or cups with infected people.
  • Children with HFMD should be kept home from child care or school until their fever goes away and they are well enough to participate in normal activities. Adults with illness should stay home from work until symptoms resolve.
  • Report cases or clusters of severe or unusual HFMD to your local health department.

How is HFMD treated?

  • There is no specific treatment for HMFD. Almost all children with HFMD recover on their own. People with HFMD should rest and drink liquids to prevent dehydration. A health care provider may also recommend medications to control fever and pain.
  • Intravenous (IV) fluids might be needed if the infected person is not able to swallow enough liquids because of painful mouth sores.
  • In rare cases, HFMD can cause complications, such as viral meningitis. Symptoms of viral meningitis include headache, stiff neck, and fever. People with viral meningitis sometimes need to be hospitalized.

Where can I find more information?