What you need to know about Hand, Foot, and Mouth Disease


Contributed by Chelsea Wicks, M.D.

The most common symptoms of hand, foot, and mouth disease include fever, ulcerative lesions in the mouth, and an ulcer-like rash on the palms and soles. Despite popular belief, the infection carries very few associated consequences.

I know the name sounds horrible, but in all honesty, hand, foot, and mouth disease is one of the most common infections we see in pediatrics and has very few associated consequences. 

You may have noticed hand, foot, and mouth disease making headlines lately because of a new strain of coxsackie, the most common virus that leads to the illness, that has been picked up here in Washoe County. This new A6 strain seems to be causing more exaggerated symptoms, and tends to be affecting adults more than we’re used to seeing, but still has not caused a lot of new concerns.

What Does Hand, Foot and Mouth Disease Look Like?

Coxsackie usually affects children under age 5 and the most common symptoms include fever, ulcerative lesions in the mouth, especially back by the throat, and an ulcer-like rash on the palms and soles. This rash can occasionally include other parts of the body such as the extremities and the diaper area.

As a parent, I believe the worst part of this infection is the pain children experience from the mouth sores. Because of this, they will often stop eating and, even more concerning, they may stop drinking. Usually this pain is easily managed with ibuprofen or acetaminophen. If this doesn’t seem to be enough, seek medical attention from your primary care provider to ensure your child is not getting dehydrated. There is also a prescription mouth wash that can be used to help control the pain. 

I have seen the fever reach as high as 104 and may last as long as 4 days but then resolves as the infection clears. The usual fever reducers may be used to keep the child comfortable.

The skin rash is rarely bothersome but can be used as an indicator for contagiousness. A child is thought to no longer be contagious once the lesions seem to have scabbed over and you no longer see new lesions arising.  As with anything, if you have concerns about how your child is doing, it’s always worth contacting your pediatrician to determine if your child needs to be seen.