Hand, Foot and Mouth Disease

How it Spreads

• Hand, Foot, and Mouth Disease is caused by viruses. A person infected with one of the viruses can be contagious, meaning they can pass the virus easily to other people. It can be spread through contact with:
  • Droplets with virus particles made after the infected person sneezes, coughs, or talks. These droplets can land on or be rubbed into the eyes, nose, or mouth.
  • Contact with the droplets from objects contaminated by children who have the viruses.
  • Fluid from blisters.
  • Stool of children who are infected. This generally involves an infected child contaminating their own fingers and then touching an object that another child touches. The child who touched the contaminated object then puts their fingers into their own mouth or another person's mouth.

Signs and Symptoms

• Tiny blisters in the mouth and on the fingers, palms of hands, buttocks, and soles of feet that last a little longer than a week (one, few, or all of these body sites may be involved with the blisters).
• May see common cold signs or symptoms with fever, sore throat, runny nose, and cough.
• Blisters in the mouth that can make it difficult for children to eat or drink.
• Vomiting and diarrhea can occur, but are less frequent.
• Most children have mild symptoms for seven to ten days.

Prevention

• Wash hands often for at least 15 to 20 seconds:
  • after changing diapers
  • after using the toilet
  • after handling items soiled with stool or saliva
  • after blowing your nose, coughing, or sneezing
  • before/after caring for someone who is sick
  • before eating or making meals
• Avoid touching your eyes, nose, and mouth.
• Keep blisters clean and avoid touching them.
• Teach and help children to wash their hands and avoid toughing the blisters.
• Avoid sharing of toys between children who are likely to place toys in their mouth.
• Avoid close contact with infected people (e.g., hugging, kissing).
• Do not share eating and drinking utensils.
• Clean and disinfect high-touch surfaces and shared items, such as toys and doorknobs, as well as change tables and pads after each diaper change.

Treatment

It is okay to attend, unless they are too ill to participate in activities, have uncontrolled drooling with mouth sores, or have a fever with behavioural change.

For schools and childcare centres, exclusion will not reduce the spread because some children may shed the virus without being symptomatic, and other children who became ill may shed the virus for weeks in their stool.

Follow the direction of your healthcare provider or occupational health at your workplace.

• Centers for Disease Control and Prevention. (2024). About Hand, Foot, and Mouth Disease. Retrieved from: www.cdc.gov/hand-foot-mouth/index.html
• Shope, Timothy R., Hashikawa, Andrew N. (2023). Managing Infectious Diseases in Child Care and Schools - A Quick Reference Guide (6^th ed.). American Academy of Pediatrics.