Hand, Foot and Mouth Disease: When to Bring Your Child (or Yourself) In

Hand, foot and mouth disease is a common viral infection that causes fever, painful sores in the mouth and a spotty rash on the hands and feet. It's most common in children under 5, but older kids and adults catch it too. Most people get better on their own in 7 to 10 days. The main reason to bring a child in is if they aren't drinking enough, the fever lasts more than a few days, or you aren't sure what the rash is.

What is hand, foot and mouth disease?

It's caused by a group of viruses called enteroviruses, most often coxsackievirus. It spreads easily in daycares, preschools and households through saliva, nasal mucus, fluid from the blisters, and stool. In the US, cases tend to rise in summer and fall.

It isn't related to foot-and-mouth disease in cattle, and you can't catch it from pets.

What are the symptoms?

Symptoms usually start 3 to 6 days after exposure, often in this order:

• Fever, sore throat and feeling unwell, with a poor appetite, for a day or two
• Painful mouth sores: small red spots on the tongue, gums and inside of the cheeks that turn into blisters or ulcers
• A rash: flat or raised red spots, sometimes blisters, on the palms of the hands and soles of the feet, and often the knees, elbows, diaper area or buttocks

The rash usually isn't itchy. In younger children, the mouth sores are the hard part: kids often refuse to eat or drink because it hurts to swallow. Some people get only the rash or only the mouth sores.

A few weeks after the illness, some people notice peeling skin on the hands and feet or a fingernail or toenail coming loose. It looks alarming, but it typically grows back normally.

Hand, foot and mouth disease in adults

Many adults who catch it have mild symptoms or none at all, which is one way it spreads through a family. But some adults get a full-blown case, with fever, painful mouth sores and a sore, blistering rash on the hands and feet that can make it uncomfortable to walk or use your hands for a few days. Adults who are pregnant should let their own doctor or midwife know if they've been exposed, especially close to the due date.

How is it treated?

There's no medicine that cures the virus, and antibiotics don't help. Treatment is about comfort and keeping fluids up while it runs its course:

• Offer small, frequent sips of water or milk, ice pops, and cold, soft foods
• Avoid salty, spicy and acidic foods and drinks, like orange juice, which sting the mouth sores
• Use over-the-counter fever and pain relievers as the label directs for age and weight. Don't give aspirin to children.
• Leave blisters alone so they can heal

A clinician can examine your child or you, confirm whether it looks like hand, foot and mouth disease or something else, and discuss ways to manage the pain so eating and drinking are possible.

When should you bring your child (or yourself) in?

Come to urgent care if:

• Your child isn't drinking much, or is having fewer wet diapers or trips to the bathroom
• The fever lasts more than 3 days
• Symptoms aren't getting better after 10 days
• Your child is younger than 6 months, or has a weakened immune system
• You aren't sure the rash is hand, foot and mouth disease. Several rashes can look similar early on.
• You need a note for school, daycare or work

We see patients of all ages, so a parent and child who both have it can come in together. If a fever is the main worry, our fever page covers what to watch for.

Call 911 or go to the ER if your child shows signs of serious dehydration (no urine in 8 hours, no tears, very dry mouth, sunken eyes, or being very sleepy and hard to wake), or has a stiff neck, severe headache, confusion, a seizure, unusual jerking movements or weakness, or trouble breathing.

How long is it contagious, and when can kids go back to school?

People are most contagious during the first week of the illness, but the virus can stay in saliva for days and in stool for weeks after symptoms are gone. Frequent handwashing, especially after diaper changes and before meals, is the best protection for the rest of the household. Clean shared toys and surfaces, and don't share cups or utensils.

Children can usually go back to school or daycare once they've been fever-free without medicine and feel well enough to take part. Some schools and childcare centers have their own rules, so check with yours.

What does a visit cost?

An in-clinic visit starts at $175 self-pay; the cost and insurance page explains the visit tiers. We contract with all major commercial and government plans, including Colorado Medicaid and Medicare. We can't guarantee a commercial plan has us in network, and if you're out of network or your benefits are denied, we bill you at our self-pay rates.

Where to find us

Four clinics across metro Denver, all ages welcome, se habla español:

• Hampden (Southeast Denver): 8 AM–11 PM daily
• Littleton: 8 AM–11 PM daily
• Thornton: 8 AM–11 PM daily
• Highlands: Mon–Fri 5–11 PM, Sat–Sun 8 AM–11 PM

Walk in, or book online.