What is it?

Hand, foot and mouth disease is a common viral illness in children. It is not related to foot and mouth disease associated with cattle.

Symptoms of hand, foot and mouth disease can vary for each person but usually includes a mild fever, painful sores in the mouth, a rash that can be flat or raised with blisters on hands and feet and feeling unwell.

How does it spread?

The hand, foot and mouth virus is spread from person to person by direct contact with poos of an infected person, when someone with the illness coughs or sneezes, spraying droplets of fluid from the nose or throat, and contact the fluid from blisters.

Three to seven days after a person is infected by the virus, symptoms will start to appear.

Infectious period

A person is most infectious in the first week of the illness.

Exclusion period

A child with hand foot and mouth should stay at home if they are unwell or have blisters. This is very important for infants and toddlers who may dribble that can spread the illness quickly through a centre.

The fluid inside the blisters is very infectious, this means that a child can only return to the centre when the blisters have dried and crusted over. If there are only a small number of blisters that can be covered, the child may return to the centre.

Responsibilities of staff

  • Tell parents that a child at the centre has hand, foot and mouth.
  • Display information about hand, foot and mouth on your notice board.
  • Hand washing after nappy changes or helping children with going toilet is important; the poos can be infectious for several weeks after the initial illness.
  • Make sure staff and children’s hands are washed often with soap and warm water and are thoroughly dried to prevent the spread of the virus.
  • Remove play dough until there are no more cases of hand, foot and mouth.
  • Increase how often you clean your toys. Rotate or put out fewer toys, this will make the increased cleaning manageable.
  • Toys that children suck or chew should be cleaned in the dishwasher or washing machine separately.
  • Clean all toys and surfaces with detergent, and then disinfect by wiping with or soaking in 1:10 dilute bleach (1 teaspoon bleach to 500ml water). Disinfecting toys and general surfaces such as tables is a precaution for outbreaks, not a ‘normal’ procedure. When you don’t have an outbreak frequent washing with detergent is okay.

Responsibilities of parents

  • Keep your child at home if they are unwell or have blisters. Your child can return when the blisters have dried and crusted over. If there are only small numbers of blisters that can be covered the child may return to the centre.


There is no specific treatment for hand, foot and mouth. There are some medications that may provide relief from fever, aches or pain from the mouth ulcers.


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Last updated 14 July 2022.