Coxsackie (Hand, Foot and Mouth)       


Symptoms include small ulcers in the mouth, small water blisters or red spots on the palms and soles of the feet and in between fingers and toes. This illness can be accompanied by low grade fever (100degrees F). Mainly occurs in children 6 months to 4 years of age.  However, older children and adults can also get it. In the United States it is more common for people to get HFMD from spring to fall.


It is caused by the Coxsackie virus. The incubation period after contact is 3 to 6 days. The fever can last 3-4 days with resolution of the rash in 7-10 days.

Is Hand, Foot, Mouth contagious?

Yes. The viruses that cause HFMD can be found in an infected person's:

HFMD spreads from an infected person to others through:

People with HFMD are most contagious during the first week of their illness. However, they may be contagious for weeks after symptoms go away. Some people, especially adults, may not develop any symptoms, but can still spread the viruses to others. 

Care Advice

  1. Reassurance: Hand-foot-mouth disease is a harmless viral rash.
  2. Liquid Antacid for Mouth Pain:
    • Use a liquid antacid 4 times per day.
    • For younger children, put teaspoon (2 ml) in the front of the mouth 4 times per day after meals.
    • Children over age 4 can use 1 teaspoon (5 ml) as a mouthwash after meals.
  3. Soft Diet:
    • Encourage favorite fluids to prevent dehydration.
    • Cold drinks, milkshakes, popsicles, slushes, and sherbet are good choices.
    • Avoid citrus, salty, or spicy foods.
    • For infants, give fluids by cup, spoon or syringe rather than a bottle. (Reason: The nipple can cause pain.)
    • Solid food intake is not important.
  4. Fever Medicine: Give acetaminophen (e.g., Tylenol) or ibuprofen for fever above 102 F (39 C) or severe mouth pain.
  5. Contagiousness: Quite contagious but a mild and harmless disease. Incubation period is 3-6 days. Can return to child care or school after the fever is gone (usually 2 to 3 days). The rash is not contagious.
  6. Expected Course:
    • The fever lasts 2 or 3 days.
    • The mouth ulcers resolve by 7 days.
    • The rash on the hands and feet lasts 10 days. The rash on the hands and feet may then peel.
  7. Call Your Doctor If:
    • Signs of dehydration develop
    • Fever present over 3 days
    • Your child becomes worse

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