Transmission and incubation period
Once infection with the HFMD virus has occurred, the time until symptoms appear (incubation period) is usually between three and six days.
HFMD is most contagious in the first week after symptoms appear or while there is fluid in the affected child’s blisters. However, the virus can remain present in the faeces for several weeks.
It is caused by enteroviruses, most commonly coxsackie virus subtypes. In 2013, for example, doctors were alerted to an outbreak of HFMD caused by the coxsackie virus A6 strain in Auckland and other parts of the North Island.
Signs and symptoms
Initial symptoms of HFMD often appear suddenly and include a mild fever and sore throat. A headache may also be present. One to two days later the following symptoms develop:
- Painful ulcer-like blisters in the mouth - particularly on the lining of cheeks, roof of the mouth, gums and tongue.
- A rash with small fluid-filled blisters on the pads of the fingers and palms of the hands and/or soles of the feet. Occasionally the rash and blisters appear on the buttocks.
HFMD is usually a mild, self-limiting disease that resolves by itself seven to 10 days after symptoms first appear, although some strains of the virus may present more severe symptoms. Recommended treatment may include:
- Medications such as paracetamol that relieve pain and reduce fever.
- Antiseptic mouthwashes that can soothe the discomfort in the mouth.
- Preventing infection of the blisters by trimming children’s fingernails short and washing hands frequently with soap and warm water.
- Encouraging adequate fluid intake - ice chips and iceblocks can be soothing on the mouth as well as providing fluid intake.
- Rest is also important in assisting overall recovery.
There are no anti-viral medications available for treatment of HFMD.
It is therefore important to watch for any signs of complications. Consult a doctor if the fever is particularly high or persists for more than 24 hours. Consult a doctor immediately if the child seems very sick, confused or difficult to wake, has trouble walking or has a stiff neck.
In order to help prevent the spread of the condition, it is usually recommended that children are kept home from school or childcare while the blisters in the mouth and on the hands and/or feet are present.
Further information and support
Freephone: 0800 611 116 (operates 24 hours a day, 7 days a week)
Plunketline Freephone: 0800 933 922 (operates 24 hours a day, 7 days a week)
DermNet New Zealand (1998). Hand foot and mouth disease (Web Page). Hamilton: DermNet New Zealand Trust. http://www.dermnetnz.org/topics/hand-foot-and-mouth-disease/ [Accessed: 22/08/16]
Canterbury District Health Board Community and Public Health (2012). Hand, foot and mouth disease (Pamphlet). Christchurch: Canterbury District Health Board. http://www.cph.co.nz/wp-content/uploads/med0006.pdf
Carson-De Witt, R. and Wells, K. R. (2006). Hand-foot-and-mouth disease. The Gale Encyclopedia of Medicine, Third Edition. Jacqueline L. Longe, Editor. Farmington Mills, MI: Thompson Gale.
Ministry of Health (2016). Hand, foot and mouth disease (Web Page). Wellington: Ministry of Health. Available from: http://www.health.govt.nz/your-health/conditions-and-treatments/diseases-and-illnesses/hand-foot-and-mouth-disease [Accessed: 22/08/16]