Hand, Foot, and Mouth Disease (HFMD)

Hand, foot, and mouth disease (HFMD) is a common viral illness of infants and children. It is characterized by fever, sores in the mouth, and a rash with vesicles (blisters). HFMD begins with a mild fever, poor appetite, fatigue, and, frequently, a sore throat. One or two days after the fever begins, sores develop in the mouth. They begin as small red spots that blister and then often become ulcers. The sores are usually located on the tongue, gums, and inside of the cheeks. The skin rash develops over 1 – 2 days with flat or raised red spots, some forming fluid-filled vesicles (blisters). The rash does not itch and is usually located on the palms of the hands and the soles of the feet. It may also appear on the buttocks. A person with HFMD may have only the rash or the mouth ulcers.

Mode of Transmission

Several related viruses cause HMFD. They are spread from person to person by direct contact with nose and throat discharges or the stool of infected persons. A person is most contagious during the first week of the illness but may shed the virus after symptoms are gone. HFMD is not transmitted to or from pets or other animals.

Incubation Period

Usually 3 – 6 days. Fever is often the first symptom.

Infectious Period 

HFMD is infectious 2 days before the rash appears and during the acute stage of illness, perhaps longer. Virus may be found in respiratory secretions for several days and in stool for several weeks.

Control of Spread

  1. Clean or dispose of articles soiled with nose and throat discharges and wash hands after handling such articles. 
  2. Clean and disinfect frequently touched surfaces and soiled items, including toys. 
  3. Cover mouth with tissue when coughing or sneezing. If no tissue is available, encourage students to “catch your cold in your elbow” by covering their mouth and nose with the crook of their arm and coughing or sneezing into their shirt or coat sleeve. 
  4. Avoid close contact such as kissing, hugging, or sharing eating utensils or cups with people with hand, foot, and mouth disease.
  5. Encourage proper hand washing techniques.

For more information about HFMD, please see the CDC website.

Contact school nurse Lea Hysom at lea.hysom@tbcs.org to report a case of hand, foot, and mouth disease.