Hand, foot and mouth disease - Symptoms of hand, foot and mouth disease

The symptoms of hand, foot and mouth disease usually develop between three and five days after initial exposure to the infection. This is known as the incubation period.

Early symptoms of hand, foot and mouth disease include:

a high temperature (fever) – usually around 38-39°C (100.4-102.2°F)
loss of appetite
cough
abdominal pain
sore throat

Occasionally, hand, foot and mouth disease can cause vomiting, particularly if it is caused by the enterovirus 71 strain.

These early symptoms can last 12-48 hours.

Mouth ulcers

After one or two days, red spots develop inside the mouth, particularly around the tongue, gums and inside of the cheeks.

At first, the sores are about the size of a small button. They then rapidly develop into larger yellow-grey mouth ulcers surrounded by a red ring of tissue. You would normally expect to see 5-10 ulcers in the mouth.

The ulcers can be very painful and can make eating, drinking and swallowing difficult, which may cause a young child to dribble excessively.

The ulcers should pass within five to seven days.

Skin rash

Soon after the mouth ulcers appear, you will probably notice small red spots on your child’s skin.

The most common places for the spots to develop are on the fingers, palms of the hand, soles of the feet and occasionally the buttocks and groin.

The spots are around 2-5mm in size, with a darkish-grey centre and a "rugby-ball" shape.

These are usually painless and non-itchy, although they can turn into small blisters, which are sometimes painful and tender. It is important not to burst any blisters, as this can spread the infection.

The skin rash and any blisters can last up to 10 days.

When to seek medical advice

Most cases of hand, foot and mouth disease do not require medical attention as the symptoms will pass within seven days, without the need for treatment.

However, if you're unsure whether your child does have hand, foot and mouth disease, you can contact your GP or NHS 111 for advice.

You should also contact your GP if:

your child is unable or unwilling to drink any fluids
your child is showing signs of dehydration, including not passing as much urine as normal
your child’s symptoms have not improved or worsen after seven days
your child has additional symptoms, such as a change in mental state, seizures (fits) and changes in personality and behaviour