Hand Foot Mouth Disease (HFMD): Symptoms, Stages, Treatment & Prevention

Hand Foot and Mouth Disease (HFMD) is a contagious viral infection that mainly affects children under five, although adults can get it too. It often starts with a fever, sore throat and loss of appetite. A day or two later, painful mouth sores and a rash may appear on the hands and feet.

Most children recover within 7–10 days. The main concern is keeping children hydrated, as mouth sores can make eating and drinking painful.

Here's what parents need to know about HFMD, from the first symptoms to recovery and preventing the infection at home.

HFMD is caused by enteroviruses, particularly Coxsackievirus A16 and A6. The infection spreads through saliva, respiratory droplets, blister fluid, infected stool and contaminated surfaces.

Young children are more susceptible because they have less immunity to these viruses. HFMD can spread quickly in nurseries and schools through close contact and shared toys.

Although usually mild, HFMD can occasionally cause complications. It is unrelated to foot-and-mouth disease in animals.

Hand Foot and Mouth Disease (HFMD) is a recognised childhood infection in Qatar. According to Hamad Medical Corporation (HMC), more than 1,900 children were diagnosed with HFMD at its Pediatric Emergency Centres between January and June 2018.

Qatar's Primary Health Care Corporation (PHCC) also identified HFMD among the leading communicable disease notifications in its 2021 Population Health Profiling report.

HFMD can spread through close contact and shared objects, making hand hygiene particularly important in nurseries, schools and indoor play areas. Parents should take precautions throughout the year.

The most common HFMD symptoms are fever, painful mouth ulcers and a rash or blisters on the hands and feet. Symptoms usually begin 3–6 days after exposure, although the timing and severity vary.

• Fever, sore throat and tiredness.
• Reduced appetite or refusal to eat.
• Irritability, especially in babies.
• General discomfort or feeling unwell.

Some children may develop HFMD without a noticeable fever.

Small red spots may appear on the tongue, gums or inside the cheeks before turning into painful ulcers. Children may refuse food or drinks because swallowing hurts.

Flat or raised spots, sometimes forming blisters, commonly appear on the palms and soles. They may also affect the buttocks, knees, arms and legs.

The rash may appear red, pink or darker than the surrounding skin, depending on skin tone. It is usually not itchy but can be uncomfortable.

Doctors can usually diagnose HFMD by examining the mouth sores, skin rash and other symptoms. Laboratory tests are rarely needed. Other childhood illnesses can cause similar rashes, so have your child examined if you're unsure what is causing the symptoms.

HFMD symptoms typically develop in stages, although the timing varies between children. The timeline below starts from the first day of symptoms.

Not every child follows this timeline. Symptoms may overlap, appear in a different order or be absent altogether.

Babies and toddlers with HFMD may drool excessively, become unusually irritable or refuse feeds due to painful mouth sores.

• Reduced breastfeeding or formula intake.
• Fewer wet diapers than usual.
• Unusual sleepiness or difficulty waking.

There is no antiviral medicine routinely used to cure HFMD. Treatment focuses on reducing discomfort and preventing dehydration while the infection clears.

Antibiotics do not treat HFMD because the infection is viral.

No cream cures HFMD, and most skin blisters heal without treatment. Keep the blisters clean and avoid breaking them.

If the surrounding skin becomes dry or uncomfortable, a gentle, fragrance-free moisturiser may help. Check with a pharmacist before applying products to a child's rash, particularly when the skin is blistered or broken.

Most people recover within 7–10 days, although mouth sores and skin changes may take longer to resolve.

Signs of recovery include:

• Normal appetite and fluid intake returning.
• Fever disappearing.
• Blisters fading and mouth ulcers healing.
• Normal urination.

Some children may develop temporary skin peeling or nail changes after recovery. HFMD blisters usually heal without leaving scars. Temporary skin peeling or nail changes may occur as the child recovers.

HFMD spreads easily among children in nurseries, schools and shared play areas. Parents in Qatar can reduce the risk by following these precautions:

If one child has HFMD, limit close contact with siblings while the child is unwell. Avoid sharing towels, food and personal items. Wash hands thoroughly after diaper changes, carefully dispose of used diapers and clean frequently touched household surfaces.

HFMD can also spread from people who have no noticeable symptoms. Continue practising good hand hygiene and cleaning frequently touched surfaces, particularly when another family member has the infection.

These precautions can reduce household transmission, but they cannot eliminate the risk.

There is no fixed quarantine period. Children can generally return to school when they have no fever, feel well enough to participate and have no uncontrolled drooling from mouth sores.

Parents in Qatar should follow their nursery or school's return policy.

Contact a paediatrician if your child:

• Urinates less than usual or has fewer wet diapers.
• Has not improved after 10 days.
• Develops increasingly red, swollen or pus-filled blisters.
• Is younger than six months or has a weakened immune system.

Most children recover from HFMD without complications. Keeping them hydrated, relieving discomfort and maintaining good hygiene can make the illness easier to manage.

If you're unsure which fever medicine or supportive healthcare product is suitable for your child, speak with a pharmacist at Care n Cure Pharmacy Qatar.