Symptoms usually appear 3 to 6 days after infection. Hand-foot-and-mouth disease may cause all of the following symptoms or just some of them.

Infants and toddlers with hand-foot-and-mouth disease may be fussy.

At any age, children may get a fever and develop a sore throat. They sometimes lose their appetites and don't feel well.

One or two days after the fever begins, painful lister-like lesions may form in the front of the mouth or throat. This includes the tongue, gums and inside of the cheeks.

A rash on the hands and feet and sometimes on the buttocks also may appear. The rash is not itchy, but sometimes it has blisters. Depending on skin tone, the rash may appear red, white or gray. Or it may show only as tiny bumps.

If sores form in the back of the mouth and throat, a related viral illness called herpangina may be the cause. Other symptoms of herpangina include a sudden high fever and, sometimes, seizure. Rarely, sores form on the hands, feet or other parts of the body.

Most often, hand-foot-and-mouth disease is a minor illness. It typically only causes fever and mild symptoms for a few days. But you should call your child's healthcare professional for any of the following reasons:

• Your child is younger than six months.
• Your child has a weakened immune system.
• Fever doesn't get better in three days.
• Mouth sores or a sore throat makes it painful for your child to drink fluids.
• Your child's symptoms cause a lot of discomfort.
• Your child's symptoms don't get better after 10 days.

The most common cause of hand-foot-and-mouth disease is infection from coxsackievirus A16. This coxsackievirus belongs to a group of viruses called nonpolio enteroviruses. Other types of enteroviruses also may cause hand-foot-and-mouth disease.

Most people get the coxsackievirus infection — and hand-foot-and-mouth disease — through the mouth. The illness spreads by person-to-person contact with an infected person's:

• Nose secretions or throat discharge.
• Saliva.
• Fluid from blisters.
• Stool.
• Droplets sprayed into the air after a cough or sneeze.

Common in child care setting

Hand-foot-and-mouth disease is most common in children in child care. That's because young children need frequent diaper changes and help using the toilet. They also tend to put their hands in their mouths.

Your child is most contagious during the first week of having hand-foot-and-mouth disease. But the virus can stay in the body for weeks after the symptoms go away. That means your child still can infect others.

Some people, especially adults, can pass the virus without showing any symptoms of the disease.

Outbreaks of the disease are more common in summer and early autumn. In tropical climates, outbreaks occur during the rainy season.

Different from foot-and-mouth disease

Hand-foot-and-mouth disease isn't related to foot-and-mouth disease. Foot-and-mouth disease is an infectious viral disease found in farm animals. It's sometimes called hoof-and-mouth disease.

You can't catch the viruses that cause hand-foot-and-mouth disease from pets or other animals. You can't spread the viruses to animals either.

Age is the main risk factor for hand-foot-and-mouth disease. The disease mostly affects children younger than ages 5 to 7 years. Children in child care settings are especially at risk because the viruses that cause the illness spread by person-to-person contact.

Hand-foot-and-mouth disease typically affects young children, but anyone can get it.

Older children and adults are thought to have immunity against hand-foot-and-mouth disease. Their bodies often make protective proteins called antibodies after being exposed to the viruses that cause the disease. But teenagers and adults sometimes still get hand-foot-and-mouth disease.

The most common complication of hand-foot-and-mouth disease is dehydration. That's when the body loses more fluid than it takes in. Hand-foot-and-mouth disease can cause sores in the mouth and throat, making it painful to swallow.

Encourage your child to drink fluids during the illness. If children become too dehydrated, they may need fluids through a vein in the hospital.

Most often, hand-foot-and-mouth disease is a minor illness. It usually only causes fever and mild symptoms for a few days. A rare and sometimes serious form of the enterovirus can affect the brain and cause other complications:

• Viral meningitis. This is a rare infection and swelling of the protective layers of tissue and fluid that surround the brain and spinal cord.
• Encephalitis. This rare disease involves brain swelling caused by a virus. Encephalitis can be life-threatening.

You can lower your child's risk of hand-foot-and-mouth disease in many ways:

• Wash hands often. Wash your hands for at least 20 seconds. Be sure to wash your hands after using the toilet or changing a diaper. Also, wash your hands before preparing or eating food and after blowing your nose, sneezing or coughing. When soap and water aren't available, use hand sanitizer.
• Teach good hygiene. Show your children how to wash their hands and help them do it often. Show them how to practice overall good hygiene. Explain to them why it's best not to put their fingers, hands or any other objects in their mouths. Also tell them not to touch their eyes, noses and mouths.
• Disinfect common areas. Clean high-traffic areas and surfaces first with soap and water. Next, clean with a diluted solution of chlorine bleach and water. If you're in a child care setting, follow a strict schedule of cleaning and disinfecting. The virus can live for days on surfaces in common areas, including on doorknobs. The virus also can live on shared items such as toys.
• Don't have close contact with sick people. Viruses that cause hand-foot-and-mouth disease can spread easily. So, people with the illness should try to stay away from others while they have symptoms. Keep children with hand-foot-and-mouth disease out of their child care settings or schools. Don't let them go back until the fever is gone and mouth sores have healed. If you have the illness, stay home from work.

Diagnosis involves a physical exam to find out whether your child's symptoms are caused by hand-foot-and-mouth disease. Your healthcare professional likely will decide if your child has hand-foot-and-mouth disease or other types of viral illnesses by reviewing:

• Your child's age.
• Your child's symptoms.
• What your child's rash or sores look like.

Your child's healthcare professional may take a throat swab or stool sample. The healthcare professional sends the sample to the lab to find out which virus caused the illness.

There's no specific treatment for hand-foot-and-mouth disease. Symptoms of hand-foot-and-mouth disease usually clear up in 7 to 10 days.

Pain medicines sold without a prescription may help ease general discomfort. These include acetaminophen (Tylenol, others) and ibuprofen (Advil, Motrin IB, others). Do not give aspirin to children, especially for flu-like symptoms or chickenpox. Aspirin is linked with a rare but serious condition called Reye's syndrome that often affects children and teens.

Medicine called a topical oral anesthetic may help relieve the pain of mouth sores. Some lozenges and throat sprays include topical oral anesthetics. But don't give lozenges to children younger than 4 years old, because they can raise the risk of choking. Don't use throat sprays that contain an ingredient called benzocaine for children younger than 2. Benzocaine can cause a life-threatening condition called methemoglobinemia in children this young.

Some foods and drinks may irritate blisters on the tongue or in the mouth or throat. Try these tips to help make blister soreness less painful. These tips also might make it easier to eat and drink.

• Suck on ice pops or ice chips.
• Eat ice cream or sherbet.
• Sip cold drinks, such as water.
• Sip warm drinks, such as tea.
• Don't have acidic foods and drinks, such as citrus fruits, fruit drinks and soda.
• Eat soft foods that don't need much chewing.

If your child can rinse without swallowing, swishing with warm salt water may be soothing. Have your child rinse many times a day to ease the pain and swelling of mouth and throat sores.

You may start by taking your child to your child's usual healthcare professional.

Here's some information to help you get ready for your appointment.

What you can do

When you make the appointment, ask if there's anything you need to do in advance. For instance, your child may not be allowed to eat for a certain number of hours before having a specific test. This is called fasting. You also can get ready by making a list of:

• Your child's symptoms. Include any that don't seem related to the reason for your appointment.
• Key personal information. Include major stresses, recent life changes and family medical history.
• All medicines, vitamins or supplements your child takes. Also include the amounts of medicines taken, called the doses.
• Questions to ask your child's healthcare professional.

Take a family member or friend along, if you can. This person can help you remember the information you're given.

For hand-foot-and-mouth disease, some basic questions to ask your healthcare professional include:

• What's likely causing my child's symptoms?
• Other than the most likely cause, what are other possible causes for my child's symptoms?
• What tests does my child need?
• What's the best course of action?
• My child has other health conditions. How can I best manage them together?
• What can I do at home to make my child more comfortable?
• Are there restrictions I need to follow for my child?
• Are there brochures or other printed material I can have? What websites do you recommend?

What to expect from your doctor

Your healthcare professional is likely to ask you questions such as:

• When did your child's symptoms begin?
• Have your child's symptoms been constant or do they happen once in a while?
• How bad are your child's symptoms?
• Has your child recently been exposed to anyone who was sick?
• Have you heard of any illnesses at your child's school or child care?
• What, if anything, seems to make your child's symptoms better?
• What, if anything, seems to make your child's symptoms worse?

What you can do in the meantime

Try not to do anything that seems to make your child's symptoms worse.

To help lessen your child's discomfort, healthcare professionals often recommend these tips:

• Get rest.
• Drink enough fluids to prevent dehydration.
• Stay away from cigarette smoke, including secondhand smoke. Also limit other things that may irritate the mouth and throat.