Hand, Foot, and Mouth Disease: What NH Parents and Caregivers Should Know

Written by: Rachel Sessler, MD

If your child has recently come down with a fever and rash, you’re not alone. We are currently seeing a seasonal rise in cases of hand, foot, and mouth disease (HFMD) across New Hampshire. While usually mild, the disease can be uncomfortable for kids and spreads easily in places like daycares and schools. Understanding its symptoms and how it spreads can help protect your family and the community. 

What Is Hand, Foot, and Mouth Disease? 

HFMD is a common viral illness most often caused by Coxsackievirus A16 or Enterovirus 71. According to the American Medical Association (AMA), it affects over 200,000 children each year in the U.S. Those children are primarily under age 5, though older kids and adults can get it too. 

Symptoms usually develop 3–5 days after exposure and last about a week. 

Common symptoms include: 

• Fever (often the first sign)
• Painful sores or blisters in the mouth
• Rash or red spots on the hands, feet, and sometimes buttocks
• Sore throat and irritability
• Decreased appetite or difficulty drinking

According to the Centers for Disease Control and Prevention (CDC), HFMD outbreaks often peak in late summer and early fall, which is consistent with what we’re seeing in New Hampshire this year. 

How Does HFMD Spread? 

Hand, foot, and mouth disease is highly contagious, especially in group settings such as childcare centers, playgrounds, and classrooms. The virus spreads through saliva from coughing or sneezing, fluid from blisters, and stool—particularly during diaper changes. The virus can also survive on contaminated surfaces such as toys and doorknobs.  

Children are most contagious during the first week of illness, but the virus can linger in their system for several weeks after symptoms resolve. That’s why good hygiene is essential even after your child is feeling better. 

How to Help Prevent an Outbreak 

The best defense is prevention. Parents and caregivers can reduce the risk of spreading HFMD by: 

• Washing hands frequently with soap and water—especially after diaper changes or using the bathroom. 
• Disinfecting toys and high-touch surfaces daily.
• Avoiding close contact with anyone who shows symptoms. 
• Keeping sick children home until they’re fever-free for at least 24 hours and mouth sores have healed.

Can Kids Go to Daycare or School with Hand, Foot, and Mouth Disease? 

It’s a common question for parents—especially when symptoms are mild. American Family Physician says children with HFMD can return to daycare if they are fever-free, feeling well enough to participate, and staff can care for them without compromising the care of others. While it’s important to be cautious, keeping children out of daycare hasn’t been shown to reduce the spread of HFMD. That’s because the virus can still be present in a child’s system even after symptoms improve. 

Caring for Your Child at Home 

While there’s no specific treatment for HFMD, most cases can be managed at home with supportive care: 

• Use acetaminophen or ibuprofen to relieve fever and discomfort (do not use aspirin in children).
• Offer cold, soft foods such as yogurt, smoothies, or popsicles to soothe mouth sores.
• Encourage frequent sips of water to prevent dehydration. 
• Avoid acidic or spicy foods that may irritate the mouth. 

Most children recover in 7–10 days with rest and fluids. 

When to Call Your Pediatrician 

While most cases resolve without complications, there are situations where medical attention is recommended. Parents should contact their child’s pediatrician if they have a fever that exceeds 104°F or persists for more than three days. They should also call if the rash worsens or if their child is showing any signs of dehydration—such as a dry mouth or fewer wet diapers. Additionally, children under six months of age or those with weakened immune systems may be at higher risk for complications and should be evaluated promptly. In rare cases, HFMD can lead to serious complications, such as viral meningitis or encephalitis. Early medical attention is key if your child’s symptoms escalate. 

Supporting Our Families, Together 

While HFMD can be disruptive, most children recover quickly with rest and good at-home care. Early recognition, strong hygiene habits, and support from your pediatrician are the best ways to keep your family and the community healthy.  

Elliot Pediatrics Primary Care is here to care for your child through every season, and every step of the way.