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Herpangina and hand, foot and mouth disease

What is herpangina and hand, foot and mouth disease?

Both herpangina and hand, foot and mouth disease are infections caused by the Coxsackie virus. In Herpangina small red spots that become ulcers appear at the back of the mouth. In hand, foot and mouth disease, the rash can appear as small red, blisters on the hands, feet, mouth or diaper area. Both illnesses can be very painful and may cause your child to refuse food and water.

The spots and ulcers in both illnesses will go away on their own within 10 days.

The virus spreads by touching or breathing

The virus is common in the summer and early fall. It is found in saliva and stool.

A child with herpangina or hand, foot, and mouth disease is most infectious during the first week of illness. However, a child can spread the virus for several weeks.

The incubation period for the virus is three to six days. During this time, a child can spread the virus without having any signs of being sick.

The virus spreads from person to person through tiny droplets that are released when a person sneezes or coughs. The virus can also survive on surfaces and objects, such as counters and toys, long enough to spread to another person. Your child can also get infected if they touch the stool or fluid from the blisters of an infected person.

Preventing spread and future episodes

To prevent the spread of infection, wash your hands and your child’s hands often. Be sure to do so:

  • after wiping the child’s nose
  • after changing a diaper
  • after using the toilet
  • before preparing food

There is no vaccine against Coxsackie virus.

Signs and symptoms

Both herpangina and hand, foot and mouth disease can start with fever, sore throat and generally not feeling well for several days before the small red spots appear. Children may not want to eat and become very irritable. Older children may complain of headache, sore throat and lack of energy.

Complications are mild

The most common complication of herpangina and hand, foot and mouth disease is dehydration. Dehydration means not having enough water in the body. Children may refuse to drink fluids due to the pain in their mouth. However, with care at home, most children can get enough liquids to stay hydrated.

Other complications are very rare.

Taking care of your child at home

The treatment of herpangina and hand, foot and mouth disease is supportive. Keep your child hydrated and as comfortable as possible. This will help the body fight off the infection.

Antibiotics do not work on viruses. They will not help heal herpangina or hand, foot and mouth disease.

Pain relief

To control pain, give your child acetaminophen or ibuprofen. Pain relieving rectal suppositories can be given if your child cannot take the medication by mouth. Always follow the instructions on the label or speak with your child’s doctor.

Drink small amounts of fluids often

Give your child fluids often and in small amounts to prevent dehydration. Cold foods and soft foods such as ice cream and apple sauce are soothing and will not irritate the sores. Citrus, soft drinks, and salty or spicy foods may cause more pain.

When to get medical assistance

Call your child’s regular doctor

  • The pain is not relieved with acetaminophen or ibuprofen the ulcers in the mouth last for more than 10 days.
  • Your child has not made any urine in more than eight hours and is very sleepy.

Go to your nearest Emergency Department or call 911

  • Your child has chest pain, shortness of breath, feels their heart racing or seems overly tired.
  • Your child has a headache, vomiting, neck pain or stiffness or a change in behaviour.

Key points

  • Herpangina is a common, painful infection featuring ulcers at the back of the mouth in children.
  • Hand, foot and mouth disease is a common infection that causes small blisters on the hands, feet, inside or outside of the mouth and in the diaper area.
  • Herpangina and hand, foot and mouth disease are caused by the Coxsackie virus and the small red spots can last up to 10 days.
  • The only treatment is good pain control and making sure your child gets enough liquids to stay hydrated.
  • Be sure to wash your hands and your child’s hands often to prevent spreading the disease.

Shawna Silver, MD, FRCPC, FAAP, PEng