Red flags & when to go in person for Hand-Foot-and-Mouth Disease - Triage

Audience: pediatric

Hand-Foot-and-Mouth Disease (HFMD) is a common viral illness that mostly affects young children. It often causes fever, mouth sores, and a rash on the hands and feet. Most children recover fully without special treatment. However, some signs mean you should seek in-person medical care quickly. These include difficulty swallowing, dehydration, persistent high fever, or unusual behavior like extreme drowsiness. Telemedicine can help assess mild symptoms, provide advice on care, and guide when to seek further help. It cannot replace physical exams or urgent treatments needed for serious complications. Knowing the red flags and when to get in-person care helps keep your child safe and comfortable during HFMD.

Red flags — go in person / ER

• Child cannot swallow or is refusing fluids — seek urgent in-person care to prevent dehydration.
• Persistent high fever above 39°C (102°F) lasting more than 3 days — see a healthcare provider promptly.
• Extreme drowsiness, irritability, or unusual behavior — seek immediate medical attention.

What telemedicine can do

• Assessment of mild symptoms such as low-grade fever and rash.
• Providing guidance on home care and symptom relief.
• Advice on when to seek in-person medical evaluation.

What telemedicine cannot do

• Physical examination to check for dehydration or complications.
• Emergency treatment for severe symptoms like breathing difficulty or neurological signs.
• Laboratory testing or procedures requiring in-person visits.

What is Hand-Foot-and-Mouth Disease?

Hand-Foot-and-Mouth Disease (HFMD) is a viral infection common in young children. It usually causes a mild illness with fever, painful sores in the mouth, and a rash on the hands, feet, and sometimes the buttocks. The illness typically lasts 7 to 10 days. HFMD spreads easily through close contact, coughing, and touching contaminated surfaces.

Common Symptoms of HFMD

Typical symptoms include:

Most children feel better within a week without needing special medicines.

When to Seek In-Person Medical Care

While HFMD is usually mild, some symptoms mean your child needs to see a healthcare provider in person:

If any of these occur, seek urgent medical care.

How Telemedicine Can Help

Telemedicine allows you to connect with healthcare providers remotely. For HFMD, telemedicine can:

However, telemedicine cannot perform physical exams or provide emergency treatments.

Preventing Spread of HFMD

To reduce the risk of spreading HFMD:

How to prepare for your tele-visit

• Have your child's symptom history ready, including when symptoms started.
• Note any fever measurements and how high the fever has been.
• Prepare a list of any medications your child is taking.
• Be ready to describe your child's behavior and fluid intake.
• Ensure a quiet, well-lit space for the telemedicine visit.
• Have a caregiver available to assist during the visit if needed.

After your tele-visit

• Follow the healthcare provider's advice on symptom management at home.
• Monitor your child's symptoms closely for any worsening or new red flags.
• Keep your child hydrated with fluids they can tolerate.
• Maintain good hygiene to prevent spread to others.
• Schedule an in-person visit if symptoms worsen or do not improve as advised.

FAQs

Is Hand-Foot-and-Mouth Disease contagious?

Yes, HFMD spreads easily through close contact with an infected person’s saliva, nasal secretions, blister fluid, or stool. Good handwashing and cleaning surfaces help reduce spread.

How long does Hand-Foot-and-Mouth Disease last?

Symptoms usually last about 7 to 10 days. Most children recover fully without complications.

Can my child go to school with HFMD?

Children should stay home while they have a fever and until mouth sores have healed to avoid spreading the virus to others.

What can I do to relieve my child's symptoms?

You can give age-appropriate fever reducers, offer plenty of fluids, and use soothing foods if mouth sores make eating painful. Avoid acidic or spicy foods.

When should I call a healthcare provider?

Contact a provider if your child has difficulty swallowing, signs of dehydration, persistent high fever, or unusual behavior like extreme drowsiness.

Sources

1. Hand, Foot, and Mouth Disease — Centers for Disease Control and Prevention (CDC).
2. Hand-Foot-and-Mouth Disease — MedlinePlus, U.S. National Library of Medicine.
3. Hand-Foot-and-Mouth Disease — Mayo Clinic.
4. Hand-Foot-and-Mouth Disease — Merck Manuals Consumer Version.

This telemedicine guidance is for educational and triage purposes only. It is not a substitute for in-person medical evaluation and care when needed. If your child shows any danger signs or worsening symptoms, seek in-person medical attention promptly.