Hand, Foot and Mouth Disease and Herpangina
Enterovirus infection
What it is
Hand, foot and mouth disease and herpangina is a contagious viral infection caused by enteroviruses and mainly affect children. They can cause fever and sores in the mouth. Spots or fluid-filled blisters may also appear on the skin, including on the hands or feet, or in the throat.
What you can do at home
What to do
- To relieve pain, take acetaminophen (Tylenol) or ibuprofen (Advil). When in doubt, ask a pharmacist for advice.
Important: Ibuprofen is contraindicated for children under 6 months of age.
If there is a fever
- Get as much rest as possible.
- Drink warm or cold fluids often, whichever feels more soothing.
- Eat according to appetite.
- Adjust clothing or blankets as needed to prevent feeling too hot, too cold, or chilled.
- If needed, see the health advice sheets on
Sores in the mouth
- Drink cold fluids.
- Avoid acidic, spicy, salty, hard, or very hot foods and beverages.
- Brush teeth regularly with a very soft toothbrush.
- Rinse the mouth with cold water or salt water 4 to 6 times a day, especially after eating or drinking.
- Avoid mouthwash containing alcohol.
- For young children: Use a cup, spoon, or syringe instead of a bottle because sucking increases mouth pain.
- For older children: Use a straw.
- Anesthetic gel is not recommended.
Important: Anesthetic gel is contraindicated for children aged 2 years and younger. When in doubt, ask a pharmacist for advice.
To prevent spreading the infection
- Wash hands often.
- Cough into the elbow or a tissue.
- Do not share items that have been in contact with the sick person’s mouth.
- Stay home during the most contagious period.
- Avoid contact with babies, pregnant people, and people who are immunocompromised.
- Regularly clean and disinfect frequently touched surfaces and objects.
Avoid
- Avoid citrus juices, such as orange, lemon, and grapefruit juice, as well as spicy foods.
When to seek medical attention
Symptoms lasting more than 10 days despite following the recommended advice
Fever lasting more than 3 days despite following the recommended advice
Redness, warmth, pain, or pus (yellow-green fluid) around a sore or spot lasting more than 3 days
For a pregnant person: contact with someone who has hand, foot and mouth disease or herpangina
Need help?
Call Info-Santé at 811, Option 1, to speak with a nurse at any time.
Go to the pharmacy for advice on medications or treatment.
Make an appointment at your medical clinic or CLSC.
If you do not have a family doctor, go to gap.soinsvirtuels or call 811, Option 3.
When to go to the hospital right away
Severe headache with fever or a stiff neck
Severe or sudden chest pain
Weakness in the face, an arm, or a leg
Rapid changes in the person’s condition:
- unusual fatigue (drowsiness) or difficulty staying awake
- reduced responsiveness to what is happening around them
- confusion, agitation, or unusual behaviour
- hallucinations (seeing or hearing things that are not real)
Severe difficulty breathing, especially with the following symptoms:
- breathing becomes increasingly difficult, even at rest
- there is a high-pitched or wheezing sound when breathing (stridor)
- the chest or abdomen pulls inward with each breath (retractions)
- the skin, lips or fingers are blue or bluish (cyanosis)
- in babies and children under 2 years of age: the nostrils flare with each breath
Signs of dehydration that persist despite drinking plenty of fluids:
- dry mouth
- extreme thirst
- dark yellow urine (pee)
- no urine (pee) for more than 12 hours (for babies: a dry diaper or much less urine than usual)
- crying without tears
- weakness
Drinking very little fluid