Hand, foot and mouth disease in childcare

What it is

Hand, foot and mouth disease is a common viral infection in young children, caused by enteroviruses. It isn't related to foot-and-mouth disease in animals. Children usually get small blisters in the mouth and on the hands, feet, nappy area or legs, often with a fever. Mouth blisters can make eating and drinking painful. Adults usually have mild symptoms or none.

How it spreads

The virus is in saliva, mucus, faeces and blister fluid. It spreads through close contact, touching blister fluid, contaminated toys and surfaces, droplets, and changing the nappy of an infected child. A person is infectious while the blisters contain fluid, and the virus can stay in faeces for several weeks — so good hygiene still matters after a child returns.

Exclusion

The NHMRC's Staying healthy guidance says to exclude a child with hand, foot and mouth disease until all blisters have dried. State health departments, such as Victoria's, apply the same rule. Contacts without symptoms aren't excluded. Follow your service's exclusion policy.

If you think a child has it

1. Tell the responsible person and contact the family to collect the child.
2. Keep the child apart from the group while they wait, and keep comforting them.
3. Don't burst or pierce blisters — the fluid is infectious.
4. Record the illness in your service's register.

Stopping it spreading

• Clean your hands carefully after nappy changes, wiping noses and touching blisters, and help children wash theirs.
• Wear gloves for nappy changes and contact with blister fluid.
• Clean mouthed toys and frequently touched surfaces, and follow your cleaning schedule.
• Teach children to cough and sneeze into a tissue or their elbow.
• Don't share cups, cutlery or food.

Pregnant staff

The risk in pregnancy is low, but pregnant educators who are concerned should talk to their doctor and their service about precautions.