Hand, Foot, and Mouth Disease (HFMD) is a common viral illness that frequently affects young children, and it often raises questions for parents about when their child can safely return to school or daycare. Understanding the appropriate guidelines for returning children to group settings is important. This knowledge helps prevent further spread of the virus and supports the child’s well-being during recovery.
Understanding Hand, Foot, and Mouth Disease
Hand, Foot, and Mouth Disease is a contagious viral infection caused by enteroviruses, most commonly Coxsackievirus A16, though others like EV-A71 can also be responsible. The illness usually begins with flu-like symptoms such as a mild fever, sore throat, loss of appetite, and sometimes a runny nose or stomach ache. These initial symptoms can last one to three days.
After this initial phase, rashes and painful sores develop. Small red spots, which can turn into blisters, commonly appear inside the mouth on the tongue, gums, and inner cheeks. A rash, sometimes with blisters, also develops on the palms of the hands and soles of the feet, and can extend to the buttocks, knees, or elbows. While symptoms are mild and resolve within 7 to 10 days, mouth sores can make eating and drinking uncomfortable.
Key Indicators for School Return
Deciding when a child can return to school or daycare after HFMD depends on observable indicators. A child should be fever-free for at least 24 hours without fever-reducing medications. This means the child’s body temperature has normalized.
The child’s overall well-being is a factor. They should feel well enough to actively participate in school activities and not require excessive care that would impact other children’s care.
While blisters and rashes may still be present, especially on the hands and feet, the most contagious period is during the first week of illness, when fever is present and blisters are weeping fluid. Oral lesions should have healed or dried so the child is comfortable eating and drinking without uncontrolled drooling. Some schools may allow return even if a few non-blistering spots remain, provided the child meets the fever-free and well-being criteria.
Preventing Transmission
Guidelines for returning to school after HFMD help minimize virus spread in group settings. HFMD is highly contagious and spreads through direct contact with an infected person’s saliva, nasal or throat discharges, fluid from blisters, and stool. The virus can also spread through airborne droplets from coughs and sneezes or by touching contaminated surfaces.
Frequent and thorough handwashing with soap and water is a preventative measure, especially after using the toilet, changing diapers, or before eating. Avoiding close contact, such as hugging or sharing eating utensils and drinks, reduces transmission. Even after symptoms resolve, the virus can be shed in stool for several weeks, underscoring the importance of good hygiene practices.
Working with Schools and Healthcare Providers
Parents should communicate proactively with their child’s school or daycare about their Hand, Foot, and Mouth Disease policies. Institutions may have their own requirements for a child’s return. Seeking advice from a pediatrician or family doctor is advisable, especially if a child’s symptoms are severe, persist, or if there are concerns about dehydration. Following both medical guidance and school rules helps ensure a smooth and safe return for the child and the wider community.