In some children it begins with malaise, fever, loss of appetite and irritability. General signs of the disease are aphthous-like blisters in the mouth, especially in the throat; the child saying or trying to show that their mouth hurts when eating; redness and rashes, particularly on and around the feet and palms, as well as on the arms, legs, bottom and around the lips; and fever lasting 1 or 2 days that cannot be brought down, pain and itching.

It is a human disease caused by intestinal viruses of the Picornaviridae family. The most common causative viruses are coxsackievirus A and enterovirus 71 (EV-71).

The disease usually affects babies and children and is quite common. It is moderately contagious and spreads through direct contact with the mucus, saliva or faeces of an infected person. It typically causes small outbreaks in nurseries and kindergartens, usually in the summer and autumn months. The usual incubation period is 3–7 days. It is less common in adults, but people with immune deficiency are very susceptible to the disease.

Signs and symptoms
* Rash on the hands
* Rash on the feet
* Fever
* Headache
* Vomiting
* Weakness
* Malaise
* Earache
* Sore throat
* Painful lesions, ulcers, vesicles or pustules in the mouth, nose or face
* Body rashes: redness on the palms, soles, inside the mouth and sometimes the lips, which may later turn into skin ulcers and pustules. The rash is rarely itchy in children but can be extremely itchy in adults.
* Sores or blisters may also be present on the buttocks of young children and babies.
* Loss of appetite
* Diarrhoea

Treatment of the Disease
As the disease is a viral infection, there is no antibiotic treatment; recovery begins once it has run its course, and the illness passes. There is no vaccine to prevent the disease. Various sprays and gels can be used to reduce the pain of mouth sores and speed healing, and drying zinc-containing lotions can be used for the rashes. To bring down fever and reduce pain, a paracetamol syrup that your doctor considers suitable can be given, no more often than every 4 hours. Antihistamines prescribed by your doctor according to your child's age can also be used for pain and itching.

Analgesics can be used for fever and for pain caused by the rashes. It is a self-limiting disease. In older children, adolescents and adults it is typically mild and lasts about 1 week, although it can sometimes last longer.

Only a very small proportion of patients may need to be admitted to hospital. In particular, the development of rare neurological complications (encephalitis, meningitis or acute flaccid paralysis) or conditions such as pulmonary oedema or pulmonary haemorrhage require hospital admission.

Prevention
The disease should be prevented by avoiding contact with infected people as far as possible and by following some basic hygiene rules. Attention should be paid to hand hygiene, and hands must be washed, especially after using the toilet or changing nappies.