From the Research
A child with hand, foot, and mouth disease (HFMD) can generally return to school once they have been fever-free for at least 24 hours without the use of fever-reducing medications and when they feel well enough to participate in activities. This recommendation is based on the most recent and highest quality study available, which suggests that the disease is most contagious during the first week of illness, particularly in the early stages before symptoms appear 1. While blisters or rashes may still be present, the child is no longer considered highly contagious once they have been fever-free for 24 hours.
Key Considerations for Return to School
- The child should be fever-free for at least 24 hours without the use of fever-reducing medications
- The child should feel well enough to participate in activities
- Good hygiene practices are essential to prevent spread, including thorough handwashing after diaper changes or using the bathroom, avoiding close contact like kissing or hugging, and not sharing utensils or cups
- The virus spreads through contact with an infected person's saliva, fluid from blisters, feces, or respiratory droplets, which is why the contagious period typically ends as symptoms improve and the body clears the virus 2, 3
Management and Prevention
- There is no specific medication required for HFMD as it is a viral infection that typically resolves on its own within 7-10 days
- During recovery, ensure the child stays hydrated, especially if mouth sores make drinking uncomfortable
- Cold liquids, popsicles, and soft foods may be easier to consume
- Good hygiene practices are essential to prevent spread, including thorough handwashing after diaper changes or using the bathroom, avoiding close contact like kissing or hugging, and not sharing utensils or cups 4, 5