When can a child with Hand, Foot, and Mouth Disease (HFMD) return to school?

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Last updated: March 10, 2025View editorial policy

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From the Research

Children with hand, foot, and mouth disease can return to school when they have been fever-free for 24 hours without fever-reducing medications and when their sores are no longer weeping fluid, typically after 3-5 days of symptoms, as supported by the most recent study 1. This recommendation prioritizes the reduction of morbidity, mortality, and improvement of quality of life for the child and their community. The most contagious period is usually during the first week of illness, particularly when fever is present 2.

Key Considerations for Return to School

  • The child should be fever-free for 24 hours without the use of fever-reducing medications.
  • The sores should no longer be weeping fluid, indicating a reduced risk of transmission.
  • Good hygiene practices are essential upon return, including:
    • Frequent handwashing with soap and water.
    • Avoiding sharing utensils or drinks.
    • Covering coughs and sneezes. These precautions are crucial because hand, foot, and mouth disease spreads through contact with an infected person's saliva, fluid from blisters, or feces, as well as through respiratory droplets 3, 4, 5.

Treatment and Prevention

Treatment for hand, foot, and mouth disease is mainly symptomatic and supportive, with acetaminophen or ibuprofen used for fever and pain management 2. There are no specific antiviral agents approved for the treatment of the disease, but vaccination of susceptible individuals in high-risk areas and good personal hygiene are important preventative measures 2. Counseling and monitoring are integral parts of managing hand, foot, and mouth disease without complications, as highlighted in a recent case series 1.

Reducing Transmission Risk

The virus can remain in stool for weeks after symptoms resolve, making continued good hygiene crucial even after returning to school 3. By following these guidelines, the risk of transmission can be significantly reduced, allowing children to return to school safely while minimizing the spread of the disease.

References

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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