Hand, Foot & Mouth Disease — Medicaid (QUEST) Accepted

A fever, a fussy child who won’t eat, and then little spots on the hands, feet, and in the mouth — hand, foot, and mouth disease is common, contagious, and almost always mild. It runs through daycares and playgroups, and most keiki are back to themselves within a week to ten days.

What it is

Hand, foot, and mouth disease (HFMD) is a viral illness, most often caused by coxsackievirus A16, according to the Centers for Disease Control and Prevention. It causes fever, painful mouth sores, and a rash of small spots or blisters, classically on the hands and feet. Symptoms usually appear 3 to 5 days after exposure.

How it spreads — and the daycare question

HFMD spreads easily through saliva, mucus, fluid from the blisters, and stool, which is why it moves quickly through childcare settings where little ones share close quarters. The CDC notes children are most contagious in the first week, but the virus can linger in stool for weeks, so good hand-washing matters even after your child feels better. Return-to-daycare rules vary; children can usually go back once fever is gone and they feel well enough to take part, but check your provider’s and your center’s guidance.

How we approach it at Ohana Care Clinic

There is no medicine that cures HFMD; it clears on its own, usually within 7 to 10 days. Care is about comfort and, above all, keeping your child drinking — mouth sores make swallowing hurt, so dehydration is the main thing to watch (see our page on vomiting and diarrhea for the warning signs). Cool fluids and soft foods help. We approach it with mālama and reassurance: this looks alarming and feels rotten, but it is rarely dangerous.

Getting care by telehealth

Most of our care at Ohana Care Clinic happens by secure video across Hawaiʻi. A new primary-care or pediatric patient is seen in person for the first visit at our Hilo clinic; after that, many follow-ups and quick questions work well by video. When your keiki is sick, a video visit can often tell us whether they need to be seen in person, saving you a drive when it isn’t needed.

When to get help now

Call 911 or go to the nearest emergency room if your child is struggling to breathe, turning blue around the lips, unresponsive, or you believe this is a life-threatening emergency. When in doubt, call us at (808) 867-8002 or use our symptom checker for after-hours guidance on whether your child needs to be seen.

Medically reviewed by Donna Leonard, MSN, APRN, FNP-C, pediatric nurse practitioner, and George Mackel, MSN, APRN, NP-C, PMHNP-BC, CARN-AP, President & Owner of Ohana Care Clinic.
Date published: July 2, 2026 · Last reviewed: July 2026 · Citations verified: July 2026

This article is general health education from Ohana Care Clinic. It is not a substitute for a personal evaluation by a qualified clinician who knows your child’s situation, and reading it does not create a provider–patient relationship. If you think your child may have a medical condition, reach out to us or another licensed provider. In an emergency, call 911.

References

Centers for Disease Control and Prevention. (2024). Hand, foot, and mouth disease: Causes and how it spreads. https://www.cdc.gov/hand-foot-mouth/causes/index.html

Common questions

How does hand, foot and mouth disease spread?

It spreads easily through saliva, mucus, blister fluid, and stool, which is why it moves quickly through daycares and playgroups. Good hand-washing helps, even after your child feels better.

When can my child go back to daycare?

Usually once the fever is gone and your child feels well enough to take part, but check your provider and your center, since policies vary.