A rash on the palms and soles is a common sign of HFMD.

LANDSTUHL, Germany - It starts with a fever and a cranky child, and then you notice the skin rash on the palms of the hands and soles of the feet – all tell-tale signs of Hand, Foot, and Mouth Disease. And while unpleasant, officials at Public Health Command Europe want to assure parents that the disease is generally not serious.

Hand, Foot, and Mouth Disease is a common, contagious viral infection, particularly in children under five years old. While cases can occur year-round, they often see an increase in the spring and fall, especially in regions with fluctuating climates like those across Europe. Recent reports indicate a slight uptick in cases across several European countries in the past month.

The virus is characterized by sores in the mouth and a rash on the hands and feet. It’s highly contagious and spreads through direct contact with an infected child’s saliva, sputum, nasal mucus, or even fecal matter. This can happen by touching contaminated surfaces like toys, tabletops, or doorknobs.

HFMD is particularly common in child-care settings where toddlers and young children frequently put their hands in their mouths, and where diaper changes and potty training are common.

Importantly, adults can also carry and spread the virus, sometimes without exhibiting any symptoms themselves. This can contribute to ongoing transmission.

If you suspect your child has Hand, Foot, and Mouth Disease, PHCE generally advises parents to keep their child home during the initial days of illness to minimize exposure to other children.

“Unless the child has a fever, there’s no strict medical reason to exclude them, as the virus can be spread for weeks and a significant number of those infected show no symptoms, making blanket exclusion ineffective,” said Public Health Nurse Consultant Lt. Col. Simeon Smith from Public Health Command Europe.

However, individual schools and child care centers may have specific guidelines for return-to-care, particularly if there’s a localized outbreak. Parents should always check with their child’s facility for their specific protocols.

Symptoms of HFMD include:

  • Fever
  • General feeling of being unwell
  • Sore throat and loss of appetite
  • Painful, red, blister-like spots on the tongue, gums, and inside of the cheeks
  • A red rash, which can blister but doesn't typically itch, on the palms, soles, and sometimes the buttocks

While completely preventing spread in very young children can be challenging, parents are encouraged to reinforce good hygiene practices. Remind children to cover their mouths when coughing or sneezing, and strictly enforce hand-washing with soap and water for at least 20 seconds. Regularly disinfecting frequently touched items (like toys) and avoiding close contact – such as kissing, hugging, or sharing eating utensils or cups – with infected individuals will help mitigate the spread of the virus.