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 not likely serious.Hand, foot and mouth disease is a contagious viral infection which is common in children under five years old. Cases can occur anytime throughout the year, but in countries like Germany with varying climates, cases occur more often in the spring and fall.Characteristics of the virus are sores in the mouth, and a rash on hands and feet. The virus, which is highly contagious, is spread through direct contact with the virus via infected child's saliva, sputum or nasal mucus and poop. This contact could be by touching a contaminated toy, tabletop, or doorknobs.Because the virus is so contagious, it is common in child-care settings due to toddlers and children often putting their hands in their mouth, frequent diaper changes and potty training.Additionally, even though the virus is generally not common in adults, they can pass the virus without showing symptoms or signs of the disease.If you suspect your child has Hand, foot and mouth, PHCE says as a general rule of thumb, parents should keep their child home during the first few days of the illness in order to minimize the exposure to other children."Unless the kids have a fever there's no medical reason to exclude even though it's contagious. It is spread for weeks and half of those infected have no symptoms, so exclusion doesn't help," said Col. Rodney Coldren, Chief of Epidemiology at Public Health Command Europe.However, if your child's school or child care center has an increased number of cases of the virus, they may have specific guidelines for parents to follow in order for their child to return to care.Symptoms of the virus include: - Fever - Feeling of being unwell - Sore throat and a 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 itch, on the palms, soles and sometimes the buttocksWhile it may be hard to fully prevent a very young child from spreading the virus, parents are always encouraged to remind their kids to cover their mouths when they cough or sneeze and strictly enforce hand-washing for at least 20 seconds. Additionally, disinfecting soiled items (like toys) and avoiding close contact such as kissing, hugging, or sharing eating utensils or cups with infected kids will mitigate the spread of the virus.