Hand, Foot, and Mouth Disease (HFMD) in South Africa: What Parents Need to Know
- Samantha Pieterse
- 20 hours ago
- 9 min read
Updated: 2 minutes ago
Right now, South Africa is seeing a spike in Hand, Foot, and Mouth Disease (HFMD) cases, especially among younger children. This viral illness is highly contagious, surprisingly common, and can make little ones feel miserable for a few days. If your child is in crèche or preschool, there’s a good chance you’ve already heard about HFMD from teachers or seen it in your own home.
Whether this is your first encounter or your third round this year, here’s what you need to know about how HFMD looks, how it spreads, and most importantly, how to help your child feel better fast
What is Hand, Foot, and Mouth Disease (HFMD)?
Hand, Foot, and Mouth Disease (HFMD) is a common viral infection that mostly affects young children, especially those under the age of five. It’s caused by a group of viruses known as enteroviruses, with Coxsackievirus A16 often being the cause. The illness usually presents as a mild fever and a rash or small blisters on the hands, feet, and (you guessed it) inside the mouth. In some cases, it can also appear on the buttocks, legs, or around the knees.
HFMD spreads quickly and easily through close contact with an infected person’s saliva, mucus, or stool. That’s why crèches and preschools have such frequent outbreaks. All the shared toys and the occasional sneeze in the face make the spread super easy if many children are in one space.
Once hand, foot, and mouth disease hits your house, it often sticks around for a week or so before disappearing with little to no long-term effects. Most kids bounce back pretty quickly with a bit of rest, fluids, and some TLC. But, as with any virus, there’s a small risk of complications. According to medical studies, in very rare cases (about 1.1%), the virus can travel to the brain and cause infections such as viral meningitis. While that sounds scary (and yes, it's something to be aware of), most kids recover without needing hospital care.
And just so you know, HFMD isn’t just for the under-fives. While kids are the most common victims (and carriers), adults can also catch it, especially if they are around young children.
Common Hand, Foot, and Mouth Disease (HFMD) Symptoms in Kids
The Typical Early Hand, Foot, and Mouth Disease Signs Include:
Fever (mild to high)
Sore throat or difficulty swallowing
Tiredness, crankiness
Loss of appetite
Then The Classic HFMD Signs Follow:
Painful mouth sores (on the tongue, cheeks, or gums)
Red spots, sometimes blisters, on the hands, feet, buttocks, knees, or elbows
Rash that’s not usually itchy but can be sore
What Does Hand, Foot, and Mouth Disease (HFMD) Look Like Day by Day?
Here’s a rough timeline of how HFMD usually progresses:
Days 1–2:
Fever, sore throat, and irritability begin.
Days 3–4:
Painful mouth sores appear, followed by a red rash or blisters on hands and feet.
Days 5–7:
Symptoms peak. Your child may feel miserable and struggle to eat or walk comfortably.
Days 7–10:
Blisters begin to heal, appetite returns, and energy levels improve.
How Does HFMD Spread?
Hand, Foot, and Mouth Disease spreads like wildfire in places where children are in close contact, such as crèches, preschools, playdates, or even the backseat of your car.
The virus lives in saliva, nasal mucus, blister fluid, and stool. It spreads through:
Coughing or sneezing – little droplets can hang in the air or land on surfaces
Touching contaminated surfaces – like toys, door handles, or changing tables
Close contact – hugging, sharing cups, dummies, or food
Nappy changes or toilet use – the virus can stay in poo for weeks, even after symptoms clear up
It’s one of those sneaky bugs that start spreading before you even know your child is sick, especially in the first few days when fever and sore throat begin. And because young kids aren't exactly great at handwashing or covering their mouths when they cough, HFMD tends to move quickly through classrooms and homes.
That's why good hygiene, regular handwashing, and staying home when symptoms start are so important; they’re your best defense against it spreading like a mini plague.
How Long Is HFMD Contagious?
HFMD is usually most contagious in the first week, especially when your child has symptoms like fever, a rash, or painful mouth sores. The virus is actively present in saliva, mucus, and blister fluid, making it easy to spread through coughing, sneezing, or close contact.
Here’s what many parents don’t realise, though: even after your child starts feeling better, they can still spread the virus.
This happens because of something called prolonged viral shedding. This is where the virus continues to live in the body and is passed in the stool for up to 3–6 weeks after recovery. So your little one might look totally fine but still be shedding the virus when they use the toilet or wear a nappy, especially if hand hygiene isn’t perfect (which, let’s be honest, rarely is with toddlers).
So, while they may be symptom-free, it’s still a good idea to practice extra hygiene for a while, particularly during nappy changes, toilet training, or when siblings share spaces and snacks.
Is HFMD Dangerous?
In most cases, Hand, Foot, and Mouth Disease is mild and clears up on its own with rest, fluids, and symptom relief. Kids may feel uncomfortable for a few days, but usually bounce back quickly without any long-term effects.
However, as with any viral illness, complications can occur, though they are rare. In a small number of cases, the virus can spread beyond the skin and mouth, causing inflammation in the brain or surrounding tissues. This can lead to more serious conditions, such as viral meningitis (inflammation of the lining around the brain and spinal cord) or encephalitis (inflammation of the brain itself).
These complications are not common, but it’s important to be aware of them, especially if your child’s symptoms seem more severe than expected or if they’re not improving after a few days. Watch out for high or persistent fevers, extreme sleepiness, vomiting, stiff neck, or signs of confusion or weakness. These could signal something more serious and would need urgent medical attention.
For most children, though, HFMD runs its course without any drama. Still, it's always wise to stay in touch with your healthcare provider if you’re unsure or if something just doesn’t feel right.
HFMD in Adults: Can Grownups Get It?
Yes, they can (and no, it’s not just a “kids’ illness”). While rare, adults can get HFMD, especially if they're around young children or work in daycare or healthcare settings. Adults usually experience milder symptoms, but the rash and mouth ulcers can still be pretty unpleasant.
How to Care for a Child With Hand, Foot, and Mouth Disease
Because HFMD is viral, there is no specific treatment. This disease is what we call “self-limiting,” which means that it works itself out of the system with time. The best way to care for a person with hand, foot, and mouth disease is through symptomatic treatment. This means that if they have a symptom, we treat that specifically. For example, if your child developed a fever from HFMD, you would give them medication to reduce the fever. If they had pain, you would provide pain medication, and so on.
Hand, Foot, and Mouth Disease Symptom Relief at Home:
Fever: Use age-appropriate fever reducers like paracetamol.
Mouth pain: Offer soft, bland foods (think yogurt, mash, oats) and avoid anything spicy, salty, or acidic.
Hydration: Offer lots of fluids, even if it’s just ice lollies or diluted juice.
Rest: Let your child rest as much as they need to.
Home Remedies That Help for HFMD:
Ice lollies: Great for soothing sore mouths.
Saltwater mouth rinse: In older kids, it can help clean and soothe.
Cold compress: Gently dab rashes or blisters for comfort.
Soft foods only: Avoid acidic fruits, crackers, or anything too crunchy.
When to Seek Medical Help For HDMD
In most cases, Hand, Foot, and Mouth Disease (HFMD) is mild and usually resolves on its own. However, certain symptoms can indicate the need for medical attention. One of the first red flags is a persistent fever. If the fever lasts more than three days or rises above 39°C, it could signal a more serious issue. This type of prolonged or high fever may not respond well to the usual medications, raising concerns for complications that require professional care.
Another concern with HFMD is dehydration. Children often refuse to eat or drink due to the painful mouth sores. If a child is not urinating frequently, seems tired, or has noticeably dry lips, they may be dehydrated. Dehydration in young children can escalate quickly; in some cases, intravenous fluids might be needed to restore proper hydration.
It’s also important to monitor for unusual symptoms such as difficulty breathing or extreme lethargy. If a child with Hand, Foot, and Mouth Disease is unusually drowsy, overly irritable, or showing signs of laboured breathing, these could be early signs of more severe complications. Though rare, HFMD can sometimes lead to viral meningitis or encephalitis, both of which require immediate medical attention.
Lastly, keep an eye on the rash. While the rash associated with HFMD is generally mild, a worsening or infected rash can indicate trouble. If the skin becomes unusually red, swollen, or begins to ooze pus, it may indicate a bacterial infection that needs antibiotics. Staying alert to these signs can help prevent the condition from worsening and becoming more serious.
If the symptoms are worsening or if your child has difficulty swallowing, persistent high fever, or signs of dehydration (such as decreased urination, dry mouth, or lethargy), it’s important to consult a healthcare professional. You can make an appointment to see us here.
In short, if you or your child has any of the following, please seek some help:
A fever lasting more than 3 days or rising above 39°C
Signs of dehydration (dry mouth, few wet nappies, sunken eyes)
A child who’s extremely sleepy, irritable, or not responding normally
Difficulty swallowing or refusing all food/drink
A rash that looks infected (red, swollen, or oozing)
How to Prevent Hand, Foot, and Mouth Disease
Preventing HFMD in daycare starts with good hygiene and keeping things clean. One of the best HFMD prevention tips is simple: wash your hands. Children and caregivers should wash their hands regularly, especially after changing diapers, blowing their noses, or using the bathroom. It’s one of the easiest ways to stop the spread of HFMD in a daycare setting, where kids are constantly in close contact.
Cleaning and disinfecting surfaces and toys is another key step. Tables, toys, and any other shared objects should be wiped down often. Even shared items like towels or bedding need regular washing. Keeping the environment clean goes a long way in preventing HFMD from spreading to other kids.
If a child starts showing symptoms of Hand, Foot, and Mouth Disease, such as a rash or fever, they should stay home until they feel better. Daycares can help by having clear policies that remind parents to keep children who are sick at home. This is one of the simplest ways to prevent an outbreak.
Teaching kids habits like covering their mouths when coughing or sneezing also helps stop the spread of HFMD. These small steps may not completely prevent the illness, but they can definitely make a big difference in keeping it from spreading through a daycare.
How to Prevent HFMD In Crèches and Daycares
HFMD spreads easily, but you can lower the risk with some simple steps:
✅ Wash hands often – especially after using the toilet or changing nappies
✅ Disinfect toys, surfaces, and shared items daily
✅ Keep sick kids home until fever and blisters are gone
✅ Teach kids to cough/sneeze into their elbow
✅ Don’t share food, cups, towels, or dummies
HFMD FAQs
Can you get HFMD twice?
Yes. Unfortunately, having it once doesn’t give lifelong immunity, and different strains of the virus can strike again.
Should kids with HFMD stay home from school?
Absolutely. Keep them home until their fever is gone and their mouth sores are healing, usually about 7 to 10 days.
Can pregnant women catch HFMD?
Yes, but complications are rare. Still, pregnant women should avoid direct contact with infected kids.
Final Thoughts on HFMD
Hand, Foot, and Mouth Disease (HFMD) in children is generally mild, but knowing how to manage it can make a big difference. We’ve covered some essential HFMD treatment tips, including keeping kids hydrated, managing their symptoms at home, and watching for signs needing medical attention. Preventing the spread, especially in settings like daycares, involves simple practices like handwashing, disinfecting surfaces, and keeping sick kids home until they’re better.
We’d love to hear about your experiences with HFMD or answer any questions you might have. Feel free to share your story or ask for advice in the comments below.
If you’re unsure about any symptoms or have concerns about your child’s health, it’s always best to consult your pediatrician. You can also schedule an appointment for a proper diagnosis or learn more about treatment options. Taking these steps can ensure your child gets the right care and stays healthy.
Need a Hand? We’re Here to Help
If you have a bout of Hand, Foot, and Mouth Disease and you're unsure what's normal or when to worry, we’re just a message away. Whether it’s for a proper diagnosis, treatment advice, or just reassurance, we’re here to support you.
Click here to book an appointment with our clinic or get in touch, because you shouldn’t have to manage sick days on your own.
💬 Have questions or stories to share? Drop them in the comments below. We love hearing from our parent community.
Bình luận