Hand, foot and mouth disease: symptoms, relief and video visits in Puerto Rico

It is a viral infection, most common in children under 5, though anyone can catch it, adults included. It is usually mild and clears up on its own in 7 to 10 days.

The virus spreads through droplets from coughing, sneezing or talking; by touching objects and surfaces with the virus on them; through fluid from the blisters; and through stool. That is why it passes easily in daycare and school, especially among children still in diapers.

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Hand, foot and mouth disease is handled in a US$79 doctor visit, the same price for every age, with no membership. You pay by card when you request the visit, and you get a full refund if the visit can’t take place. A doctor’s note after your visit is included at no extra charge.

We do not bill insurance; the pharmacy charges separately. See all prices. The service is run by The Health Initiative, a nonprofit.

Symptoms usually start 3 to 5 days after exposure:

• Fever and cold-like symptoms
• Sore throat
• Painful mouth sores: small red spots on the tongue and inside the mouth that turn into blisters
• Red spots on the palms and soles, flat or slightly raised, sometimes with small blisters; they can also appear on the buttocks, legs and arms, and usually do not itch
• Less interest in eating or drinking because swallowing hurts

There is no antibiotic or vaccine for this illness; antibiotics do not work on viruses. Treatment means easing symptoms while the body fights off the virus, and the most important thing is keeping your child drinking despite the sore mouth.

Usually no lab test is needed: the doctor recognizes it from the sores and spots. If the symptoms do not fit or do not improve, she tells you what to do next and, if needed, gives you a lab order for a lab near you.

• Offer fluids often, in small sips, even if your child is eating little.
• Acetaminophen or ibuprofen help with fever and pain. Dose by weight and use the device that comes with the medicine.
• Never give aspirin to a child unless their doctor says so.

According to the CDC, your child can return to school or daycare once they have no fever, feel well enough to take part, and are not drooling uncontrollably from mouth sores. Check your school or daycare’s own rules too. A doctor’s note after the visit is included.

There is no vaccine, so hygiene is the best protection: wash hands often with soap and water, especially after diaper changes or using the bathroom; clean toys and frequently touched surfaces; and avoid kissing, hugging, or sharing cups and utensils with the sick person.

Babies: for a very young baby, especially under 6 months, book a visit soon: we evaluate your baby by video with you on camera and check how much they are drinking. For safety: a baby under 3 months with a temperature of 100.4 °F (38 °C) or higher needs the emergency room right away. See fever in children.

Toddlers and school-age children: the most common age. Make sure they drink and pee; book a visit if the fever lasts more than 3 days or symptoms are not better after 10 days. See our online doctor for kids.

Teens and adults: they catch it too, usually mildly. Pregnant women who have been exposed should talk to their doctor.

Complications are rare. For your safety, go to the emergency room or call 911 for these signs. See when to go to the ER.

• Not drinking, or barely peeing
• Signs of dehydration: dry mouth, crying without tears, unusual sleepiness
• Severe headache with a stiff neck
• A seizure
• Very listless, hard to wake or working hard to breathe
• A baby under 3 months with a temperature of 100.4 °F (38 °C) or higher