Hand, foot and mouth disease in Luxembourg

Hand, foot and mouth disease is a very common viral illness in young children, usually caused by a coxsackievirus. It causes small blisters inside the mouth and on the palms and soles, along with a fever that is generally mild. It is a harmless illness that clears up on its own within seven to ten days, but it spreads very easily in crèches and nurseries. In Luxembourg, the paediatrician is the natural first contact if symptoms are worrying or if the child refuses to eat because of mouth pain.

A common childcare-setting illness

Despite its slightly alarming name, hand, foot and mouth disease is neither exotic nor serious. It mainly affects children under five, often in small outbreaks within nurseries and crèches, in both summer and autumn. The virus spreads through respiratory droplets, saliva and stool, which explains how quickly it moves among young children who put everything in their mouths and are still learning to wash their hands properly.

What to expect

It often starts with a mild fever, tiredness and sometimes a sore throat, much like an ordinary cold. Within a day or two, small red spots appear and turn into greyish blisters ringed with red: inside the mouth, on the tongue and inner cheeks, as well as on the palms, fingers, soles and sometimes the buttocks. The mouth sores are usually the most troublesome, making swallowing painful for two to three days. On the skin, the blisters rarely itch much and heal without leaving a mark.

Eating and drinking despite a sore mouth

The real challenge with this illness is mealtimes. A child in pain when swallowing may drink less, with a risk of dehydration worth watching for. A few practical tips genuinely help:

• Offer cold or lukewarm food — never hot, acidic or spicy: yoghurt, apple sauce, ice lollies, lukewarm soup.
• Split meals and drinks into small, frequent amounts rather than pushing for large portions at once.
• Avoid citrus juices and crunchy or salty foods that irritate the mouth blisters.
• Keep an eye on nappies or toilet visits, which is the best sign of whether the child is drinking enough.

The paediatrician can suggest a pain reliever suited to the child’s weight to make meals more manageable, especially given shortly before eating.

Exclusion from childcare: not automatic

Contrary to a common assumption, hand, foot and mouth disease does not always call for strict exclusion from nursery: the child is already contagious before the blisters even appear, and many settings allow a return once the child feels well, is fever-free and can join in normal activities. The exact rule depends on each nursery’s or crèche’s own policy; when in doubt, it is best to check directly with the setting or with the paediatrician.

The one habit that truly slows the spread

The virus keeps shedding in the stool for several weeks after the blisters have healed, long after visible symptoms disappear. Handwashing — the child’s own, and that of whoever changes nappies or wipes noses — remains the single most effective way to limit transmission, before and after every nappy change, meal and toilet visit.

When to see a doctor

A visit to the paediatrician is worthwhile if the child persistently refuses to drink, if fever lasts beyond three days, if their general condition worsens, or simply to confirm the diagnosis when in doubt. Seek care promptly for clear signs of dehydration (dry mouth, little or no urine, unusual drowsiness), a very high fever poorly tolerated, or blisters that turn red, swollen and painful, suggesting a bacterial infection. Call 112 without delay for breathing difficulty, neck stiffness or unusual lethargy.

A note on nursing multiple children

Households with more than one young child often ask whether it is realistic to keep siblings apart during the contagious window. In practice, full separation is rarely achievable, and the illness has usually already had time to spread within the household before the first blisters are even noticed. Rather than aiming for strict isolation, it is more useful to focus on the habits that genuinely reduce the viral load circulating at home: separate cups and cutlery for the sick child during the first days, frequent handwashing for everyone, and prompt cleaning of toys that go straight into a toddler’s mouth. A second case appearing in the family a few days later is common and does not mean anything was done wrong.

In Luxembourg

The paediatrician provides routine follow-up for young children and is the easiest contact for a common infection like this one; outside opening hours, the on-call medical centres (maisons médicales de garde) take over. Consultations are reimbursed by the national health fund under the usual health insurance rules, detailed on cns.lu. On Doctipro, you can book an appointment directly with a paediatrician near you.