Introduction
Hand, Foot and Mouth Disease (HFMD) is one of the most common childhood illnesses in China, particularly affecting children under 5 years old. Shanghai sees seasonal peaks in spring (April–June) and autumn (September–October). While usually mild, some cases can become serious — so knowing what to watch for is essential.
What Is HFMD?
HFMD is a contagious viral illness caused most commonly by Enterovirus 71 (EV71) or Coxsackievirus A16. It spreads through direct contact with saliva, nasal discharge, blister fluid, or feces of an infected person.
Symptoms to Recognize
- Fever — usually the first sign, lasting 1–2 days
- Sore throat and mouth ulcers — painful sores inside the mouth, gums, and tongue
- Skin rash — small red spots or blisters on the palms, soles of feet, and sometimes buttocks
- Loss of appetite and irritability
- Drooling due to painful swallowing
Symptoms typically appear 3–7 days after exposure and resolve within 7–10 days in mild cases.
Home Care for Mild Cases
- Keep the child hydrated — offer cold water, milk, or ice pops to soothe mouth pain
- Use paracetamol or ibuprofen for fever and pain relief (age-appropriate dosing)
- Keep the child home from school or daycare until fever-free for 24 hours and blisters have dried
- Wash hands frequently and disinfect toys and surfaces
- Avoid popping blisters — let them heal naturally
Red Flag Symptoms — Seek Immediate Medical Care
A small percentage of HFMD cases (particularly EV71) can lead to serious complications including viral meningitis, encephalitis, or pulmonary edema. Go to the hospital immediately if your child shows:
- High fever above 39°C lasting more than 3 days
- Severe headache, neck stiffness, or sensitivity to light
- Vomiting repeatedly
- Difficulty breathing or rapid breathing
- Extreme drowsiness or difficulty waking
- Limb weakness or unsteady walking
- Seizures
Prevention
- Frequent handwashing, especially before meals and after toilet use
- Avoid close contact with infected children
- Disinfect shared toys and surfaces regularly
- EV71 Vaccine: Available in China for children aged 6 months to 5 years — highly recommended for expat families. Ask CMCS about accessing this vaccine.
CMCS Recommended Hospitals for Pediatric Infectious Disease in Shanghai
If your child develops severe HFMD symptoms or you need expert diagnosis and treatment, CMCS can connect you with Shanghai's leading pediatric specialists with full English-language support.
🏥 Fudan University Children's Hospital (复旦大学附属儿科医院)
China's top-ranked children's hospital with a dedicated infectious disease and pediatric neurology department — critical for managing complicated HFMD cases.
Learn more about Pediatric Neurology at Fudan Children's Hospital →
🏥 Xinhua Hospital (新华医院)
A nationally recognized pediatric center affiliated with Shanghai Jiao Tong University, with strong infectious disease and emergency pediatric capabilities.
Learn more about Pediatrics at Xinhua Hospital →
How CMCS Can Help
HFMD can escalate quickly in young children. CMCS provides rapid appointment booking, bilingual accompaniment, and direct access to senior pediatric specialists — so you never have to navigate the system alone.
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