As surely as the clocks go back each autumn, hand, foot and mouth disease is making its yearly return.
Known by its tell-tale red rash on the hands and feet, alongside a fever and sore throat, the highly contagious infection plagues British schoolchildren around the same time every year.
And sure enough, new data from the UK Health Security Agency (UKHSA) show cases are already on the rise among young children in England.
In fact, GP consultation rates among kids aged one to four have increased five-fold from just last month, figures show.
And this year could see a particularly bad outbreak.
While cases typically peak in late summer and autumn, UKHSA officials say 2026 is already set to be a year of ‘higher activity’ for the disease.
So, with nurseries and schools likely to see a fresh wave of cases in the coming weeks, what exactly is hand, foot and mouth disease? And why are infected children often still allowed into classrooms and nurseries?
We asked a leading GP to answer our most pressing questions about the illness.
As surely as the clocks go back each autumn, hand, foot and mouth disease is making its yearly return
What exactly is hand, foot and mouth disease?
Known as HFMD for short, the infection is caused by a group of viruses known as enteroviruses.
It typically starts with a fever, a sore throat and a loss of appetite, before it affects the rest of the body.
Most commonly, red rashes and sores will then develop on the hands and feet, and painful ulcers form in the mouth.
The infection is highly contagious, can be caught more than once, spreading easily through coughs, sneezes and contact with fluid from blisters.
It is usually mild, says Dr Heather Ryan, a GP and managing director of Formby GP.
‘Most children get better within a week or so without needing to necessarily see a doctor’ she says.
But in very rare instances, HFMD can trigger severe neurological issues or problems affecting the heart and lungs.
Whilst incredibly uncommon, neurological symptoms usually begin within two to five days of the rash first appearing – and include frequent, unexplained startles or jerks, as well as persistent or extreme irritability and lethargy.
High fever and vomiting and tremors and muscle weakness are also signs the infection has become severe.
Children who develop these symptoms should be taken to the nearest emergency department immediately, according to health service guidance.
Dr Ryan says children can catch HFMD more than once because different viruses can cause the infection.
Despite its name, the illness has no link to foot-and-mouth disease, which affects livestock.
Can adults be infected?
While most parents will be focused on looking after their children, Dr Ryan warns that adults can be infected too, though they tend to be less susceptible.
Symptoms for adults are largely the same as those found in children, but experts say they can be less severe.
In some cases, infected adults may have no symptoms at all.
But even people who feel completely well can still pass the virus on to others and unknowingly spread the infection.
New data from the UKHSA show cases of the highly contagious infection are on the rise among young children in England (the red line shows GP consultations for 2026)
Can children still go to school or nursery while infected?
According to the NHS, children with HFMD should only be kept off school or nursery if they’re too unwell to go.
‘As soon as they’re feeling better, they can go back to school or nursery,’ the health service’s guidance reads.
‘There’s no need to wait until all the blisters have healed.’
The NHS adds that keeping your children away from other children for longer is unlikely to stop the illness from spreading.
Experts say this is because the virus spreads so easily and can be passed on before symptoms appear.
As a result, children are allowed to return even if they still have visible blisters or a rash, as long as they are otherwise well and do not have problems like a fever.
Dr Ryan agreed, saying keeping kids at home is ‘not an effective way of managing the spread on a population level’.
‘There are some infections where there’s a very clear infectious period and if you can tell people to isolate in that time,’ she said.
‘Then you can break the cycle and reduce the risk of infection spreading.
‘But my understanding is that it’s not necessary to exclude children for a set period of time to massively curtail or affect the spread.’
What to do if you or your child gets infected?
There is no specific treatment for HFMD, Dr Ryan says.
The NHS also says the infection cannot be treated with antibiotics or medicines.
However, most cases can be managed safely at home while symptoms run their course.
Dr Ryan said parents should focus on keeping children comfortable, encouraging them to drink plenty of fluids to prevent dehydration and giving paracetamol if needed to ease pain or bring down a high temperature.
‘If you’ve got a sore throat or you feel unwell or if you’ve got mouth ulcers, then soft foods can be helpful,’ she continued.
‘Make sure you’re drinking plenty and eat as tolerated.’
The NHS advises that cool fluids will offer the mouth some respite from the pain, but to avoid acidic drinks like fruit juice.
They also say hot, salty and spicy foods should not be eaten while infected.
Dr Ryan urged parents to keep a close eye on their child and seek medical advice if they are concerned that symptoms are worsening or signs of dehydration develop.
‘But most children will get better by themselves within a few days without requiring further intervention,’ she added.