Herpangina in Children: Symptoms, Contagion and Care
Medically Reviewed by Dr. Pedro Yelamo Vera, MD
Licensed Physician No. 484814280 · Official Medical College of Bizkaia (Spain)Last reviewed: 31 October 2026
Herpangina gives children a sudden fever and painful ulcers at the back of the mouth. How it spreads, how long it lasts, home care and when to worry.
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Dr. Pedro Yelamo Vera is an independent, bilingual GP licensed in Spain. Book a 15-minute video consultation in English or Spanish for €50, with a private electronic prescription issued under Spanish law when clinically appropriate.
Herpangina is a common viral infection in young children. It causes a sudden fever, a sore throat and small blisters that turn into painful ulcers at the back of the mouth. It is usually caused by coxsackie A viruses. It clears by itself within about a week. The main risk is that a child drinks too little.
- Typical signs: sudden fever, sore throat, pain on swallowing and a few small grey-white ulcers with a red rim at the back of the mouth.
- It is most common in children aged 3 to 10, and it spreads easily at home, nursery and school.
- It is a virus. Antibiotics do not help. Care is fluids, soft cool foods and pain relief.
- The main risk is dehydration. A child who will not drink, or is peeing much less than usual, needs a doctor today.
- See a doctor if the fever or mouth sores last more than 5 days.
Dr. Pedro Yelamo Vera is a GP licensed in Spain (Colegiado No. 484814280).
For a medical emergency, call 112 or go to the nearest local emergency department. Do not wait for a video consultation or an online reply.
What does herpangina look like?
It usually starts suddenly. MSD Manuals describes this order:
- Fever, sore throat, pain on swallowing, headache and loss of appetite.
- Babies may drool or vomit.
- About two days in, small grey spots appear at the back of the mouth. They sit on the folds beside the tonsils, the soft palate, the tonsils or the uvula.
- Within a day they become blisters with a red rim, then shallow ulcers.
MSD Manuals counts an average of 4 to 5 spots, sometimes up to 20. MedlinePlus says they have a white to greyish base and a red border, and they can be very painful. A few spots may also appear on the hands, feet or bottom.
Is herpangina the same as hand, foot and mouth disease?
They are cousins. Both come from enteroviruses, often coxsackie viruses. Herpangina mainly affects the back of the mouth and throat. Hand, foot and mouth disease adds a rash on the palms and soles. Many UK and US health pages cover herpangina under hand, foot and mouth disease. In Spain you may hear herpangina or enfermedad mano-pie-boca.
Despite the name, it is not caused by the herpes virus. MSD Manuals notes that herpes mouth ulcers are larger, more numerous, last longer and sit more at the front of the mouth.
How is herpangina spread, and how long is it contagious?
The virus spreads through coughs and sneezes, saliva, blister fluid and stools, and from toys and surfaces. The CDC says people are most contagious in the first week. They can still pass the virus on for days or weeks after they feel better. The Spanish Paediatrics Association (AEP) adds that children can spread it before symptoms start. For hand, foot and mouth disease, the CDC says symptoms usually begin 3 to 5 days after catching the virus.
So keeping a child at home longer does little to stop spread. Good handwashing does, especially after nappy changes and toilet visits. Do not share cups, cutlery or towels.
How do you treat herpangina at home?
There is no cure. The aim is comfort and fluids while the body clears the virus.
- Offer small drinks often. Cold water and milk are usually easier than juice.
- Choose soft, cool foods. Yogurt, ice lollies and smooth soups are good. Avoid citrus, salty, spicy, fried and hot food.
- Treat pain and fever. Paracetamol or ibuprofen can help. Use the children's product and the dose on the leaflet for your child's weight. In the US paracetamol is called acetaminophen.
- Ask a pharmacist about mouth gels or sprays. MedlinePlus says numbing products are usually not needed.
Antibiotics do not help, because it is a virus. Your child may be more irritable than usual for a few days. Older children can gargle with cool water.
Worried about your child's sore throat, fever or mouth ulcers?
You can book a video visit with a GP licensed in Spain, in English or Spanish. He looks at the throat on camera, checks whether your child is drinking enough, and tells you if they need to be seen in person.
Can my child go to nursery or school with herpangina?
Keep your child at home while they have a fever or feel unwell. After that the rules differ:
- UK. UK Health Security Agency guidance lists no exclusion for hand, foot and mouth disease. The NHS says children can go back as soon as they feel better, even with spots.
- Spain. There is no national exclusion rule. The AEP says a child with no fever who feels well can go to class, and that exclusion does not reduce spread. Some guarderías set their own rules, so check with the nursery.
- US. The CDC gives no national rule. Schools and local health departments decide.
When should you see a doctor about herpangina?
See a doctor today if your child:
- Is drinking much less than usual or seems dry: dry mouth or few wet nappies.
- Has a fever, sore throat or mouth sores lasting more than 5 days (MedlinePlus).
- Is a young baby, or has a weak immune system.
- Is under 3 months old with a temperature of 38°C or more. Do not wait: take them to urgencias de pediatría now.
- Has a very high fever, or a fever that will not come down.
Call 112 or go to urgencias if your child has a stiff neck, is very drowsy or hard to wake, has a seizure, has trouble breathing, or has a rash that does not fade when you press a glass on it. The CDC says meningitis and brain swelling are very rare with these viruses, but they need hospital care.
Pregnancy. For hand, foot and mouth disease, caused by the same viruses, the NHS says there is usually no risk to the pregnancy or baby. Infection shortly before birth can give the newborn a mild illness. If you are pregnant and have been in contact, tell your GP or midwife.
Talking it through with a doctor by video
Dr. Yelamo is a GP licensed in Spain. He sees adults, children and pregnant patients by video, every day from 07:30 to 20:30 (Spain time). In the visit he will:
- Ask when the fever started, how much your child is drinking, and when they last had a wee.
- Look at the throat and mouth on camera with a torch, and at any spots on the hands or feet.
- Agree a plan for fluids and pain relief, and tell you if your child needs to be seen in person.
He does not promise any test or prescription before the visit. Where clinically appropriate, following a genuine evaluation. Treatment and prescriptions are issued solely at the doctor's discretion based on evidence-based clinical guidelines.
A prescription is never guaranteed: it is issued only where clinically appropriate after a genuine evaluation, as a private electronic prescription under Spanish law. This service is for urgent, non-emergency care. In an emergency, call 112.
See how the Urgent Care video visit works. It lasts 15 minutes and costs €50.
This guide is general information. It does not replace a consultation with your doctor.
Frequently asked questions
What is herpangina?
A viral infection, usually caused by coxsackie A viruses, that gives a sudden fever, a sore throat and small blisters and ulcers at the back of the mouth. It is most common in children aged 3 to 10.
How long is herpangina contagious?
The CDC says people with these viruses are most contagious in the first week of illness, but can still pass the virus on for days or weeks after they feel better, mainly in stools. Handwashing matters most.
How long does herpangina last?
It usually clears within a week. MSD Manuals says the ulcers heal in 1 to 7 days. See a doctor if the fever, sore throat or mouth sores last more than 5 days.
Can my child go to school or nursery with herpangina?
Keep them home while they have a fever or feel unwell. In the UK there is no exclusion for hand, foot and mouth disease, and the Spanish Paediatrics Association says a child with no fever who feels well can go back. Check your school's own rules.
Is herpangina the same as hand, foot and mouth disease?
They are caused by the same family of viruses. Herpangina mainly affects the back of the mouth and throat. Hand, foot and mouth disease adds spots on the hands, feet and sometimes the bottom.
Do antibiotics help herpangina?
No. It is caused by a virus, so antibiotics do not work. Care is fluids, soft cool foods and paracetamol or ibuprofen for pain and fever.
Can adults get herpangina?
Yes, it can happen at any age, though it is much more common in young children. Adults often catch it from a child at home.
Sources
- MedlinePlus: Herpangina
- MSD Manuals: Herpangina
- CDC: Hand, foot and mouth disease, causes and how it spreads
- NHS: Hand, foot and mouth disease
- UKHSA: Exclusion periods in children's settings
Related guides
Medical Citations & Sources
This content is written and reviewed by a licensed physician with reference to the following official health authorities.
