Can my child go to daycare with hand, foot and mouth disease?
Usually yes, once a child with hand, foot and mouth disease has had no fever for 24 hours without fever-reducing medicine (the Texas rule), and the blisters don’t have to heal first. They should also stay home if they can’t take part in the day or have mouth sores with drooling they can’t control. Keeping children home longer does little to stop it spreading, because children carry the virus without symptoms and in their stool for weeks.
Updated Oct 16, 2026. State rules and national guidance, not medical advice: if you’re unsure, call your child’s doctor.
Return to daycare: Texas, national (AAP) and California rules
| Texas centers | National standard (AAP) | California centers | |
|---|---|---|---|
| Stay home? | Only with a fever, or mouth sores with drooling (unless a health professional says the child can attend). | No, unless the child has mouth sores with drooling staff can’t manage, can’t take part, or the health department orders it during an outbreak. | Up to the center. State health guidance says a child may attend unless they can’t swallow, have a fever, have trouble breathing, or drool heavily or have a muffled voice. |
| Back when | After 24 hours without fever and without fever-reducing medicine, or with a health professional’s statement. | The sores don’t need to heal first. | When the center’s policy allows. |
| Doctor’s note | Not for the illness itself. A child a doctor diagnosed needs documentation that they’re no longer contagious. | No. | Only if the center’s policy asks for one. |
Texas: DSHS chart (rev. 2024); §746.3601(3)–(4); §746.3606. National: AAP quick-reference sheet. California: CDPH symptom guidance (2023); UCSF CCHP (2024). A Texas child sent home sick may also come back after 24 hours without symptoms or with a health professional’s statement (§746.3606). California leaves illness rules to each center’s written policy; its column is the state health department’s guidance.
How it spreads and how long it’s contagious
- It spreads through coughs and sneezes, close contact such as kissing or sharing cups, diaper changes, and toys or surfaces.
- Children are most contagious in the first week, can still spread it for days or weeks after they feel better, and can spread it with no symptoms at all.
- Most children have mild symptoms for 7 to 10 days: fever, sore throat, painful mouth sores and a rash on the hands and feet.
Sources: CDC: how it spreads; CDC: about.
When to call the doctor
- Your child can’t drink well and you’re worried about dehydration
- A fever that lasts longer than 3 days, or symptoms that don’t improve after 10 days
- Your child is very young, especially under 6 months, or has a weakened immune system
- Severe symptoms
Sources: CDC. Call 911 if your child is struggling to breathe, turns blue or is hard to wake.
What the center has to do
Both states have general rules on sending sick children home and on telling Licensing and parents about outbreaks, and a center’s own written illness policy can be stricter: ask for it at enrollment. The Texas and California rules →
What the state records show
Texas inspectors’ notes name hand, foot and mouth disease in 6 citations at 5 licensed centers since October 2021, 4 of them for not reporting it to Licensing or not notifying parents in writing.
California has cited 45 licensed centers 50 times since February 2021 under its outbreak-reporting rule (22 CCR §101212) in findings that name hand, foot and mouth disease.
Since February 2021, California has investigated 50 complaints whose allegations mention hand, foot and mouth disease, and substantiated 12.
From Texas and California inspection, complaint and investigation records for centers licensed today; Texas counts are citations under the sick-child and parent-notice rules whose inspector notes name hand, foot and mouth disease. See all sick-child citations in the sick-day guide.
Common questions
How long is a child out of daycare with hand, foot and mouth disease?
Usually only while they have a fever, can’t take part, or are drooling from mouth sores they can’t control. In Texas, a child with a fever goes back after 24 hours without fever and without fever-reducing medicine, or with a health professional’s statement. The blisters don’t need to heal first.
How long is hand, foot and mouth disease contagious?
Children are most contagious during the first week, but the virus can spread for days or weeks after symptoms end and stays in stool for weeks or months, so keeping a child home longer does little to stop it.
Does the daycare have to tell parents about hand, foot and mouth?
In California, a center must report an outbreak (two or more children) to Licensing and the local health officer and tell parents. Texas Licensing has cited centers for not reporting a hand, foot and mouth outbreak to Licensing and for not notifying parents in writing.