With everything going on in your world, it can be easy to overlook the basics when it comes to your health, and the well-being of those around you. So here’s a friendly reminder: Don’t forget your flu shot.

While vaccines may have been in the news lately, there is general agreement on the benefits of the flu vaccine. Indeed, the recommendation of the U.S. Centers for Disease Control and Prevention (CDC) has not changed: Everyone six months and older should get a flu vaccine every season, with rare exceptions.

There are two basic reasons to get vaccinated for the flu, according to Bernard Camins, MD, MSc, Professor of Medicine (Infectious Diseases) at the Icahn School of Medicine at Mount Sinai.

• The vaccine may not completely prevent you from getting the flu, but the infection, if you do get the flu, will be less severe and can prevent you from being hospitalized. This is especially important for those at higher risk of developing serious flu-related complications, including those 65 and older; those with chronic medical conditions such as asthma, diabetes or heart disease; those who are pregnant; and children younger than five. Getting vaccinated also means you are less likely to expose others to the virus, notably those who may be more at risk for complications.
• You need to get the vaccine every year. Immunity can wane after a few months. Plus, the strains of the influenza virus can change from year to year, so previous vaccinations are not as effective against the current circulating strain.

If you are looking for more reasons to get the flu shot, consider these basic flu facts:

• It takes about two weeks for vaccines to be effective, and flu season usually peaks between December and January.
• The CDC recommends that those over age 65 get a version of the vaccine that elicits a more robust immune response. (You can talk with your health care provider or pharmacist if you have questions about whether this is for you.) And you can get the flu vaccine at the same time as a COVID-19 vaccine.
• Flu symptoms tend to come on suddenly. Most people who get the flu will recover in a few days, according to the CDC.
• Some may dismiss the seasonal flu as little different from the common cold. In fact, it is much more severe with 560,000 hospitalizations and 38,000 deaths attributed to the flu in the United States last season. Symptoms of flu include sudden onset of fever or chills, cough, sore throat, runny or stuffy nose, muscle or body aches, headaches, and fatigue. If you are feeling these symptoms from the flu, stay home.  If they worsen or if you have difficulty breathing, call your health care provider.
• Vaccination will play a key role in reducing influenza hospitalizations this season. Influenza vaccines prevented an estimated 240,000 hospitalizations during the 2024-2025 season, primarily in adults aged 65 years and older, according to the CDC. The flu vaccine also prevents millions of illnesses and flu-related doctor’s visits each year., and helps people avoid missing work and school.

Many parents may be unfamiliar with hand, foot, and mouth disease, but it’s actually very common among young children. The good news is that it’s typically mild, and it can be easy to treat and prevent. However, hand, foot, and mouth disease may cause parents and caregivers to worry and perhaps even cringe a bit. But why exactly?

It’s a highly contagious viral disease that predominantly affects children age five and under, but it can also affect older children and adults. The most common symptom is a rash in the mouth, and on the hands and feet. Other common symptoms include fever, painful sores and ulcers, muscle aches, dehydration due to painful swallowing, general fussiness from discomfort, and in some cases diarrhea and gastrointestinal problems. It’s known to spread rapidly, especially in daycare centers and schools, and it causes great pain and discomfort for kids.

In this Q&A, Tessa Scripps, MD, a pediatrician and Assistant Professor, Icahn School of Medicine at Mount Sinai, explains what causes hand, foot, and mouth disease, how long it’s contagious, and tips for prevention.

Tessa Scripps, MD

What causes hand, foot, and mouth disease?

It’s caused by a group of viruses referred to as enteroviruses. The most common cause is the Coxsackie A6 virus, but other strains of Coxsackie virus, as well as other enteroviruses, can cause the illness. When there is an outbreak of hand, foot, and mouth disease, there may be more than one type of virus circulating. Since there are different strains of the virus, a child can get the virus more than once. Adults may not be immune to the virus, so as a result, children can transmit it to their parents and caregivers.

How does it spread?

The virus is spread easily through:

• Person-to-person contact with droplets when an infected person talks, coughs, or sneezes. These droplets can land on objects or be rubbed into eyes, nose or mouth. These droplets do not stay in the air (like COVID-19) and do not travel more than three feet.
• Touching skin lesions (kissing, hugging) or coming into contact with objects and surfaces that have been contaminated.
• Coming in contact with an infected person’s poop, such as changing diapers, and then touching the eyes, nose, or mouth.
• Touching objects and surfaces that have the virus on them, like doorknobs or toys, and then touching your eyes, nose, or mouth.

What are the signs and symptoms of hand, foot, and mouth disease?

The signs and symptoms include:

• Fevers
• Rashes appear like red pimples that can transform into blisters mainly on the palms/between fingers/feet and around the mouth. Other common places are knees and elbows and diaper area. Children who have eczema are more susceptible and can have a more widespread and aggressive rash. Rashes normally scab over and heal without scarring, although some discoloration where the spots where can last for some time.
• Mouth sores, similar to cold sores that you can see, can develop inside the mouth and tongue but mainly at the back of the throat. This can worsen appetite due to discomfort, so dehydration is a concern in a child who cannot tolerate fluids orally.
• Diarrhea can occur before, during, or after the skin rash appears.
• Nail shedding and loss of nails can occur weeks to a few months after onset. While alarming, this is not painful or dangerous, and the nails regrow on their own.

How do you treat hand, foot, and mouth disease?

There is no specific treatment for the virus. It needs to run its course, and this normally takes 7 to 10 days. Here are some suggestions about how to treat the symptoms in kids:

• For fevers and discomfort, over-the-counter medicines like acetaminophen and ibuprofen can be used. (Note: Aspirin should not be used in children.)
• It’s important to drink plenty of fluids to prevent dehydration. Cold foods like ice cream, smoothies, and popsicles also help by numbing the area in the mouth. Soft foods like yogurt, pudding, and mashed potatoes can help, and these all can be a nice treat for kids who have trouble swallowing. Avoid hot drinks, sodas, and acidic juices or foods because they can make the pain worse.
• Get plenty of rest.
• If mouth sores are particularly bothersome, ask your doctor for treatments that may ease discomfort like lidocaine gel or magic mouthwash (usually not used in kids younger than 6 years of age).
• For skin rashes, a physician may recommend moisturizers. Symptoms do get better within 7 to 10 days for most people. Children with blisters on their hands or feet should keep the areas clean and uncovered. Wash the skin with lukewarm soap and water, and pat dry to keep it clean. If a blister pops, dab on a bit of antibiotic ointment to help prevent infection, and cover it with a small bandage.
• Try to stay as comfortable as possible, and prevent transmission by washing hands and using good hand hygiene.

 How do you prevent hand, foot and mouth disease?

There are some steps you can take to prevent this condition. These include:

• Wash hands with soap and water often.Hand washing is especially important after using the toilet, after changing diapers or potty training, before and after eating, and before preparing food.
• Keep hands away from the eyes, nose, and mouth.
• Avoid close contact with anyone who has it.
• Disinfect surfaces if an infected person came in contact with them.

When can my child return to school or daycare?

A child can return to school if:

• There is no fever for 24 hours
• There are no new skin lesions or open blisters (most lesions should be scabbing over).
• They appear well enough and active.

When should I call my doctor?

You should call the doctor if:

• Your child is not able to drink normally and you’re worried they might be getting dehydrated (very sluggish, urine less than three times a day, sunken eyes).
• The fever lasts longer than three to four days.
• Symptoms do not improve after 10 days.
• Your child has a weakened immune system (body’s ability to fight germs and sickness).

Telemedicine appointments with a pediatrician are one option available to parents who do not want to delay seeking care from their doctor. Tessa Scripps, MD, a pediatrician and Assistant Professor at the Icahn School of Medicine at Mount Sinai, explains what to expect from a telemedicine appointment and some of the benefits.

How is a telemedicine well visit similar to an in-office well visit?
Similar to an in-office visit, during the telemedicine visit, which consists of a face-to-face video conference with your child’s pediatrician, you will have the opportunity to discuss nutrition, development, sleep, parenting, updates on any chronic conditions, and any concerns you have.

How does a telemedicine well visit differ from an in-office visit?
Your child’s pediatrician will not be able to perform a complete exam, however there are many parts of the exam which can be observed on the video conference such as examining your child’s skin or looking for any signs your child may have difficulty breathing. Some of the screening exams which are performed in the office, such as hearing, vision, and blood pressure screens, cannot be done, however your child’s pediatrician will discuss with you the best time to have these checked. If your child is due for immunizations and/or lab work, the doctor will discuss with you the best time to bring your child in for these.

What are some benefits of telemedicine well visits?
During a time that you may not be able to bring your child to the office, telemedicine well visits give you the opportunity to connect with your child’s pediatrician, ask questions, and address concerns you may have. The doctor has the unique opportunity to observe the child in their natural environment, whether it be their permanent or temporary home. Children are often more comfortable in these familiar places and therefore are more playful and vocal. Your pediatrician will be able to do a developmental assessment based on these observations and can guide you about future milestones to look out for. Telemedicine visits let you and your child’s doctor stay up to date with your child’s medical care and allow your family to remain safe at home.

Tessa Scripps, MD

How can you and your child prepare for telemedicine well visits?
Prior to the visit, if you have a scale, you can try to measure your child’s weight without clothes and a diaper on. If you have a measuring tape, you can attempt to measure your child’s height by having them lie down, make a mark or place an object at the top of their head and bottom of their feet and measure the distance in between. Let your child’s doctor know about these measurements during the visit. They will be able to plot them, and you can review your child’s growth curve together.

During the visit, you should have your child available. It is okay if they crawl or walk off to play. Your child’s doctor is happy to observe them play as part of the visit. If possible, have your child wear clothes that can be easily raised up or pulled down in case there is anything you would like the doctor to examine as part of the telemedicine visit.

In which cases may your child’s pediatrician consider treating your child with antibiotics?
Antibiotics are medications which treat bacterial infections. Common bacterial infections that often require antibiotic treatment in children include ear infections, sore throat caused by streptococcal bacteria, certain skin infections, pneumonias, and urinary tract infections.

Why are doctors careful about prescribing antibiotics?
If antibiotics are overused, bacteria can become resistant to them and the medication loses its effectiveness in treating the bacteria. In addition, like all medications, antibiotics can be associated with side effects. Pediatricians have to carefully consider these variables when making the best decision for treatment for your child.

Is an in-office exam necessary to get a prescription for the antibiotics?
Pediatricians use the physical exam as an important diagnostic tool to make decisions about whether or not antibiotics are needed. Some parts of the exam/visit cannot be performed virtually. These include an internal ear exam, listening to the lungs, and swabbing the throat to test for infection. There are some parts of the exam that can be observed virtually including the skin exam and signs of difficulty breathing. If it is not possible for your child to come into the office, your pediatrician may recommend a telemedicine visit so they can observe your child. Based on the history and this observed exam, your child’s pediatrician may determine that a bacterial infection is likely and may consider prescribing antibiotics without seeing the child in the office.