Explaining hand-foot-and-mouth disease — OSCE

Candidate instructions (8-minute station)

You are the paediatric registrar in the clinic. A 3-year-old child has classic hand-foot-and-mouth disease — two days of fever, painful oral ulcers, and vesicles on the palms, soles and buttocks. The child is feeding small amounts, is afebrile today, and is recovering well. At home there is also a 6-week-old newborn sibling. ^[2]

Your tasks are: ^[1]

1. Explain the diagnosis of hand-foot-and-mouth disease and what the illness will look like over the coming days, in plain language. ^[2]
2. Explain the childcare-exclusion and infectivity plan, and why the child remains infectious even after the fever settles. ^[1]
3. Explain the red flags that should bring the family straight back — and explain why the 6-week-old sibling is the family member you are most concerned about. ^[5]
4. Address the parent's question of why there is no routine vaccine for HFMD when there are vaccines in some countries. ^[8]

You are not expected to prescribe a specific management plan for the newborn without review — flag that any concern about the infant needs same-day assessment. ^[2]