Hand, Foot and Mouth Disease

What is hand, foot, and mouth disease?

Hand, Foot, and Mouth disease (HFMD) is a common illness of infants and children. It is characterized by fever, sores in the mouth, and a rash with blisters. HFMD begins with a mild fever, poor appetite, malaise (feeling sick), and frequently a sore throat. One or two days after the fever begins, painful sores develop in the mouth. They begin as small red spots that blister and then often become ulcers. They are usually located on the tongue, gums, and inside of the cheeks. The skin rash develops over one to two days with flat or raised red spots, some with blisters. The rash does not itch, and it is usually located on the palms of the hands and soles of the feet. It may also appear on the buttocks. A child with HFMD may have only the rash or the mouth ulcers.

What causes HFMD?

Viruses from the group called enteroviruses cause HFMD. The most common cause is coxsackie virus A16; sometimes, HFMD is caused by enterovirus 71 or other enteroviruses. The enteroviruses group includes polio viruses, coxsackie viruses, echoviruses and other enteroviruses.

Is HFMD contagious?

Yes, HFMD is moderately contagious. Infection is spread from child to child by direct contact with nose and throat discharges, saliva, fluid from blisters, or the stool of infected persons. A child is most contagious during the first week of the illness. HFMD is not transmitted to or from pets or other animals.

How soon will someone become ill after getting infected?

The usual period from infection to onset of symptoms (incubation period) is three to seven days. Fever is often the first symptom of HFMD.

Who is at risk for HFMD?

HFMD occurs mainly in children under 10 years old, but may also occur in adults too. Everyone is at risk of infection, but not everyone who is infected becomes ill. Infants, children, and adolescents are more likely to be susceptible to infection and illness from these viruses, because they are less likely than adults to have antibodies and be immune from previous exposures to them. Infection results in immunity to the specific virus, but a second episode may occur following infection with a different member of the enterovirus group.

How is HFMD diagnosed?

HFMD is one of many infections that result in mouth sores. Another common cause is oral herpes virus infection, which produces an inflammation of the mouth and gums (sometimes called stomatitis). Usually, the physician can distinguish between HFMD and other causes of mouth sores based on the age of the patient, and the symptoms reported by the patient, and the appearance of the rash and sores on examination. A throat swab or stool specimen may be sent to a laboratory to determine which enterovirus caused the illness. Since the testing often takes two to four weeks to obtain a final answer, the physician usually does not order these tests.

How is HFMD treated?

No specific treatment is available for this or other enterovirus infections. Symptomatic treatment is given to provide relief from fever, aches, or pain from the mouth ulcers.

Can HFMD be prevented?

Specific prevention for HFMD or other non-polio enterovirus infections is not available, but the risk of infection can be lowered by good hygienic practices. Preventive measures include frequent handwashing, especially after diaper changes, cleaning of contaminated surfaces and soiled items first with soap and water. Avoidance of close contact (kissing, hugging, sharing utensils, etc.) with children with HFMD may also help to reduce of the risk of infection to caregivers.