Hand, Foot, and Mouth Disease (HFMD)

Hand, Foot, and Mouth disease (HFMD) is a common viral illness that usually affect infants and children younger than 5 years old. However, it may occur in older children and adults. Generally, a person with HFMD is most contagious during the first week of illness. People can sometime be contagious for days or weeks after symptoms go away.

HFMD is not the only infection with mouth sores. Health care providers usually identify mouth sores caused by HFMD by considering the patient’s age, symptoms, and the look of the rash/sores. A health care professional may use a throat swab or take a sample of the patient’s blood or feces then send it to a lab to be tested for the virus.

Health complications from HFMD is not common. Viral meningitis can occur with HFMD, but it is rare. It causes fever, headaches, stiff neck, or back pain. An infected person may need to stay at a hospital for a few days. Fingernail and toenail loss has been reported within a few weeks after having HFMD. It is not sure if the nail loss is due to HFMD, but the nail loss was temporary and  grew back without medical treatment.

  • Symptoms
  • Causes
  • Prevention
  • Treatment

HFMD usually begins with:

  • Fever
  • Reduced appetite
  • Sore throat
  • A feeling of being unwell (malaise)

One or two days after the fever starts, painful sores can develop in the mouth. They tend to start as small red spots, often in the back of the mouth, that blister and can become painful. 

A skin rash on the palms of the hands and sole of the feet may also pop up over one or two days as flat, red spots, sometime with blisters. They may also appear on the knees, elbows, buttocks, or genital area. 

Young children may get dehydrated if they are not able to swallow enough liquids due to the painful mouth sores. Seek medical care in these situations. 

Not everyone will get all of these symptoms. Some people, especially adults, may become infected and show no symptoms, but they can still pass the virus to others. 

HFMD is caused by viruses that belong to the Enterovirus group, which include polioviruses, coxsackieviruses, echoviruses, and other enteroviruses. Coxsackievirus A16 is the most common cause of HFMD in the United States. 

The viruses can be found in an infection person’s:

  • Nose and throat secretions
  • Blister fluid
  • Feces

You can get exposed to the viruses that cause HFMD through:

  • Close personal contact with an infection person
  • The air when an infected person coughs or sneezes
  • Contact with feces, such as changing diapers of an infected person, then touching your eyes, nose or mouth before washing your hands
  • Contact with contaminated objects and surfaces, like touching a doorknob that has viruses on it, then touching your eyes, mouth, or nose before washing your hands

It is possible to become infected with the viruses that cause HFMD by swallowing recreational water, such as water in a swimming pool. However, it is not very common. This is more likely to happen in water that is not properly treated with chlorine. 

There is no current vaccine in the US to protect against the viruses that cause HFMD. Researchers are working on developing a vaccine to help prevent the disease in the future. 

You can lower your risk of being infected by:

  • Washing your hands often with soap and water, especially after changing diapers and using the toilet.
  • Clean and disinfect frequently touched surfaces and soiled items, including toys.
  • Avoid close contact such as kissing, hugging, or sharing eating utensils or glassware with people with hand, foot, and mouth disease. 

There is no specific treatment for HFMD. However, you can relieve symptoms by doing the following:

  • Take over-the-counter medicines to relieve pain and fever. (Caution: Aspirin should not be given to children)
  • Use mouthwashes or sprays that numb mouth pain

If a person has mouth sores, it might be painful for them to swallow. It is important that people with HFMD to get enough liquids to prevent dehydration. If you are concerned about symptoms, contact your health care provider. 

Sources: Centers for Disease Control and Prevention

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