Hand, foot, and mouth disease is the result of a viral infection. It mainly affects children. Symptoms include rashes on the feet and hands and painful blisters around the nose and mouth.

Severe cases of hand, foot, and mouth disease (HFMD) may require medical attention, but the condition usually clears up without intervention.

It is often confused with foot-and-mouth disease, which affects livestock but cannot infect humans.

HFMD is most common in children under 10 years of age, but it can also affect older children and adults.

Outbreaks typically occur in Asia. It remains fairly uncommon in the United States. There is currently no vaccine for the disease.

Fast facts on hand, foot, and mouth disease

  • Hand, foot, and mouth disease (HFMD) is a viral infection caused by enteroviruses.
  • Its symptoms include a painful rash on the feet and hands, as well as ulcers in the mouth.
  • There is no way to treat or prevent HFMD, but it normally clears up without treatment within 7 to 14 days.
  • Outbreaks are rare in the United States. They are more common in Western Pacific countries, such as Japan and Singapore.

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HFMD is recognizable by a distinctive rash on the hands and feet.

Symptoms of HFMD usually occur around 3 to 7 days after first contact with the virus.

The first noticeable symptoms are a 24-to-48-hour fever of 100° to 102° Fahrenheit, or 38 to 39º Celsius, and a sore throat.

These are followed by a range of symptoms, including:

  • a rash on the hands and soles of the feet, with flat, painful, red blisters, occurring 1 to 2 days after the fever
  • loss of appetite
  • headache
  • throat, mouth, and tongue ulcers

Some people will have no symptoms, but they can pass on the virus to others. It is most contagious during the first 7 days of illness.

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HFMD can spread through coughing and sneezing.

Viruses in the enterovirus category usually cause HFMD.

Coxsackieviruses are the most common type of enterovirus linked to HFMD, especially coxsackievirus A16. Enterovirus 71 is also a common cause.

These viruses normally spread via the mouth and anus and are usually found in the saliva, mucus, feces, and blister fluid of a person with HFMD.

Common methods of passing on the virus include:

  • close, personal contact with an infected person
  • coughing and sneezing
  • touching contaminated objects
  • direct or indirect contact with infected feces

Children under 10 years of age are most at risk of catching HFMD, especially those under 5 years old. The immune system will not yet have developed the antibodies to fight the disease in many younger children.

Children who regularly spend time around other children have an increased risk of becoming infected, such as those who attend childcare centers or schools.

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Washing the hands thoroughly with soap is one way to prevent the spread of HFMD.

A doctor can usually diagnose HFMD diagnosis by conducting a physical examination.

They might look for sores or blisters on the feet, hands, and genitals. They may also check for other common symptoms that occur alongside the sores.

Sometimes, a lab test may be needed to confirm a diagnosis. Doctors may look for related antibodies or viral materials in the blood or collect throat and stool samples for examination.

There is no cure and no specific treatment for HFMD.

Over-the-counter (OTC) medications can help to relieve pain and fever in some people.

Numbing mouthwashes or sprays may help reduce mouth pain. This can be helpful for increasing fluid and food intake.

Soft foods, such as soup, can make eating less painful. Be sure to avoid hot or spicy foods. If mouth ulcers become too painful, drinking cold water or sucking on ice cubes can help to relieve discomfort.

A small number of patients may need to visit a hospital if complications develop.

Prevention

There is no vaccine to prevent HFMD.

It spreads through person-to-person contact, and good hygiene can lower the chance of getting it.

Tips for reducing the risk of infection include:

  • disinfecting surfaces
  • frequently washing the hands with soap and hot water
  • not sharing utensils and drinking cups

However, completely avoiding contact with others is not usually possible.

HFMD is most common in children, but it can affect adults, too.

Adults and older children usually have a milder form of the disease, and they may pass on the virus without knowing they have it. Sometimes, they can have severe symptoms.

The treatment is the same for children and adults.

Complications are rare but can develop if HFMD is left untreated in certain individuals.

If the underlying cause is a virus known as enterovirus 71, it can affect the nervous system.

This can lead to:

  • Meningitis, an inflammation of the spinal cord.
  • Encephalitis, an inflammation of the brain.
  • Acute flaccid paralysis, which weakens the respiratory muscles and reduces the ability to swallow.

Congenital deformities can occur if a woman contracts coxsackievirus during pregnancy. This may be linked to the development of fetal heart problems. However, the risk of this is very low, as it is rare that the virus can pass through the placenta.

Scratching at blisters or rashes can lead to a secondary infection.

If blisters develop in the throat, there may be a risk of dehydration.

In severe cases, cardiorespiratory failure can occur.

HFMD can sometimes result in hospitalization and even death, but most people recover without complications.

For those who are otherwise healthy, HFMD is not a life-threatening disease, and it clears up without treatment within a week or two.

Outbreaks of HFMD sometimes occur in Asian countries. The incidence appears to be increasing in Western Pacific countries, such as Japan and Singapore. Enterovirus 71 is normally responsible for wider outbreaks.

Occasionally, an outbreak occurs in the U.S.

In 2015, an outbreak on the Princeton University campus affected more than a dozen students. In 2012, there was an outbreak in Alabama.

However, outbreaks in the U.S. are rare.