Hand, foot, and mouth disease (HFMD) is a common virus * that primarily affects infants and children up to 10 years of age; however, it is sometimes seen in adults. HFMD is contagious * and can be spread by direct contact with an infected person, or contact with surfaces and objects touched by an infected person. The virus causes fever, sores in the mouth, and a skin rash on the hands and feet. Rarely, the infection is more severe and can lead to life-threatening complications. HFMD occurs most often from spring through fall in most clinates.
HFMD is a common viral illness primarily affecting children but sometimes is seen in adults. In the 21st century, HFMD has become the most severe contagious disease among children in the Asia-Pacific region of the world. Epidemics occur in the United States from time to time.
The agents that cause HFMD are coxsackievirus A16 or enterovirus 71. These viruses can be found in the secretions of an infected person, including:
The virus can be spread by:
Infants and children up to 10 years of age who are exposed to HFMD are most at risk for the disease. Children are more likely to be exposed to HFMD in places where they gather (for instance, at day care, school, and playgroups). Adults can get HFMD, especially if they are caring for children with the disease. The virus is most contagious during the first week that the person has the disease.
The early symptoms of HFMD include fever, headache, loss of appetite, sore throat, and a vague feeling of being unwell (malaise * ).
One or two days after fever begins, painful sores begin appearing in the mouth, throat, and on the tongue. A skin rash develops mostly on the palms of the hands and soles of the feet. The rash can appear in other areas, including the buttocks. The rash begins as small, sore spots that turn into painful blisters. The patient can also have dehydration * because mouth sores make it difficult to swallow.
Diagnosis of HFMD is usually made based on how and when symptoms began, the patient's age, and the appearance of the mouth sores and skin rash. Cultures * of the throat and the feces may be taken to determine whether the infection bacterial or viral, and if viral, if it is a virus associated with HFMD.
At-home treatment for HFMD focuses on treating and relieving the symptoms of the disease.
If a child or adult with HFMD becomes dehydrated because of painful mouth sores, the patient may have to be admitted to a hospital to receive fluid and nutrition intravenously (through a tube placed in the patient's vein). As of 2016, no medicines have been developed to treat most cases of HFMD, but drugs were under development to help fight enterovirus 71.
As of spring 2016, there was no vaccine * or immunization against HFMD available in the United States. However, China's Food and Drug Administration approved two vaccines in 2015 and 2016 to prevent HFMD from enterovirus 71. Risk for getting HFMD can be decreased by:
Because HFMD can be spread by contact, children with HFMD should be kept at home until they have recovered. Full recovery usually occurs in five to seven days.
See also Coxsackievirus and Other Enteroviruses • Viral Infections
Long, Sarah S., Larry K. Pickering, and Charles G. Prober, eds. Principles and Practice of Pediatric Infectious Diseases. 4th ed. St. Louis, MO: Saunders, 2012.
MedlinePlus. “Hand-Foot-Mouth Disease.” U.S. National Library of Medicine. https://www.nlm.nih.gov/medlineplus/ency/article/000965.htm (accessed March 16, 2016).
Nervi, Stephen J. “Hand-Foot-Mouth Disease.” Medscape. http://emedicine.medscape.com/article/218402-overview (accessed March 23, 2016).
Sanicas, Melvin. “Severe Hand, Foot, and Mouth Disease (HFMD) Is Now Vaccine-Preventable (at Least in China)!” Bill & Melinda Gates Foundation. http://www.impatientoptimists.org/Posts/2016/01/Severe-Hand-Foot-and-Mouth-Disease-HFMD-is-now-vaccinepreventable-at-least-in-China#.V6OhhfkrIdU (accessed August 4, 2016).
Centers for Disease Control and Prevention. 1600 Clifton Rd., Atlanta, GA 30329-4027. Toll-free: 800-CDC-INFO (800-232-4636). Website: http://www.cdc.gov (accessed March 23, 2016).
* virus (VY-rus) is a tiny agent that can cause infectious diseases. A virus can multiply only within the cells it infects.
* contagious (kon-TAY-jus) means transmittable from one person to another, usually referring to an infection.
* malaise (muh-LAZE) is a general feeling of tiredness, discomfort, illness, or uneasiness that cannot be explained.
* dehydration (dee-hi-DRAY-shun) is a condition in which the body is depleted of water, usually caused by excessive and unre-placed loss of body fluids, such as through sweating, vomiting, or diarrhea.
* cultures (KUL-churs) are tests in which a sample of fluid or tissue from the body is placed in a dish containing material that supports the growth of certain organisms. Typically, within days the organisms will grow and can be identified.
* over the counter (OTC) means medications or other treatments that can be bought without a doctor's prescription.
* vaccine (vak-SEEN) is a preparation of killed or weakened organisms, or a part of an organism or product it produces, given to prevent or lessen the severity of the disease caused by exposure to the organism. Use of vaccines for this purpose is called immunization or vaccination.
* disinfect means to destroy harmful organisms by physical or chemical means.