Hand, foot, and mouth disease
Common viral infection causing fever and blisters on hands, feet, and mouth.
Hand, foot, and mouth disease (HFMD) is a common viral infection caused by a group of enteroviruses from the Picornaviridae family. It primarily affects young children, particularly those under five years old, though adults can occasionally contract it. The illness typically begins with a fever and a general feeling of being unwell, followed a day or two later by a rash of flat, discolored spots or bumps that may develop into blisters. These lesions appear on the palms of the hands, soles of the feet, and inside or around the mouth, and can also occur on the buttocks, groin, and lips. The rash is rarely itchy in children but can be extremely itchy in adults. Painful ulcers or blisters may also form in or near the nose and mouth. Symptoms generally emerge three to six days after exposure to the virus, and the rash usually resolves on its own within about a week. The disease is self-limiting, with most people recovering without specific treatment in seven to ten days.
The most common cause of HFMD is Coxsackievirus A16, followed by Enterovirus 71. Other strains of coxsackievirus and enterovirus, such as CV-A6 and CV-A10, can also be responsible. The viruses spread through close personal contact, airborne droplets from coughing, contact with feces of an infected person, or contaminated objects. Individuals can be infectious for days to weeks after symptoms resolve, and some people carry and transmit the virus without showing any symptoms. No animals are involved in transmission. Diagnosis is usually made based on the characteristic signs and symptoms; if unclear, a throat swab or stool sample may be tested for the virus.
While most cases are mild, complications can rarely occur, including viral meningitis, encephalitis, or paralysis resembling polio. Infections from Enterovirus 71 tend to be more severe, with higher risk of neurological or cardiac complications, including death. Non-neurologic complications such as inflammation of the heart, fluid in the lungs, or bleeding into the lungs may also arise. There is no specific antiviral treatment or vaccine available in most regions, though a vaccine for EV71 is used in China. Management focuses on symptom relief, such as over-the-counter pain medications like ibuprofen for fever and mouth sores; aspirin should be avoided in children. Occasionally, hospitalized children may require intravenous fluids for dehydra
- caused_by
- Enteroviruses (primarily Coxsackievirus A16 and Enterovirus 71)
- incubation_period
- 3–6 days
- typical_duration
- 7–10 days
- affected_population
- Children under 5 years old (occasionally adults)
- transmission
- Close personal contact, airborne droplets, fecal-oral route, contaminated objects
- seasonality
- Spring, summer, and fall
Lore & Background
Hand, foot, and mouth disease is a common viral infection caused by enteroviruses from the Picornaviridae family. The most frequent cause is Coxsackievirus A16, followed by Enterovirus 71, though other strains like CV-A6 and CV-A10 are also responsible. The illness typically begins with fever and general malaise, followed one to two days later by flat, discolored spots or bumps that may blister. These lesions appear on the hands, feet, and mouth, and occasionally on the buttocks and groin. The rash is rarely itchy in children but can be extremely itchy in adults. Painful ulcers or blisters may also develop inside or around the nose and mouth. Symptoms generally emerge three to six days after exposure, and the rash usually resolves on its own within about a week. The disease is highly contagious, spreading through close personal contact, airborne droplets from coughing, and fecal-oral transmission. Contaminated objects can also spread the virus. Infected individuals may remain contagious for days to weeks after symptoms resolve, and some people carry and transmit the virus without showing any symptoms. No animals are involved in transmission. Childcare settings are common sites of outbreaks due to diaper changes and toilet training. Diagnosis is typically made based on symptoms, though throat or stool samples may be tested if unclear. Most cases resolve without treatment in seven to ten days, with over-the-counter pain relievers used for fever and mouth sores. Severe complications are very rare but can include viral meningitis or encephalitis, particularly with Enterovirus 71 infections. The disease occurs worldwide, often in small outbreaks in nurseries or kindergartens, and large outbreaks have been occurring in Asia since 1997. It is most common in children under five but can affect adults, and it typically appears in spring, summer, and fall. Hand, foot, and mouth disease should not be confused with foot-and-mouth disease, which affects livestock.
Reader's Guide
Hand, foot, and mouth disease is significant as a highly contagious but usually mild illness that primarily affects children under five. The disease is often confused with foot-and-mouth disease in livestock, but they are unrelated. Prevention focuses on hygiene and avoiding contact with infected individuals. While no specific antiviral treatment exists, symptomatic relief with pain medications is common. Rare complications include viral meningitis, encephalitis, and flaccid paralysis, with Enterovirus 71 infections tending to be more severe. The disease typically resolves on its own, and most cases require no medical intervention.
Did You Know?
- The rash of HFMD is rarely itchy for children but can be extremely itchy for adults.
- Fingernail and toenail loss has been reported in children 4–8 weeks after having HFMD, though it is temporary.
- HFMD is not the same as foot-and-mouth disease, which affects livestock.
- Some people can carry and pass on the virus without having any symptoms.
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