Hand, Foot, and Mouth Disease*

Symptoms of Hand, Foot, and Mouth Disease

Symptoms of hand, foot, and mouth disease usually include fever, mouth sores, and skin rash. The rash is commonly found on the hands and feet. Hand, foot, and mouth disease is common in infants and children younger than 5 years old. Most children have mild symptoms for 7 to 10 days.

Symptoms include

1. Fever and flu-like symptoms
   Children often get a fever and other flu-like symptoms 3 to 5 days after they catch the virus. Symptoms can include fever, eating or drinking less, sore throat or feeling unwell.
2. Mouth sores
   Your child can get painful mouth sores. These sores usually start as small red spots, often on the tongue and insides of the mouth, that blister and can become painful. Signs that swallowing might be painful for your child include not eating or drinking, drooling more than usual or only wanting to drink cold fluids
3. Skin rash
   Your child can get a skin rash on the palms of the hands and soles of the feet. It can also show up on the buttocks, legs, and arms. The rash usually is not itchy and looks like flat or slightly raised red spots, sometimes with blisters that have an area of redness at their base. Fluid in the blister and the resulting scab that forms as the blister heals can contain the virus that causes hand, foot, and mouth disease. Keep blisters clean and avoid touching them.

Causes and Transmission

Hand, foot, and mouth disease spreads easily through person-to-person contact, respiratory droplets containing virus particles when an infected person coughs or sneezes or contact with contaminated surfaces.

Hand, foot, and mouth disease is contagious and is caused by viruses. A person infected with one of these viruses is contagious, which means that they can pass the virus to other people. The virus can spread to others through an infected person’s
- Nose and throat secretions, such as saliva, drool, or nasal mucus
- Fluid from blisters or scabs
- Feces (poop)

People with hand, foot, and mouth disease are usually most contagious during the first week that they are sick. People can sometimes spread the virus to others for days or weeks after symptoms go away or if they have no symptoms at all.

How it spreads You can get hand, foot, and mouth disease by
- Contact with respiratory droplets containing virus particles after a sick person coughs or sneezes
- Touching an infected person or making other close contact, like kissing, hugging, or sharing cups or eating utensils
- Touching an infected person’s feces, such as changing diapers, then touching your eyes, nose, or mouth
- Touching objects and surfaces that have the virus on them, like doorknobs or toys, then touching your eyes, nose, or mouth

Rarely, you can also get the viruses by swallowing recreational water, such as water in swimming pools. This can happen if the water is not properly treated with chlorine and becomes contaminated with feces from a person who has hand, foot, and mouth disease.

Hand, Foot, and Mouth Disease is Common in summer and fall in North America, but you can get it any time of year. In schools and daycares. Children should stay home while they have symptoms of hand, foot, and mouth disease.

Viruses that cause hand, foot, and mouth disease

Hand, foot, and mouth disease is caused by viruses that belong to the Enterovirus family; small non-enveloped viruses. Common causes of hand, foot, and mouth disease are:

- Coxsackievirus A16 is typically the most common cause of hand, foot, and mouth disease in North America. Other coxsackieviruses can also cause the illness.
- Coxsackievirus A6 can also cause HFMD and the symptoms may be more severe.
- Enterovirus 71 (EV-A71) has been associated with cases and outbreaks in East and Southeast Asia. Although rare, EV-A71 has been associated with more severe diseases such as encephalitis (swelling of the brain).

Preventing Hand, Foot, and Mouth Disease

This disease is very contagious.
Wash your hands often with soap and water for at least 20 seconds, if soap and water are not available, use an alcohol based hand sanitizer. Always wash your hands after changing diapers, after using the toilet, after blowing the nose, coughing, or sneezing and before and after caring for someone who is sick. Help children wash their hands. Teach them how to wash their hands and make sure they wash them often. Avoid touching your eyes, nose, and mouth. You can get infected with hand, food, and mouth disease if you have the virus on your hands and then touch your eyes, nose, or mouth. To lessen your chance of getting sick, don’t touch your eyes, nose, and mouth with unwashed hands.
Avoid close contact with sick people. Avoid touching someone who has hand, foot, and mouth disease, such as hugging or kissing them. Stay home if you are sick with hand, food and mouth disease. Talk with your healthcare provider if you are not sure when you should return to work or when your child should return to school or daycare.

Cleaning and Disinfection**

Clean and disinfect frequently touched surfaces and shared items, including toys and doorknobs. Disinfectants that are effective against small non-enveloped viruses should only be considered.

Treating Hand, Foot, and Mouth Disease

Most people with hand, foot, and mouth disease get better on their own in 7 to 10 days. There is no specific medical treatment for hand, foot, and mouth disease. There is no vaccine or medication that protects against hand, foot and mouthy disease. You can take steps to relieve symptoms and prevent dehydration while you or your child are sick.

Treat symptoms and prevent dehydration
Take over-the-counter medications to relieve fever and pain caused by mouth sores. Never give aspirin to children. Drink enough liquids. Mouth sores can make it painful to swallow, so your child may not want to drink much. Make sure they drink enough to stay hydrated.

When to see a healthcare provider
See a healthcare provider if
- Your child is not able to drink normally and you’re worried they might be getting dehydrated.
- Your child is not alert and responsive.
- Your child’s fever lasts longer than 3 days.
- Symptoms do not improve after 10 days.
- Your child has a weakened immune system (body’s ability to fight germs and sickness).
- Symptoms are severe.
- Your child is very young, especially younger than 6 months.