Hand, foot, and mouth disease

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
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Hand, foot, and mouth disease
Synonyms	N/A
Pronounce	N/A
Specialty	N/A
Symptoms	Fever, sore throat, rash on hands, feet, and mouth
Complications	Viral meningitis, encephalitis, dehydration
Onset	3–6 days after exposure
Duration	7–10 days
Types	N/A
Causes	Coxsackievirus A16, Enterovirus 71
Risks	Close contact with infected individuals
Diagnosis	Clinical diagnosis, PCR test
Differential diagnosis	N/A
Prevention	Hand washing, disinfection of surfaces
Treatment	Supportive care, pain relief
Medication	Analgesics, antipyretics
Prognosis	N/A
Frequency	Common in children under 5 years
Deaths	Rare

Hand, foot, and mouth disease, as the name suggests, is a clinical syndrome that is usually caused by enterovirus infection, and that is characterized by fever, anorexia, and painful sores in the mouth, distal extremities, such as hands, foot, and/or other sites, including the buttocks.

Epidemiology

Hand, Foot, and Mouth Disease is common in the summer and fall in the U.S., but you can get it any time of year.

• Common causes of hand, foot, and mouth disease are:
• Coxsackievirus A16 is typically the most common cause of hand, foot, and mouth disease in the United States.
• 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 very rare, EV-A71 has been associated with more severe diseases, such as encephalitis.

Characteristic rash of hand, foot, and mouth disease, on a human foot

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. 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 might not want to drink much. Make sure they drink enough to stay hydrated.

Cause

Common causes of hand, foot, and mouth disease are:

• Coxsackievirus A16 is typically the most common cause of hand, foot, and mouth disease in the United States. 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.

Hand, Foot and Mouth Disease Blisters

Encephalitis

Although very rare, EV-A71 has been associated with more severe diseases, such as encephalitis.

Transmission

Hand, foot, and mouth disease spreads easily through

• Person to person contact
• The air when an infected person coughs or sneezes
• Contact with contaminated surfaces and objects
• Hand, foot, and mouth disease is contagious
• Hand, foot, and mouth disease is caused by viruses.

The virus can spread to others through an infected person’s

Hand, Foot and Mouth Disease. Blisters on the foot of a 30 year old male.

Nose and throat secretions, such as saliva, sputum, 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. Transmission is by:

• Breathing air after a sick person coughs or sneezes
• Touching a sick person or making other close contact, like kissing, hugging, or sharing cups or eating utensils
• Touching a sick person‚Äôs 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.

Complications

Complications from hand, foot, and mouth disease are rare. Dehydration Some people, especially young children, may get dehydrated if they are not able to swallow enough liquids because of painful mouth sores. Parents can prevent dehydration by making sure their child drinks enough liquids. Fingernail and toenail loss Very rarely, people may lose a fingernail or toenail after having hand, foot, and mouth disease. Most reports of fingernail and toenail loss have been in children. In these reported cases, the person usually lost the nail within a few weeks after being sick. The nail usually grew back on its own. Experts don’t know if hand, foot, and mouth disease caused the nail loss. Viral (aseptic) meningitis Although very rare, a small number of people with hand, foot, and mouth disease get viral meningitis. It causes fever, headache, stiff neck, or back pain and may require the infected person to be hospitalized for a few days. Encephalitis or polio-like paralysis Very rarely, a small number of people with hand, foot, and mouth disease get encephalitis (swelling of the brain) or paralysis. It is extremely rare. Pregnant women Pregnant women should contact their healthcare provider if they think they may have been exposed to hand, foot, and mouth disease or think they may have the disease. Although complications from it are rare, patient medical history and how far along a woman is in her pregnancy can affect the situation.

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