What is hand, foot, and mouth disease?

Hand, foot, and mouth disease (HFMD) is a common viral infection in infants and children that is caused by enteroviruses (most often Coxsackievirus A16). Symptoms begin 3-7 days after exposure and usually begin with a fever, poor appetite, a general feeling of being sick, and a sore throat. One to 2 days later, persons usually develop painful sores in the mouth and a rash with blisters. The rash does not itch and is usually located on the palms of the hands and soles of the feet, but may also be on the buttocks.

Hand, foot, and mouth disease is spread by direct contact with nose and throat discharges (coughing, sneezing), saliva, fluid from blisters, and stool of infected persons. Persons are very contagious in the first week of illness, but virus can be shed in the stool for several weeks.

Most persons experience a mild illness and recover without medical treatment in 7 to 10 days. The most common complication is dehydration because the mouth sores can make swallowing difficult and painful. In rare cases, a serious form of the virus may cause viral meningitis or encephalitis, which can be life-threatening.

Hand, foot, and mouth disease (HFMD) occurs mainly in children under 10 years old, but may occur in adults as well. HFMD is most common in children in child care settings, where diaper changing and potty training are constant and little hands are often in and out of the mouth frequently. Everyone is at risk for infection, but not everyone who is infected gets ill. Children are more likely to experience illness because they may not have immunity from a previous infection. Infection results in immunity to the specific virus, but a second episode may occur resulting from a different type of enterovirus. HFMD is more common in the summer and early autumn months.

View tips on protecting your child from hand, foot, and mouth disease on this page: Preventing Hand, Foot, and Mouth Disease

Your healthcare provider can usually diagnose hand, foot, and mouth disease upon visual examination. No specific treatment is available, but symptomatic treatment can be given to relieve fever, aches, pain from the mouth sores, and to maintain hydration.

There are no specific recommendations for excluding children with HFMD from child care settings, although children with a fever should stay home. Excluding children may not prevent additional cases because the virus can be excreted for weeks after the symptoms have disappeared. Some benefit may be gained, however, by excluding children who have blisters in their mouths and drool or who have weeping lesions on their hands. Your child care provider may recommend that your child stay home if the child is unable to participate in activities or if the provider is unable to care for the child without compromising the ability to care for other children.