What Is Hand, Foot, and Mouth Disease?

Hand, foot, and mouth disease is a common childhood virus that spreads quickly throughout schools and daycare centers. It most commonly affects children under 5, but older children and adults can get it.

Common symptoms of hand, foot, and mouth disease include a fever, sore throat, mouth ulcers, and skin rash. The condition usually resolves on its own, and its symptoms can be managed at home.

This article will provide an overview of hand, foot, and mouth disease, including the common symptoms, how it is treated, and when to call your healthcare provider. 

Symptoms

It usually takes about three to six days from exposure for symptoms of hand, foot, and mouth disease to develop. Symptoms typically last less than a week and are most severe during the first few days of illness. 

Common symptoms of hand, foot, and mouth disease include:

• Mouth ulcers: Small red spots form in the back of the mouth. These sores can turn into painful blisters that make eating and swallowing painful.
• Rash: A classic sign of hand, foot, and mouth disease is a rash of flat red spots on the fingers, palms of hands, soles of feet, and buttocks. These spots may blister over. 

Other symptoms may include:

• Fever
• Sore throat
• Runny nose
• Drooling 
• Headache
• Loss of appetite 

Causes 

Hand, foot, and mouth disease is caused by viruses that belong to the enterovirus family. The virus coxsackievirus A16 most commonly causes the illness. Severe cases may be caused by coxsackievirus A6. 

Transmission

Hand, foot, and mouth disease is a highly contagious illness. A sick individual is considered most contagious during their first week of illness but may shed the virus from their respiratory tract for up to three weeks and their stool for weeks to months. 

Hand, foot, and mouth disease is spread from person to person via the following routes:

• Respiratory: Respiratory droplets from talking, coughing, or sneezing can infect others. 
• Person-to-person: Touching the fluid from the blisters of a person with hand, foot, and mouth disease can spread the virus. 
• Fecal-oral: The stool of an ill individual can infect others, which often happens at daycare centers where diapers are changed. 

Diagnosis

Hand, foot, and mouth disease is usually diagnosed with a medical history and physical exam. Many healthcare providers will diagnose this illness based on an individual’s symptoms.

The presence of common symptoms like fever, mouth ulcers, and a rash on the hands and feet is usually enough to determine the diagnosis. In addition, your healthcare provider may recommend taking a fluid sample from the blisters to confirm the diagnosis. 

Treatment

There is no cure for hand, foot, and mouth disease, and the illness usually resolves on its own. To ease the symptoms, consider the following home remedies:

• Over-the-counter pain medicine: Advil (ibuprofen) and Tylenol (acetaminophen) can be given to relieve pain and lower a fever. Never give a baby or young child aspirin because of the risk of Reye’s syndrome. 
• Mouth rinse: A saline mouth rinse may relieve pain caused by mouth ulcers. Mix 1/2 teaspoon of salt with one glass of warm water and gently swish in your mouth. Avoid mouthwash as this could be very irritating. 
• Fluids: It is important to drink plenty of fluids to avoid dehydration. Opt for water, and avoid juice and soda because they could irritate the mouth. Cold milk may feel soothing to the mouth sores. 

When to Call a Healthcare Provider

Call your healthcare provider if you or your child have had a fever for over three days or symptoms longer than 10 days. Talk with your healthcare provider right away if you are concerned about dehydration. 

Complications 

Hand, foot, and mouth disease usually resolves on its own, and complications are rare. Possible complications may include:

• Dehydration: Because mouth sores often make swallowing painful, children are at risk of becoming dehydrated. Encourage as many fluids as possible. 
• Febrile seizures: Children may experience febrile seizures when a high fever goes untreated for a prolonged period. 
• Nail loss: While rare, it is possible to lose fingernails or toenails after having hand, foot, and mouth disease. 
• Viral meningitis: This very rare complication may happen to a small number of people who get hand, foot, and mouth disease. Symptoms include a high fever, stiff neck, and back pain.

Prevention

It can be difficult to prevent hand, foot, and mouth disease because the virus is so contagious. To lower the risk of transmission, keep in mind:

• Always cover your nose and mouth when coughing or sneezing. 
• In crowded settings like school or daycare, wash your hands regularly using soap and water. It is especially important to wash hands after changing a baby or child’s diaper. 
• Avoid sharing personal items like food, drinks, cups, and utensils. Regularly clean any toys or surfaces that a sick individual has touched. 
• Ask your healthcare provider when your child can return to school or daycare. Children who are fever-free and feel well can usually attend school. Because they shed the virus in their respiratory secretions for weeks and stool for months, it is unnecessary to stay home until they are no longer contagious. 

Summary

Hand, foot, and mouth disease is a common childhood illness. It usually affects children under 5, but anyone can become sick from it. Hand, foot, and mouth disease is caused by viruses that belong to the enterovirus family. Common symptoms include fever, mouth sores, and a rash on the hands, fingers, and feet. It is usually diagnosed based on a history of symptoms and physical exam. There is no cure, and the illness usually resolves on its own.

A Word From Verywell

Hand, foot, and mouth disease is usually not a serious illness, but it can be uncomfortable. It is natural for children with hand, foot, and mouth disease to feel irritable and have trouble sleeping because of their discomfort. Talk with your healthcare provider about relieving the symptoms and when to return to school or daycare.