Hand-foot-and-mouth Disease Introduction Hand-foot-and-mouth disease is a common viral illness. It usually affects infants and children younger than 5 years old. But it can sometimes happen in adults. Hand-footand-mouth disease causes fever, blister-like sores in the mouth and a skin rash. Treatment focuses on relieving symptoms caused by the illness. The illness is usually mild, but complications are possible. This reference summary explains handfoot-and-mouth disease. It talks about symptoms and causes of the illness, as well as diagnosis and treatment options. What is Hand-foot-and-mouth Disease? Hand-foot-and-mouth disease is a contagious infection. It is common in young children. It is caused by a virus. Hand-foot- and-mouth disease causes sores in the mouth and a rash on the hands and feet. Hand-foot-and-mouth disease is often confused with foot-and-mouth disease, or hoof-and-mouth disease. Foot-and-mouth disease is a disease that affects cattle, sheep and swine. The 2 diseases are caused by different viruses and are not related. Humans do not get the animal disease, and animals do not get the human disease. Outbreaks of handfoot-and-mouth disease are more common in warmer seasons and in tropical climates. Symptoms The first symptoms of hand-foot-and-mouth disease include: Decreased appetite. Feeling unwell. Fever. Sore throat. 1
After 1 or 2 days, additional symptoms appear. These include painful sores in the mouth. They often form in the back of the mouth. The mouth sores begin as small red spots that blister. They often become ulcers, or open sores. A skin rash also develops. The rash has flat or raised red spots, sometimes with blisters. It usually affects the palms of the hands and soles of the feet. The rash may also appear on the: Elbows. Knees. Buttocks. Genital area. Some people, especially young children, can become dehydrated. The painful mouth sores can make it hard to swallow enough liquids. Children may also experience: Drooling. Irritability or sleepiness. Muscle aches and other flu-like symptoms. Hand-foot-and-mouth disease may not cause any symptoms in some people. This is especially true for older children and adults who get the illness. If you noticed symptoms of hand-foot-and-mouth disease, contact your or your child s health care provider. Causes Hand-foot-and-mouth disease is contagious. This means it can be spread from person to person. The viruses that cause hand-foot-and-mouth disease can be found in an infected person s: Feces, or stool. Fluid from blisters. Nose and throat secretions, such as saliva or nasal mucus. 2
An infected person may spread the viruses that cause hand-foot-and-mouth disease through: Breathing in air infected from coughing or sneezing. Close personal contact with an infected person. Contact with feces. Objects and surfaces can also become contaminated with the virus. This happens when an infected person sneezes into their hand and then touches a surface. It can also happen if an infected person uses the bathroom and does not wash their hands. Contact with contaminated objects and surfaces can cause a person to get hand-foot-and-mouth disease. It is also possible to get infected with a virus that causes hand-foot-and-mouth disease if you swallow recreational water, such as water in swimming pools. But this is not common. A person with hand-foot-and-mouth disease is most contagious during the first week of illness. People can sometimes be contagious for days or weeks after symptoms go away. Even people that never have symptoms may still be contagious. Hand-foot-and-mouth disease is not transmitted to or from pets or other animals. Hand-foot-and-mouth disease is most common in children in child care settings. This is because of frequent diaper changes and potty training, and because little children often put their hands in their mouths. Diagnosis Your child s health care provider will first ask about symptoms and medical history. He or she will also perform a physical exam. Health care providers can usually diagnose hand-footand-mouth disease based on: How old the patient is. What symptoms the patient has. How the rash and mouth sores look. 3
In some cases, samples from the throat or stool may be collected. The samples will then be sent to a laboratory and tested for the viruses that can cause hand-foot-andmouth disease. Treatment There is no specific treatment for hand-foot-and-mouth disease. Symptoms of handfoot-and-mouth disease usually go away in 7 to 10 days. Treatments are available to help relieve symptoms until the infection goes away. Taking over-the-counter medications to relieve pain and fever can help. But aspirin should not be given to children. Giving aspirin to children may cause Reye s syndrome. Reye s syndrome is a rare illness that can affect the blood, liver and brain of someone who has recently had a viral infection and has taken aspirin. It can lead to a coma and brain death, so quick diagnosis and treatment are critical. Using mouthwashes or sprays that numb the mouth can relieve pain from mouth sores. Skin areas with blisters should be kept clean. Wash the skin with soap and lukewarm water. Pat the area dry. If a blister pops, dab on a bit of antibiotic ointment to help prevent infection. Then cover it with a small bandage. It is also important to drink plenty of fluids, especially for children with hand-foot-and-mouth disease. This can prevent dehydration. Rarely, hand-foot-and-mouth disease can lead to complications such as viral meningitis or encephalitis. In these cases, other treatments may also be needed. Viral meningitis is an infection of the fluid around the brain and spinal cord. Encephalitis is an infection and inflammation of the brain. 4
Prevention There is no vaccine to protect against the viruses that cause hand-foot-and-mouth disease. But a person can lower their risk of infection. Wash your hands frequently using soap and water, especially after going to the bathroom or changing a diaper. This can help prevent infections. Clean and disinfect frequently touched surfaces and soiled items, including toys. Doing so regularly can prevent infections from spreading. Try to avoid close contact with people who have hand-footand-mouth disease. Some examples of close contact are kissing, hugging or sharing eating utensils. If you are infected, you can also protect other people by staying home while you are sick with hand-foot-and-mouth disease. Talk with your health care provider if you are not sure when you should return to work or school. The same applies to children returning to daycare. Summary Hand-foot-and-mouth disease is a common viral illness. It usually affects infants and children younger than 5 years old. But it can sometimes happen in adults. Hand-footand-mouth disease causes fever, blister-like sores in the mouth and a skin rash. Outbreaks of hand-foot-and-mouth disease are more common in warmer seasons and in tropical climates. Hand-foot-and-mouth disease is contagious. This means it can spread from person to person. An infected person may spread the viruses that cause hand-foot-and-mouth disease through: Breathing in air infected through coughing or sneezing. Close personal contact with an infected person. Contact with feces. 5
Health care providers can usually diagnose hand-foot-and-mouth disease based on symptoms and the age of the patient. Treatment focuses on relieving symptoms caused by the illness. The illness is usually mild, but complications are possible. A person can lower their risk of infection by: Washing their hands frequently. Disinfecting touched surfaces and soiled items. Avoiding close contact with infected people. Talk to your or your child s health care provider if you noticed symptoms of hand-foot-and-mouth disease. 6