Hand-foot-and-mouth disease (HFMD) is a highly contagious viral infection that most often occurs in children. Learn more about HFMD, the symptoms, transmission, treatment and prevention.

What is hand-foot-and-mouth disease?

HFMD is caused by members of a group of viruses known as enteroviruses, most commonly Coxsackie A virus and Enterovirus 71. The virus enters the body – usually via the mouth – and reproduces in the digestive tract. Children (especially those between the ages of 2 weeks to 5 years of age) and people with compromised immune systems are particularly prone to the disease because their immune systems have not fully developed or are weak.

HFMD symptoms

The typical incubation period (the amount of time from infection to onset of symptoms) is between three to six days. An infected person is most contagious during the first week of the illness. Early symptoms include fever, a sore throat, and loss of appetite. One to two days after the onset of fever, small, painful ulcers may develop in the mouth, on the gums, throat and tongue. The palms and fingers of the hand, soles of feet, and buttocks may also be affected by a non-itchy rash with characteristic vesicles (small, painful blisters).

However, HFMD is seldom serious and rarely requires medical treatment. Most patients typically recover within seven to 10 days without any serious complications. In rare circumstances, complications in other parts of the body can occur, which include myocarditis (inflammation of the heart), pneumonia (inflammation of the lungs), encephalitis (inflammation of the brain) and aseptic meningitis (inflammation of the linings of the brain).

How is hand-foot-and-mouth disease spread?

HFMD is very contagious and spreads through direct contact with the bodily fluids (e.g. nasal discharge, saliva, throat discharge), fluid from the blistering HFMD sores and stool of an infected person. HFMD can also spread when an infected person coughs or sneezes, or through contaminated surfaces, such as utensils, toys and telephones.

HFMD is most common among children, and can spread rapidly wherever groups of children are in close contact (e.g. childcare centers, play group classes, and schools). Outbreaks in child care facilities and schools usually coincide with an increased number of cases in the community.

Advice for parents

If your child has symptoms of HFMD, consult a doctor early. Since HFMD is caused by a virus, antibiotics is not effective and is not indicated. However, your physician may prescribe some medications to relieve the symptoms of fever or sore mouth. Do ensure that your child drink plenty of fluids to prevent dehydration (a common complication) and get as much rest as possible until symptoms subside. Stay alert for signs of drowsiness or breathing difficulty – if these occur, send your child to the hospital as soon as possible.

Children who are infected should be kept away from crowded public places (such as schools, preschools, play groups, daycare centers, supermarkets) and should remain home until their physician advises them otherwise.

Preventing transmission of hand-foot-and-mouth disease

You can reduce the likelihood of your child becoming infected with HFMD with the following practices:

Wash hands thoroughly. Most experts agree that the single most effective practice that prevents the spread of germs in the childcare setting is good hand washing by childcare providers and children. For effective handwashing, use warm, running water and a mild, preferably liquid, soap. Rub hands together vigorously to lather up and continue for at least 15 seconds. Be sure to scrub between fingers, under fingernails, and around the tops and palms of hands.

Practice good personal hygiene such as washing of hands before and after using the toilet, and before and after preparing food and changing diapers. Children should be taught good hygiene practices (e.g. frequent hand washing and bathing, refraining from putting their fingers into their mouths) to avoid diseases.

Wash items handled by the infected child separately. Clean and disinfect common areas, surfaces and objects used by the child with detergent or by boiling.

Avoid contact with infected persons.