After spending the morning in daycare, six-year-old Derek came home complaining that his throat hurt and looking exhausted. Assuming he had probably just “overdone it” playing with the other kids, his mom got him settled on the couch and slipped a thermometer in his mouth. To her surprise, he was running a high temperature, so she called Derek’s pediatrician to schedule an appointment for early the following day.
By morning, Derek’s fever had broken, but he now had a rash on the palms of his hands and the soles of his feet. Worse, ugly sores had erupted on his tongue and the insides of his cheeks.
After the pediatrician’s evaluation, however, Mom’s fears were put to rest. She diagnosed Derek with a case of hand, foot, and mouth disease (HFMD), a common illness of infants and children that tends to appear more frequently in summer and early autumn.
What causes HFMD?
HFMD can be caused by various enteroviruses, but the most common culprit is the virus coxsackievirus A16. This relatively common condition usually resolves within a week to ten days without medical intervention. The first symptoms to manifest themselves are typically fever, loss of appetite, and general malaise. Within a day or two of symptom onset, a rash develops on the hands, feet, and, possibly, the buttocks and/or genitals. However, the rash is not always accompanied by mouth sores and vice versa.
Not to be confused with hoof-and-mouth disease
Upon first hearing the diagnosis “hand, foot, and mouth disease,” parents often ask their pediatrician whether it’s connected in any way to “hoof-and-mouth disease,” which affects livestock. But, in spite of the similar-sounding names, these two diseases have nothing in common with one another.
Is HFMD contagious?
According to the Centers for Disease Control and Prevention, HFMD is usually not serious but is very contagious. Infection is spread from person to person by direct contact with nose and throat discharges, saliva, fluid from blisters, or the stool of infected persons. An infected individual is most contagious during the first week of the illness. However, the virus remains in the feces and can be spread for several weeks after the blisters and mouth sores have healed.
Given its contagious nature and modes of transmission, outbreaks of hand, foot, and mouth often occur in childcare or preschool settings where it easily spreads among groups of children.
Though HFMD occurs primarily among children under age 10, people of all ages can get the virus. It’s much less common among adults as they are more likely to have developed immunity to coxsackievirus A16 from previous exposure.
Can HFMD be prevented?
Proper hygienic practices can help reduce the risk of HFMD infection. The CDC recommends the following steps to minimize exposure (all of which are also helpful in preventing the spread of COVID-19 and other communicable illnesses):
- Washing hands frequently and correctly, especially after changing diapers and after using the toilet.
- Cleaning and disinfecting dirty surfaces and soiled items.
- Avoiding close contact, such as kissing, hugging, sharing eating utensils, etc., with persons who have HFMD.
Parents should also advise their children to cover their mouth and nose when sneezing or coughing. If a child who drools has mouth sores, it’s a good idea to keep him or her out of preschool, daycare, or play group until the sores resolve.
How is HFMD treated?
While there is no specific treatment for hand, foot, and mouth disease, your pediatrician may recommend over-the-counter pain relievers and fever reducers to help manage the symptoms. He or she may also recommend mouth washes or sprays to reduce the pain associated with mouth sores.