Hand Foot and Mouth Disease

What is hand foot and mouth (HFM) disease?

Hand foot and mouth disease (HFM) is a viral infection characterized by fever and a typical rash most frequently seen on the palms of the hands, soles of the feet, and inside the mouth. It should not be confused with foot (hoof) and mouth disease that affects cattle, sheep, and swine. HFM is caused by several members of the enterovirus family of viruses. The most common cause is Coxsackie virus A16.

What are the symptoms and signs of hand foot and mouth disease?

Initial symptoms of mild fever and malaise are followed within one or two days by a characteristic rash. Small (2 mm-3 mm) red spots that quickly develop into small blisters appear on the palms, soles, and oral cavity. The gums, tongue, and inner cheek are most commonly involved. Oral lesions are commonly associated with a sore throat and reduced appetite.

What is the course of hand foot and mouth disease?

The incubation period (from exposure to symptoms) is generally 5 days. The illness is generally mild and self-limited and is usually resolves within a week. Complications such as viral meningitis and encephalitis and paralytic disease are very rare.

How is hand foot and mouth disease diagnosed?

Usually, the diagnosis of HFM is made on a combination of clinical history and characteristic physical findings. Laboratory confirmation is rarely necessary unless severe complications develop.

What is the treatment for hand foot and mouth disease?

Therapy for HFM is directed toward symptomatic relief of fever and sore throat and prevention of dehydration. Antibiotics are not indicated for this viral disease.

Hand, Foot, and Mouth Disease Prevention and Vaccines

Appropriate infection control practices are recommended to prevent the spread of hand, foot, and mouth disease. Good hand hygiene (washing hands) is always important. Children infected with the virus causing hand, foot, and mouth disease generally have mild illness and recover within one week of developing symptoms. There is no vaccine; however, the illness is typically mild and self-limited, and children generally cannot develop the illness twice. In addition, most adults have persistent immunity and cannot become infected either.