Hand, Foot, and Mouth Disease (HFMD) is a common, highly contagious illness primarily caused by viruses belonging to the Enterovirus genus, most frequently Coxsackievirus A16. The infection typically presents with fever, mouth sores, and a rash on the hands and feet. Because the virus spreads easily through respiratory droplets, blister fluid, and fecal-oral contact, specific preventive measures are necessary to halt transmission in households and shared spaces.
Essential Personal Hygiene Practices
Rigorous hand hygiene is the most effective defense against the spread of HFMD. Hands should be washed with soap and running water for a minimum of 20 seconds, scrubbing all surfaces, including the backs of the hands, between the fingers, and under the nails. This mechanical action physically removes the virus from the skin, which is more effective than relying on soap alone.
Proper handwashing must be performed at several key moments throughout the day. These moments include after using the toilet or changing a diaper, before preparing or eating food, and immediately after touching any blisters or sores on an infected person. If soap and water are unavailable, an alcohol-based hand sanitizer containing at least 60% alcohol can be used, though it may be less effective against non-enveloped viruses like those causing HFMD.
Beyond hand care, basic respiratory etiquette and preventing saliva transfer are important. Individuals should cover coughs and sneezes with a tissue or the elbow, and used tissues must be discarded immediately before washing hands. Furthermore, personal items that come into contact with saliva, such as eating utensils, cups, towels, and toothbrushes, should never be shared with an infected person.
Disinfecting Surfaces and Contaminated Objects
Environmental cleaning is important because enteroviruses are non-enveloped, making them more resistant to standard disinfectants than many other viruses. To effectively inactivate these pathogens, surfaces must be cleaned with products specifically noted as effective against non-enveloped viruses. A bleach solution (sodium hypochlorite) is a recommended disinfectant, often used at a concentration of 3120 parts per million (ppm).
When cleaning, focus on high-touch surfaces that may have been contaminated by respiratory droplets or soiled hands. These surfaces include doorknobs, light switches, faucet handles, countertops, and remote controls. Shared toys and objects in childcare settings should be cleaned daily, or after each use, using the appropriate disinfectant solution and then rinsed if children might put them in their mouths.
Laundering items that may have come into contact with body fluids or feces requires attention. Bedding, towels, and clothing used by the infected person should be washed using hot water and regular laundry detergent. This approach significantly reduces the chance of indirect transmission from objects, a common route of spread in group settings.
Guidelines for Isolation and Limiting Exposure
The period of highest contagiousness for HFMD is during the first week of illness, when fever and active blister lesions are present. Individuals with HFMD should be isolated from others to limit exposure, especially during the acute phase of symptoms. A child should be kept home from daycare or school until they meet specific criteria for returning.
The general rule for returning to group settings is that the individual must be fever-free for at least 24 hours without the use of fever-reducing medication. Additionally, all blisters must have dried up, scabbed over, or disappeared, as the fluid within the blisters is infectious. Even after symptoms resolve, the virus can continue to be shed in the stool for several weeks, meaning strict handwashing practices must continue for everyone in the household.
Infected people should avoid close contact with vulnerable populations, such as infants or pregnant individuals, throughout the isolation period. Limiting exposure involves avoiding activities like kissing, hugging, and sharing items until all acute symptoms have cleared.