Hand, Foot, and Mouth Disease (HFMD) is a common viral illness primarily seen in infants and young children, often spreading rapidly in group settings. It is caused by viruses in the Enterovirus genus, most commonly Coxsackievirus A16 or Enterovirus 71. Although adult infection is generally less common, adults are susceptible to contracting the highly contagious virus and can present with significant symptoms.
Risk and Methods of Adult Transmission
Adults are susceptible to HFMD, especially caregivers, parents, or those working in environments with young children. The lower incidence in adults is often attributed to immunity built up from prior exposure to various enteroviruses throughout life. However, since multiple strains cause HFMD, previous infection does not grant immunity against all future exposures.
The viruses are highly contagious and spread through several distinct routes. A primary method is direct contact with an infected person’s bodily fluids, including saliva, nasal mucus, and the fluid found in blisters. Respiratory droplets expelled through coughing or sneezing also transmit the virus through the air.
The virus is also transmitted via the fecal-oral route, which is particularly relevant in household settings. This occurs when adults contact fecal matter, such as during diaper changes, and then touch their mouth, nose, or eyes. Furthermore, the virus can survive on contaminated surfaces like toys, doorknobs, and counters, allowing for indirect transmission.
How HFMD Manifests in Adults
The incubation period for HFMD ranges from three to six days. The illness often begins with non-specific, flu-like symptoms, including fever, malaise, and a sore throat. Symptoms in adults can sometimes be more severe than in children, potentially including intense body aches, headache, and a high fever.
The classic hand, foot, and mouth rash may manifest differently in adults, sometimes appearing as a mild rash or being absent entirely. When present, the rash involves flat discolored spots or small blisters on the palms of the hands and soles of the feet, and painful sores may develop in the mouth. The illness typically lasts seven to ten days, resolving without specific medical intervention. Some adults are asymptomatic carriers, meaning they shed the virus and can transmit it without experiencing symptoms.
Limiting the Spread of HFMD
Preventing the spread of HFMD centers on rigorous and consistent hygiene practices, especially in homes with an infected individual. Frequent handwashing with soap and water for at least 20 seconds is the most effective preventive measure. This is important after using the toilet, changing diapers, or contacting respiratory secretions.
Disinfection of high-touch surfaces and shared items is also important to limit transmission. Surfaces like toys, counters, and doorknobs should be regularly cleaned with a chlorine bleach solution or an EPA-approved disinfectant. The virus is most contagious during the first week of illness, often before symptoms fully manifest, making early hygiene crucial. Even after symptoms disappear, the virus can be shed in the stool for several weeks, necessitating continued careful hand hygiene. Avoiding close personal contact, such as hugging or sharing utensils, further reduces the risk of transmission.