Yes, hand, foot, and mouth disease is actively circulating, and 2025 has brought higher-than-usual levels in parts of the United States. Virginia’s Department of Health reported significant increases in emergency department and urgent care visits for HFMD this year compared to previous years, along with a notable rise in reported outbreaks. K-12 schools and childcare centers account for the majority of those outbreaks. While state-level tracking varies (individual HFMD cases aren’t reportable to most health departments, only outbreaks), the pattern points to an unusually active season.
When HFMD Typically Peaks
HFMD spreads mostly in summer and fall in the United States, though infections can happen any time of year. The virus thrives when kids are in close contact, which is why daycare centers and elementary schools are ground zero for most outbreaks. If you’re hearing about cases at your child’s school or seeing social media posts from other parents, that lines up with normal seasonal timing, just at higher volumes than recent years.
How It Spreads
The virus passes through close personal contact, respiratory droplets from coughs and sneezes, contact with fluid from blisters, and touching contaminated surfaces. What makes it especially hard to contain in group settings is that children are most contagious during the first week of illness, but the virus can linger in stool for weeks after symptoms clear. A child who looks perfectly healthy can still spread it through diaper changes or incomplete handwashing.
What Symptoms Look Like
Symptoms typically appear 3 to 5 days after exposure. The illness usually starts with a fever, sore throat, reduced appetite, and general malaise. Within a day or two, painful mouth sores develop, starting as small red spots on the tongue and inside the cheeks that blister and make eating miserable.
A skin rash follows, showing up on the palms of the hands and soles of the feet. It can also appear on the buttocks, legs, and arms. The rash usually looks like flat or slightly raised red spots, sometimes with blisters surrounded by redness. It’s generally not itchy, which helps distinguish it from other childhood rashes. Most people recover fully within 7 to 10 days.
A More Aggressive Strain to Know About
Not all cases of HFMD look the same. A strain called Coxsackievirus A6 tends to cause more severe rashes, higher fevers, and one unsettling side effect: temporary nail loss. About 28% of people infected with this strain experience their fingernails or toenails partially or fully separating from the nail bed, typically showing up 4 to 7 weeks after the initial infection. The nails grow back, but it can be alarming if you aren’t expecting it. If your child’s nails start peeling weeks after an HFMD infection, that’s likely why.
Adults Get It Too
HFMD is most common in children under 5, but anyone can catch it. Adults who haven’t been exposed to a particular strain before have no immunity to it. Parents caring for sick children are especially vulnerable. The illness follows the same general pattern in adults: fever, mouth sores, and a rash on the hands and feet. Most adults recover within the same 7 to 10 day window.
Managing Symptoms at Home
There’s no antiviral treatment for HFMD. Management is about comfort and hydration. Over-the-counter pain relievers like acetaminophen or ibuprofen help with fever and general discomfort. Never give aspirin to children with viral illnesses due to the risk of Reye’s syndrome.
Mouth sores are usually the hardest part. Ice pops and ice chips can numb the pain and provide fluids at the same time. Warm salt water rinses help older children who can swish without swallowing. Avoid acidic foods and drinks like citrus juice, fruit drinks, and soda, which will sting badly. Stick to soft foods that don’t require much chewing.
Topical oral anesthetics can offer targeted relief for mouth sores, but there are age restrictions. Don’t give lozenges to children under 4 (choking risk), and avoid throat sprays containing benzocaine for children under 2, as it can cause a dangerous blood condition in very young children. Dehydration is the most common complication, so keeping fluids going is the top priority, even if your child can only manage small sips.
When Your Child Can Return to School
CDC guidance points to several practical thresholds. Your child should be fever-free for at least 24 hours without the help of fever-reducing medication. If there was a fever with a new rash, a healthcare provider should evaluate it before the child goes back. Any open skin sores should be crusted over. The child should also be well enough to participate in the school day, managing any remaining symptoms independently without requiring extra attention from staff.
Keep in mind that even after symptoms clear, the virus can still be present in stool. Thorough handwashing after bathroom use and diaper changes remains important for weeks after recovery.
Cleaning Surfaces That May Be Contaminated
Standard soap and water won’t reliably kill the viruses that cause HFMD. You need disinfectants effective against enteroviruses. Bleach-based cleaners work well. Alternatively, look for products listing alkyl dimethyl benzyl ammonium chloride as an active ingredient that specifically claim to kill norovirus and rhinovirus. Common products that meet this standard include Lysol All-Purpose Cleaner, Pine-Sol All-Purpose Cleaner, and Clorox Disinfecting Spray or Wipes. Focus on high-touch surfaces like doorknobs, toys, changing tables, and bathroom fixtures.