Hand, Foot, and Mouth Disease (HFMD) is a common viral infection caused by viruses, most often Coxsackievirus A16, that belongs to the enterovirus group. This condition is generally considered a mild illness that resolves on its own within seven to ten days. The infection is highly contagious and is characterized by a specific rash and sores that appear on the body.
Who is Most Susceptible to HFMD
HFMD primarily affects infants and young children under the age of five. This age group is particularly vulnerable because they have not yet developed immunity to the enteroviruses that cause the disease. Close quarters, like those found in daycares and preschools, facilitate the rapid spread of the virus among young children. Their developing hygiene practices, such as frequently putting hands or toys in their mouths, also contribute to the high transmission rate.
People of any age can contract HFMD, including older children and adults. Adults often experience milder symptoms or may be entirely asymptomatic because they usually have existing antibodies from previous exposures. However, adults with weakened immune systems remain at a higher risk of developing a symptomatic infection.
Identifying the Signs and Symptoms
The first signs of HFMD often mimic a common cold or flu, appearing about three to six days after exposure to the virus. Initial symptoms typically include a fever, sore throat, general malaise, and a reduced appetite. This initial phase of fever usually lasts for one to three days.
The characteristic features of the illness appear shortly after the fever subsides, beginning with painful sores in the mouth. These lesions start as small, red spots that quickly develop into blisters and then ulcers on the tongue, gums, and inside the cheeks. These mouth sores are painful and can make eating, drinking, and swallowing very difficult.
A distinct skin rash follows the mouth sores, appearing most commonly on the palms of the hands and the soles of the feet. The rash consists of flat or slightly raised red spots, which may turn into small blisters with a grayish center. The rash is typically non-itchy, though it can occasionally affect the buttocks, legs, and arms.
How HFMD Spreads and How Long it is Contagious
HFMD is highly contagious and spreads through direct contact with the viruses found in an infected person’s bodily fluids. Transmission occurs via nose and throat secretions, fluid from blisters, and respiratory droplets when a sick person coughs or sneezes. The virus can also be spread through the fecal-oral route if hands are not washed thoroughly after using the toilet or changing a diaper.
Infected individuals are most contagious during the first week of the illness, particularly when they have a fever. The virus is durable and can survive on objects and surfaces, such as toys or doorknobs, contributing to its spread in group settings. The virus can continue to be shed in the stool for weeks after the symptoms have completely resolved. Good hygiene practices, including frequent handwashing and disinfecting surfaces, are the most effective ways to limit transmission.
Home Care and When to Consult a Doctor
There is no specific antiviral treatment for HFMD, as the illness is generally mild and resolves on its own within about a week to ten days. Home care focuses on supportive measures to manage symptoms and keep the patient comfortable. Over-the-counter pain relievers, such as acetaminophen or ibuprofen, can be used to manage fever and discomfort from the mouth sores.
Maintaining hydration is a primary concern, as painful mouth sores can cause a reluctance to drink fluids. Offering cool liquids, popsicles, or soft, non-acidic foods like yogurt or smoothies can help soothe the mouth and encourage fluid intake. Blisters on the hands and feet should be left to dry naturally.
A doctor should be consulted if the patient shows signs of dehydration, such as infrequent urination, a dry mouth, or a lack of tears when crying. Medical attention is also warranted if the fever is high or lasts longer than three days, or if the patient exhibits signs of rare complications, including a stiff neck, severe headache, confusion, or difficulty breathing.