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Hand-foot-mouth disease

Coxsackievirus infection; HFM disease

Hand-foot-mouth disease is a common viral infection that most often begins in the throat.

Causes

Hand-foot-mouth disease (HFMD) is most commonly caused by a virus called coxsackievirus A16.

Children under age 10 are most often affected. Teens and adults can sometimes get the infection. HFMD usually occurs in the summer and early fall.

The virus can spread from person-to-person through tiny, air droplets that are released when the sick person sneezes, coughs, or blows their nose. You can catch hand-foot-mouth disease if:

  • A person with the infection sneezes, coughs, or blows their nose near you.
  • You touch your nose, eyes, or mouth after you have touched something contaminated by the virus, such as a toy or doorknob.
  • You touch stools or fluid from the blisters of an infected person.

The virus is most easily spread the first week a person has the disease.

Symptoms

The time between contact with the virus and the start of symptoms is about 3 to 7 days. Symptoms include:

  • Fever
  • Headache
  • Loss of appetite
  • Rash with very small blisters on the hands, feet, and diaper area that may be tender or painful when pressed
  • Sore throat
  • Ulcers in the throat (including tonsils), mouth, and tongue

Exams and Tests

The health care provider will perform a physical exam. Usually, a diagnosis can be made from asking about the symptoms and the rash on the hands and feet.

Treatment

There is no specific treatment for the infection other than symptom relief.

Antibiotics do not work because the infection is caused by a virus. (Antibiotics treat infections caused by bacteria, not viruses.) To relieve symptoms, the following home care can be used:

  • Over-the-counter medicines, such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) can be used to treat fever. Aspirin should not be given for viral illnesses in children under age 18.
  • Salt water mouth rinses (1/2 teaspoon, or 6 grams, of salt to 1 glass of warm water) may be soothing.
  • Drink plenty of fluids. The best fluids are cold milk products. Do not drink juice or soda because their acid content causes burning pain in the ulcers.

Outlook (Prognosis)

Complete recovery occurs in 5 to 7 days.

Possible Complications

Possible complications that may result from HFMD include:

When to Contact a Medical Professional

Contact your provider if there are signs of complications, such as pain in the neck or arms and legs. Emergency symptoms include convulsions.

You should also contact your provider if:

  • Medicine does not lower a high fever
  • Signs of dehydration occur, such as dry skin and mucus membranes, weight loss, irritability, decreased alertness, decreased or dark urine

Prevention

Avoid contact with people with HFMD. Wash your hands well and often, especially if you are in contact with people who are sick. Also teach children to wash their hands well and often.

Open References

References

Dinulos JGH. Exanthems and drug eruptions. In: Dinulos JGH, ed. Habif's Clinical Dermatology. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 14.

Messacar K, Abzug MJ. Nonpolio enteroviruses. In: Kliegman RM, St Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 277.

Romero JR. Coxsackieviruses, echoviruses, and numbered enteroviruses (EV-A71, EVD-68, EVD-70). In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 172.

  • Hand-foot-and-mouth disease

    Hand-foot-and-mouth disease - illustration

    Hand-foot-and-mouth disease is a viral infection caused by Coxsackievirus that usually begins in the throat. Symptoms include; fever, sore throat, ulcers in the throat, headache, and a rash with blisters on the palms of the hands and soles of the feet.

    Hand-foot-and-mouth disease

    illustration

  • Hand, foot, and mouth disease on the soles

    Hand, foot, and mouth disease on the soles - illustration

    Hand, foot, and mouth disease is cause by a coxsackie virus. It produces mouth ulcers and small blisters (vesicles) on the hands and feet. The vesicles often have a reddish border with a white or lighter colored area in the center.

    Hand, foot, and mouth disease on the soles

    illustration

  • Hand, foot, and mouth disease on the hand

    Hand, foot, and mouth disease on the hand - illustration

    The typical skin lesion of hand, foot, and mouth disease includes small blisters (vesicles) with bright red (erythematous) borders. These are typically on the pads of the fingers and palms of the hands.

    Hand, foot, and mouth disease on the hand

    illustration

  • Hand, foot, and mouth disease on the foot

    Hand, foot, and mouth disease on the foot - illustration

    The typical skin lesion of hand, foot, and mouth disease includes small blisters (vesicles) with bright red (erythematous) borders. These are typically on the pads of the fingers and palms of the hands, but can also be found on the sole of the foot, as in this picture.

    Hand, foot, and mouth disease on the foot

    illustration

  • Hand, foot, and mouth disease - mouth

    Hand, foot, and mouth disease - mouth - illustration

    Hand, foot and mouth disease is a common childhood illness. The symptoms include small, painful blisters on the fingers, palms, toes and soles; and ulcers in the mouth. This photograph shows the small whitish to yellowish mouth ulcers with surrounding redness.

    Hand, foot, and mouth disease - mouth

    illustration

  • Hand, foot, and mouth disease on the foot

    Hand, foot, and mouth disease on the foot - illustration

    Hand, foot and mouth disease is a common childhood illness. The symptoms include small, painful blisters on the fingers, palms, toes and soles; and ulcers in the mouth. This photograph shows the small blisters (vesicles) on the feet.

    Hand, foot, and mouth disease on the foot

    illustration

  • Hand-foot-and-mouth disease

    Hand-foot-and-mouth disease - illustration

    Hand-foot-and-mouth disease is a viral infection caused by Coxsackievirus that usually begins in the throat. Symptoms include; fever, sore throat, ulcers in the throat, headache, and a rash with blisters on the palms of the hands and soles of the feet.

    Hand-foot-and-mouth disease

    illustration

  • Hand, foot, and mouth disease on the soles

    Hand, foot, and mouth disease on the soles - illustration

    Hand, foot, and mouth disease is cause by a coxsackie virus. It produces mouth ulcers and small blisters (vesicles) on the hands and feet. The vesicles often have a reddish border with a white or lighter colored area in the center.

    Hand, foot, and mouth disease on the soles

    illustration

  • Hand, foot, and mouth disease on the hand

    Hand, foot, and mouth disease on the hand - illustration

    The typical skin lesion of hand, foot, and mouth disease includes small blisters (vesicles) with bright red (erythematous) borders. These are typically on the pads of the fingers and palms of the hands.

    Hand, foot, and mouth disease on the hand

    illustration

  • Hand, foot, and mouth disease on the foot

    Hand, foot, and mouth disease on the foot - illustration

    The typical skin lesion of hand, foot, and mouth disease includes small blisters (vesicles) with bright red (erythematous) borders. These are typically on the pads of the fingers and palms of the hands, but can also be found on the sole of the foot, as in this picture.

    Hand, foot, and mouth disease on the foot

    illustration

  • Hand, foot, and mouth disease - mouth

    Hand, foot, and mouth disease - mouth - illustration

    Hand, foot and mouth disease is a common childhood illness. The symptoms include small, painful blisters on the fingers, palms, toes and soles; and ulcers in the mouth. This photograph shows the small whitish to yellowish mouth ulcers with surrounding redness.

    Hand, foot, and mouth disease - mouth

    illustration

  • Hand, foot, and mouth disease on the foot

    Hand, foot, and mouth disease on the foot - illustration

    Hand, foot and mouth disease is a common childhood illness. The symptoms include small, painful blisters on the fingers, palms, toes and soles; and ulcers in the mouth. This photograph shows the small blisters (vesicles) on the feet.

    Hand, foot, and mouth disease on the foot

    illustration

A Closer Look

 

Tests for Hand-foot-mouth disease

 
 

Review Date: 7/8/2023

Reviewed By: Linda J. Vorvick, MD, Clinical Professor, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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