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Hand-foot-mouth disease

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

Alternative Names

Coxsackievirus infection; HFM disease

Causes

Hand-foot-and-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-and-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 the stools or the fluid from 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:

  • 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

A history of recent illness and a physical examination, demonstrating the characteristic vesicles on the hands and feet, are usually sufficient to diagnose the disease.

Treatment

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

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 (such as Tylenol) or ibuprofen can be used to treat fever. Aspirin should not be used in viral illnesses in children under age 18.
  • Salt water mouth rinses (1/2 teaspoon of salt to 1 glass of warm water) may be soothing.
  • Drink plenty of fluids. Extra fluid is needed when there is a fever. 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


  • Loss of body fluids (dehydration)
  • Seizures due to high fever (febrile seizures )

When to Contact a Medical Professional

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

You should also call 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.

References

Abzug MJ. Nonpolio enteroviruses. In: Kliegman RM, Stanton BF, St. GemeIII JW, Schor NF, Behrman RE, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa: Elsevier Saunders; 2011:chap 242. 

Habif TP. Exanthems and drug eruptions. In: Habif TP, ed. Clinical Dermatology. 5th ed. Philadelphia, Pa: Elsevier Mosby; 2009:chap 14.

Updated: 8/18/2013

Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.


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