• Mayo Clinic Q & A

    Mayo Clinic Q and A: Hand, foot and mouth disease

a young girl sitting on a couch, looking sad, worried or sick

DEAR MAYO CLINIC: I have 4-year-old twins and a college-bound teenager, so I am accustomed to dealing with the various ailments that affect children. After COVID-19, I became more diligent about hygiene and kept my kids home if they had symptoms of any illness. Recently, I have heard that cases of hand, foot and mouth disease are on the rise. What do I need to do differently to protect my youngsters? Also, am I or my older child at risk?

ANSWER: Hand, foot and mouth disease is a highly contagious viral infection that commonly affects kids ages 5 and under. However, anyone can become sickened, especially those residing in close living environments, such as on college campuses. Hand, foot and mouth disease is most commonly caused by a Coxsackievirus. Most outbreaks in the U.S. occur in summer or fall.

Initially, those infected with hand, foot and mouth disease present with fevers and other symptoms, including sore throat, a general unwell feeling or fatigue, irritability in infants and toddlers, and loss of appetite.

As the disease progresses, many people develop painful sores on their hands and feet, and in their mouths. Red, blisterlike lesions can appear on the tongue, gums and inside of the cheeks. Other people may develop a red rash without itching, but sometimes with blistering, on the palms of the hands, soles of the feet and on the buttocks.

A day care setting, school or other setting where there are a lot people in close contact are great breeding grounds for an outbreak of hand, foot and mouth disease. That's because the infection spreads by person-to-person contact, and young children are the most susceptible. Unfortunately, some people, especially adults, can pass the virus without showing any signs or symptoms of the disease.

The virus that usually causes hand, foot and mouth disease often is spread person to person through contact with an infected person's nasal secretions, throat discharge, saliva, stool or respiratory droplets sprayed into the air after a cough or sneeze. It also can be spread through fluid from blisters. The most common way of contracting the virus is through saliva or contact with stool.

Although your child is most contagious with hand, foot and mouth disease during the first week of the illness, the virus can remain in the body for weeks after signs and symptoms are gone. That means your child still can infect others. Keep children with hand, foot and mouth disease out of child care or school until their fever is gone and mouth sores have healed. If you have the illness, stay home and limit your contact with others.

There is no vaccine to prevent hand, foot and mouth disease. Frequent hand-washing and avoiding close contact with people who are infected with hand, foot and mouth disease may reduce your child's risk of infection.

There is no specific treatment or medication for hand, foot and mouth disease. Most people who become infected get better without any intervention. Good supportive care is essential, including ensuring patients have plenty of fluids. Dehydration is a common complication. The disease can cause sores in the mouth and throat, making swallowing painful and difficult. Rarely do those sickened with hand, foot and mouth disease require hospitalization.

Although rare, the Coxsackievirus can cause more severe issues that can involve the brain, such as viral meningitis and encephalitis. If you notice that symptoms are not resolving, but rather are worsening, or if you notice other issues such as confusion, seek prompt medical attention. Dr. Pritish Tosh, Infectious Diseases, Mayo Clinic, Rochester, Minnesota


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