Last updated date: 12-Feb-2023

Originally Written in English

Have you heard about Hand foot and mouth disease?

    Hand foot and mouth disease


    What is hand foot and mouth disease? 

    Hand-foot-and-mouth disease, abbreviated as HFMD or HFM is a common short-lasting infection caused by a group of viruses from the Enterovirus genus, called coxsackie viruses. HFMD is mostly characterized by blisters or sores in the mouth and a rash on the hands and feet. This medical condition, also medically called enteroviral vesicular stomatitis, can affect people of all ages, but it usually occurs in kids under 5 years old

    It is commonly confused with foot-and-mouth disease, which is a different condition affecting only animals, being caused by a different type of virus.

    Because the symptoms of hand, foot, and mouth illness disappear in about a week, living with it is a temporary problem. Your key goal as a parent caring for a child infected with the virus are to keep your child comfortable and hydrated. It's best to keep them at home so they can rest and prevent infecting others.


    What are the causes of HFMD? Is it a contagious disease?

    Causes of HFMD

    As mentioned, the most common cause of HFMD is infection with the coxsackievirus A16 or other types of enteroviruses. It is well known that viruses can spread from person to person due to contact through certain interactions, meaning that other causes include being in contact with an infected individual’s saliva, nasal secretions, throat discharge, liquid from blisters or simply respiratory droplets sprayed into the air during coughing or sneezing. Additionally, the transmission of the disease can occur through direct contact with areas containing traces of the specific virus.


    What are the symptoms of HFDM? What do they look like?

    The incubation period for HFMD is between 3 and 6 days, with an average of 4 days. The illness typically begins with a fever that lasts about 2 to 3 days. During this time, symptoms such as sore throat or headache may develop, as well as decreased appetite, irritability, painful blisters inside or around the mouth, red itchy rashes on the hands and soles of the feet and generally feeling unwell. Children and adults generally have similar early symptoms. Spontaneous remission is possible in children; however, this can take weeks or even months.

    The physical symptoms make it easy for HFMD to be identified. The rashes typically appear as flat red spots on one’s skin, the condition being more noticeable on one’s palms and bottom of feet, especially for people having a darker skin tone. Other than hands and feet, rashes may show up on multiple areas of the human body, including the knees, elbows or genital area. The mouth sores usually begin as small red spots placed on the back of the mouth and they might make the swallowing process very difficult. Due to this, children may refuse to eat or drink, prefer cold fluids or drool excessively. 


    What are the stages of HFDM? How long does the condition last?

    Professionals confirmed that the total duration of hand foot and mouth disease is approximately 5 days to a week. As mentioned above, the first stage consists of fever, loss of appetite, and a general feeling of being unwell (malaise). These symptoms typically occur one to three days after the viral invasion. The second stage is represented by the development of painful mouth sores and the final stage of HFMD is manifested by rashes and blisters in the mouth and on the surface of the skin as previously described.  


    When should you consult a medical professional? 

    Consult a medical professional

    As it is usual for the symptoms of hand foot and mouth disease to completely disappear after a week, it is important to consult a doctor in case they don’t improve in this amount of time. Additionally, if the symptoms are concerning (for example: the temperature is very high or one feels dehydrated), the best option is to seek help from a medical professional, as they are trained to offer the most suitable treatment option for each patient individually.

    People who have a weaker immune system should discuss HFMD with their doctor, especially if their symptoms are severe. 

    If a parent or caregiver notices signs of the virus in their kid, they should consult a pediatrician, especially if other children at their school or day care center are sick. If the child has serious symptoms, is extremely young, or is unable to eat or drink enough fluids, they should seek medical help.


    How is HFMD diagnosed?

    A healthcare professional is trained to diagnose hand foot and mouth disease mostly by performing a physical exam, looking at one’s body appearance in order to check the existence of blisters and rashes, physical symptoms of HFMD. They usually consult the patient and ask questions about other occurring symptoms and their age. Additionally, they may collect samples from one’s throat, blister or feces in order to test the virus in special laboratories, allowing them to confirm a certain diagnosis. 


    What is the treatment for hand foot and mouth disease?

    Treatment for hand foot and mouth disease

    Usually, the infection will clear on its own in about 7 to 10 days without medical treatment. Sometimes, symptomatic treatment can also be offered, such as: 

    • topical ointments (prescription or over-the-counter) to relieve blisters and rashes
    • pain relievers like acetaminophen or ibuprofen to alleviate headaches
    • medicated syrups or lozenges for sore throat relief

    Children should not be given aspirin for viral illnesses as it could cause Reye's syndrome.


    Even though there is no certain cure or vaccine designed specifically for hand foot and mouth disease, there are some home remedies available for reducing the intensity of the symptoms. Practices such as sucking on ice or very cold popsicles, eating ice cream, and drinking cold beverages may help make blisters less bothersome. Moreover, it is strongly recommended to limit the consumption of citrus fruits, fruit drinks, sodas and spicy or salty foods. 

    However, the pain associated with mouth blisters and throat sores, common symptoms of HFMD, might be relieved by swishing warm salt water in one’s mouth. 

    Since the medical condition is caused by a virus, antibiotics do not help the process of recovering.

    It is recommended to seek advice from a healthcare professional when seeking treatment, as they are able to recommend the best treatment options for both adults and children. These can include mouth ulcer gels, sprays, and mouthwashes, along with other symptom-relievers. 


    Risk factors and Complications

    Complication of hand foot and mouth disorder

    HFMD primarily affects children under the age of ten, especially those under the age of five. As the infection easily spreads through person-to-person contact, and young children are the most vulnerable, kids from child care centers are especially vulnerable to epidemics of hand, foot, and mouth disease.

    As children get older, they normally gain immunity to hand, foot, and mouth disease by developing antibodies after being previously exposed to the virus. Adolescents and adults, on the other hand, can contract the condition.

    Even though severe complications related to hand foot and mouth disease are very rare, Enterovirus 71 is more prone than other HFMD viruses to cause issues. Possible complications include:

    • Dehydration is the most prevalent complication of hand-foot-and-mouth disease. Sores in the mouth and throat can develop as a result of the sickness, making swallowing uncomfortable and difficult.
    • Viral meningitis is a rare type of infection consisting in the membranes (meninges) and cerebrospinal fluid covering the brain and spinal cord being infected and inflamed.
    • Encephalitis is a very rare, serious and sometimes even fatal condition involving brain inflammation  
    • Myocarditis may also be a complication of hand foot and mouth disorder. It is a medical condition mostly characterized by swelling of the heart muscles. 
    • In some cases, patients experience onychomadesis (or nail shedding) about two months after having the disease, yet the nails slowly return back to normal after a period of time.


    In more severe cases, enteroviral infections may lead to very serious complications that require special medical treatments. These include gut infection (medically called enteritis), brain infection (meningoencephalitis), widespread vesicular rash, spinal cord infection or acute flaccid paralysis or lung infection (pulmonary oedema and pneumonia).


    Acute flaccid myelitis (AFM) affects the spinal cord and is a rare but serious illness. It can result in sudden weakness in the arms or legs, as well as a loss of muscular tone and reflexes. The illness primarily affects youngsters under the age of five.About one to four weeks before developing signs of acute flaccid myelitis, most children experience a moderate respiratory illness or fever caused by a viral infection. It is important to seek medical help right away in case one develops signs of acute flaccid myelitis, as symptoms can develop very quickly and hospitalization may be required, as well as a ventilator for breathing assistance.


    The inflammation of your small intestine is known as enteritis. Inflammation of the stomach (gastritis) and large intestine can occur in some circumstances (colitis). Enteritis comes in a variety of forms. The following are the most common: 

    Infection caused by a virus or bacterium 

    • ionizing radiation 
    • Induced by medicine 
    • Induced by drink or drugs 
    • poor blood flow causes enteritis. 

    Inflammatory enteritis, such as Crohn's disease or ulcerative colitis, causes enteritis. Enteritis symptoms include but are not limited to fever, nausea and vomiting, diarrhea, and abdominal pain. In most cases, viral enteritis clears up on its own after a few days. If your symptoms of enteritis last longer than three or four days, or if you fear you have bacterial enteritis, visit a doctor.


    There are a few neurological associations connected to enterovirus 71 infection, including the following

    • Encephalomyelitis-  Acute disseminated encephalomyelitis (ADEM) is a condition that causes myelin destruction in the brain and spinal cord after a brief but widespread inflammatory response. ADEM is frequently associated with viral or bacterial illnesses, as well as, less frequently, vaccination for measles, mumps, or rubella. The signs of ADEM arise quickly, starting with encephalitis-like symptoms such as fever, tiredness, headache, nausea, and vomiting, and progressing to seizures and coma in the most severe cases.
    • Acute cerebellar ataxia- it is characterized by uncoordinated muscular action caused by a cerebellar illness or damage. This is the part of the brain that is in charge of controlling muscular action. Ataxia is characterized by a loss of muscle coordination, particularly in the hands and legs.
    • Guillain-Barre syndrome- it is defined as a nerve disorder that only affects a small number of people, marked by experienced symptoms such as numbness, weakness, and general discomfort associated with certain human body parts such as the feet, hands and limbs. Medical professionals confirm that this syndrome is treatable and most patients actually recover completely, yet others are left with long-term effects.
    • Acute transverse myelitis- pain in the neck, back, or head are common symptoms of acute transverse myelitis. Over hours to days, a band-like tightening around the chest or belly, weakness, tingling, numbness in the feet and legs, and difficulties voiding occur. Deficits may evolve to a complete transverse sensorimotor myelopathy over many days, resulting in paraplegia, loss of feeling below the lesion, urine retention, and fecal incontinence. Position and vibration feeling are occasionally spared, at least at first. People suffering from multiple sclerosis, SLE, or antiphospholipid syndrome may experience recurrent acute transverse myelitis.
    • Aseptic meningitis - it is an inflammatory condition that affects the tissues that surround your brain and spinal cord. A bacterial illness known as bacterial meningitis can cause inflammation. When the illness isn't caused by germs, it's called aseptic meningitis. The majority of aseptic meningitis cases are caused by viruses, which is why the condition is also known as viral meningitis. Compared to bacterial meningitis, aseptic meningitis is more prevalent. However, the symptoms are frequently milder. Serious side effects are uncommon. After the commencement of symptoms, the majority of people recover within two weeks.
    • Opsomyoclonus syndrome (OMS)- it is a neurological condition that affects a small percentage of the population. Opsoclonus (rapid, multi-directional eye movements), myoclonus (fast, involuntary muscular jerks), ataxia (uncoordinated movement), irritability, and sleep disturbance are all symptoms. It's possible that the illness will become chronic. 
    • Benign intracranial hypertension- a build-up of pressure around the brain is known as intracranial hypertension (IH). It can happen suddenly as a result of a severe head injury, stroke, or brain abscess, for example. This is referred to as acute IH. Chronic IH, on the other hand, is a persistent, long-term condition. This is unusual, and the reasons for it aren't always evident. Chronic intracranial hypertension (IH) can cause a variety of symptoms, including a constant throbbing headache that is worse in the morning or when coughing or straining; it improves when standing up temporary loss of vision – your vision may become dark or "greyed out" for a few seconds at a time; this can be triggered by coughing, sneezing, or bending down feeling sick feeling sleepy feeling irritable. Chronic IH can cause irreversible visual loss in some people, while treatment can help to lessen the chances of this happening.


    How to stop spreading HFMD?

    As previously described, hand foot and mouth disease can be transmitted from person to person through certain interactions with an infected one’s saliva, mucus in their lungs and nose or fluid from blisters. This medical condition can be spread through coughing and sneezing, close contact (sharing certain types of utensils or personal hygiene objects and cups, hugging and kissing) and contact with certain surfaces containing the virus. 

    When an individual gets infected with hand foot and mouth disease, they can start spreading it around even a few days before experiencing the symptoms and being able to identify and diagnose the disease, yet it is more common for the transmission to occur within the first five days after the symptoms start. 

    In order to minimize the infection spreading, it is recommended to follow a few practices, such as regularly washing one’s hands using soap and water, using tissues when sneezing or coughing in order to trap the germs, and throwing used tissues away as fast as possible.

    Additionally, medical professionals recommend children to stay home from school when they feel unwell for the purpose of reducing the risks of spreading the disease around. There is no need to stay home after the symptoms have completely gone away. After the rashes and blisters have healed, it is safe for them to go back to interacting with other children their age.


    Hand foot and mouth disease during pregnancy

    Although there is typically no risk to the pregnancy or the baby, it is preferable to avoid close contact with someone who has HFMD, because:

    • A high temperature during the first three months of pregnancy can result in a miscarriage, though this is extremely unusual.
    • If one catches hand, foot, and mouth disease before giving birth, their kid may be born with a minor form of the condition.

    It is essential to consult a GP in case a pregnant woman or the father of the unborn baby contacts an individual that is infected with hand foot and mouth disease.


    Hand foot and mouth disease in kids vs. in adults

    Hand foot and mouth disease in kids

    As previously described, children under the age of five are more likely to get infected with these viruses called coxsackie than teenagers or adults. However, even though it is uncommon, getting in contact with infected individuals or with surfaces containing the virus may lead to the development of the disease regardless of age. Generally, the symptoms that infected people experience and the stages of the condition do not vary based on their age, meaning that symptoms are mostly the same for both children and adults. 


    Other facts about hand foot and mouth disease:

    • It is important not to attempt to pop the blisters. This increases the chance of skin infection and the virus spreading to other children.
    • Other than the most common symptoms previously detailed, other additional symptoms that may be experienced are cold hands and feet, feeling unusually sleepy, having difficulties in performing certain movements such as walking and being dizzy, as well as experiencing headaches.
    • Certain medications such as Paracetamol and Ibuprofen may help reduce the pain levels associated with this medical condition.




    Considering all the given information, what is essential to remember about hand foot and mouth disease (HFMD) is that it is defined as an easily transmitted medical condition that is primarily characterized by red and uncomfortable rashes and blisters on certain areas of the human body, including one’s hands, feet and mouth, among many other additional symptoms. When being infected with the viruses causing the disease, it is important to try to stay home in order to avoid human interactions as much as possible, because hand foot and mouth disease is highly contagious. 

    Generally, the disease is spread by contacting infected individuals or surfaces that contain the virus. The incubation period is typically from three to six days and the symptoms usually fade completely within a week. If they persist longer than usual, contacting a healthcare provider is the best option, as they are able to accordingly diagnose the condition using a physical examination, advise and prescribe a specific medication for lowering the intensity of the experienced symptoms. Even though there is no specific treatment for HFMD, medical professionals may help ease the uncomfortable sensations.