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Public Health Solutions
District Health Department
995 East Hwy 33, Ste 1
Crete, NE 68333-2562
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Hand, Foot and Mouth Disease
What is Hand-Foot-and-Mouth Disease?
HFM disease is a viral rash illness. The rash most frequently affects the extremities but also can appear on the trunk and other areas of the body. Oral vesicles and ulcers frequently occur. Symptoms usually begin on the oral surface of cheeks and gums and sides of tongue along with fever of 100-102° F (38-39° C). The oral lesions can be painful, causing the affected individual to avoid eating. The lesions can last 7-10 days. HFM disease primarily affects children under 10 years of age, but infections in adults can occur. It occurs worldwide, both in sporadic infections and in outbreaks. The highest incidence is in the summer and early fall. HFM disease is not a reportable illness in the U.S., making estimates of incidence imprecise.
What Causes Hand-Foot-and-Mouth Disease?
While many different viruses can cause HFM disease, Coxsackievirus, Group A, type 16 predominates. Other viruses implicated less often include: Coxsackievirus, Group A, types 4, 5, 9, and 10; Group B, types 2 and 5; and Enterovirus 71.
How is it spread?
The virus is shed in discharges from the nose and throat, in feces, and in aerosolized droplets. The viruses are shed in the throat for up to 4 weeks and in the stool for up to 12 weeks. There is no reliable evidence of spread by food, water, sewage, or insects. The virus can be shed by asymptomatic carriers, which limits the ability to contain spread by isolation or quarantine of symptomatic people.
How is it treated?
HFM disease is a self-limited illness. Currently, there is no treatment for HFM disease. HFM disease can lead to secondary bacterial infections which may require antibiotics.
How long should I keep my child out of school or child care?
When your child feels well enough to resume normal activities, your child can return without restrictions. Due to the length of time the virus is shed and shedding by asymptomatic carriers, it is impractical to exclude affected people once symptoms have passed.
Who is at risk for this illness?
Children are predominantly affected by HFM disease. Immunity is acquired to the specific virus after clinical or inapparent infections. Since there are many different viruses that cause HFM disease, recurrence of HFM disease is possible.
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