Hand, Foot and Mouth Disease (HFMD) Coxsackievirus 16

Fact Sheet

What is hand, foot and mouth disease?

Hand, foot and mouth disease is a viral infection caused by a strain of Coxsackie virus. It causes a blister-like rash
that, as the name implies, involves the hands, feet and mouth.

Who gets hand, foot and mouth disease?

Hand, foot mouth disease is a contagious disease that is caused by different viruses. Infants and children younger
than 5 years old are more likely to get the disease. However, older children and adults can get the disease. In the
United States it is more common for people to get HFMD from spring to fall.

How is it spread?
The virus is spread by close contact with nose and throat discharge, blisters and feces of infected people, or
touching objects or surfaces that have the virus on them.

When do symptoms start and what are they?

The usual period from infection to onset of symptoms is 3-5 days. Symptoms usually begin with a fever, reduced
appetite, sore throat, and a feeling of being unwell. A day or two after the fever starts, painful sores can develop
in the mouth. A skin rash with flat red spots may also develop on the palms of the hands and soles of the feet.
Sometimes a rash also occurs on the knees, elbows, and buttocks. This rash may blister but won't itch.

What is the method of transmission?

The fluid in the blisters or ulcers contain the virus, which can be passed to another person through nasal and oral
secretions, touching objects or surfaces that have the virus on them, or from an infected person’s feces. Hand,
foot and mouth disease is not transmitted to or from animals or pets; it is not associated with the similarly named
disease that can cause illness in cattle.

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When and how long can someone spread the disease?
A person is contagious when the symptoms appear and may continue until the blister-like skin lesions disappear.
A person is most likely to spread the disease to others during the first week of illness. The virus may be found in
the throat of an infected person for two weeks (even if there are no lesions in the mouth) and in the stool for
several weeks after infection. Some people, especially adults, can pass the virus without showing any signs or
symptoms of the disease.

How is hand, foot and mouth disease diagnosed?

The diagnosis is generally suspected on the appearance of blister-like rash on hands and feet and mouth in a child
with mild febrile illness. Although specific viral tests are available to confirm the diagnosis, they are rarely
performed due to expense and length of time needed to complete the tests.

How common is hand, foot and mouth disease?

HFMD is usually most common in children in a child care setting because of frequent diaper changing and potty
training, and because children put their hands in their mouths.

Is hand, foot and mouth disease reportable?

No, it is not a reportable disease.

Does prior infection with the Coxsackievirus make a person immune?

When some gets HFMD, they develop immunity to the specific virus that caused infection. However, because
HFMD is caused by several different viruses, people can get the disease again.

What is the treatment?

There is no specific treatment. Treatment is aimed at fever control and maintaining good hydration.

Can there be complications associated with hand, foot and mouth disease?
The illness is typically mild, complications are rare.

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What can be done to prevent the spread of the disease?
There is no specific vaccine to protect against HFMD. However you can reduce the risk of getting infected with the
viruses that cause HFMD by washing your hands often with soap and water for 20 seconds, especially after
changing diapers. Avoid touching your eyes, nose and mouth with unwashed hands. Avoid close contact (kissing,
hugging, sharing cups and eating utensils) with people who are infected. Disinfect frequently touched surfaces
(toys, doorknobs, etc.) especially if someone is sick.

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Sources: CDC, Illinois, Iowa and New York State Health Departments

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