What Is Hand, Foot, and Mouth Disease?
Hand, foot, and mouth disease (HFMD) is a contagious viral infection that's common in children. The disease causes sores called ulcers inside or around the mouth and a rash or blisters on your hands, feet, legs, or buttocks. It can be painful but isn't serious.
Hand, foot, and mouth disease is not the same as foot-and-mouth disease, which comes from a different virus and affects only animals. HFMD is most commonly caused by coxsackievirus A16 and enterovirus A71.
Hand, Foot, and Mouth Disease vs. Monkeypox
Mpox (formerly called monkeypox) and HFMD have similar signs and symptoms, sometimes making it difficult to tell the two apart. Both can cause flu-like symptoms and sores or blisters on the hands, feet, and mouth. The incubation period is longer for mpox, with symptoms often appearing 1-2 weeks after infection.
Mpox is caused by the monkeypox virus, part of the same family of viruses that causes smallpox. Mpox symptoms can mimic smallpox but are milder and rarely fatal. Mpox can be spread easily through human-to-human contact and also by animals. Mpox isn't related to chickenpox.
HFMD and mpox can spread to anyone through close contact. The spread of mpox is also associated with intimate contact, including oral, anal, or vaginal sex and touching the genitals.
Hand, Foot, and Mouth Disease Causes
The viruses that usually cause HFMD belong to a group of non-polio enteroviruses. Some include:
- Coxsackievirus A16 (CVA16). An infection from this virus is the most common cause of HFMD in the U.S.
- Coxsackievirus A6 (CVA6). This virus was tied to a large outbreak in the U.S. in 2012, and symptoms were more serious than usual. CVA6 outbreaks have also occurred in other countries including Finland and Vietnam.
- Enterovirus 71 (EV-A71). This virus is a common cause of HFMD worldwide, including outbreaks in East and Southeast Asia. EV-A71 has been associated with more serious diseases such as encephalitis (swelling of the brain).
Anyone can have HFMD, but children under the age of 5 are most likely to get it. It tends to spread easily in the summer and fall.
Hand, Foot, and Mouth Disease Risk Factors
The main risk factor for HFMD is age. Infants and children younger than ages 5-7 years are most likely to get the disease. HFMD commonly spreads quickly among children in day-care settings and schools where there is close person-to-person contact. HFMD is transmitted by fecal-oral, oral-oral, and respiratory droplet contact. It’s a more seasonal disease, spreading often in the summer and fall months in the U.S.
Older children and adults can get the disease, and it's possible to get HFMD multiple times. Adults with weakened immune systems also are at risk of developing HFMD.
Hand, Foot, and Mouth Disease in Adults
Hand, foot, and mouth disease is much more common in younger children, but it can also affect adults.
Children typically show at least some symptoms of HFMD, while adults may not have any noticeable symptoms at all, or their symptoms may be incorrectly diagnosed.
HFMD is contagious among all ages, so good hygiene (such as washing your hands) is key to preventing the disease.
Stages of Hand, Foot, and Mouth Disease
HFMD symptoms typically appear in two stages. When the illness first starts, children might experience flu-like symptoms, including a mild fever, sore throat, runny nose, stomachache, or loss of appetite.
In a couple of days, those symptoms may be replaced by an itchy rash on the palms of the hands, soles of the feet, elbows, knees, or even genitals or buttocks. Painful sores can develop in and around the mouth and tongue, accompanied by swollen lymph nodes in the neck. Sores may appear as bright pink spots or tiny bumps, and then turn into blisters.
Symptoms of HFMD will generally clear in 7-10 days, but children under the age of 2 can take longer to clear the virus.
Hand, Foot, and Mouth Disease Symptoms
Early symptoms may include:
- Sore throat
- Painful blisters inside a child’s mouth, usually toward the back, or on their tongue
- Feeling unwell (malaise)
- Loss of appetite
A day or two later, a child might have:
- A rash that turns into blisters
- Flat spots or sores on their knees, elbows, or buttocks
Mouth sores can make it hurt to swallow. Eating or drinking less than usual could be the only sign of a child’s illness. Be sure they get enough fluids and nutrients.
Hand, Foot, and Mouth Disease Transmission
The viruses that cause HFMD are present in the fluids of an infected person’s body, including:
Hand, foot, and mouth disease spreads through:
Hand, Foot, and Mouth Disease Diagnosis
Your doctor will ask about your or your child’s symptoms and look at any sores or rashes. This is usually enough for them to decide if it’s hand, foot, and mouth disease. But they might also swab your child’s throat or take a sample of poop or blood for lab testing.
Hand, Foot, and Mouth Disease Treatment
There’s no cure or vaccine for hand, foot, and mouth disease. Because a virus causes it, antibiotics won’t help. It usually goes away on its own after 7-10 days. In the meantime, you can ease symptoms with:
- Over-the-counter pain relievers such as ibuprofen or acetaminophen or numbing mouth sprays. Don’t use aspirin, because it can cause serious illness in children.
- Cold treats such as ice pops, yogurt, or smoothies to soothe a sore throat. Avoid juice and soda, which have acids that might irritate sores.
- Anti-itch lotion, such as calamine, for rashes.
Hand, Foot, and Mouth Recovery Signs
While there is no specific medical treatment for HFMD, most people get better on their own in 7-10 days.
Fever may last 2 or 3 days, and mouth sores should go away by day 7. Rashes on the hands and feet may take as long as 10 days to stop, but peeling may continue past that point.
Hand, Foot, and Mouth Disease Complications
Serious complications from hand, foot, and mouth disease are rare. Enterovirus 71 is more likely to cause problems than other HFMD viruses.
Complications may include:
Hand, Foot, and Mouth Disease Prevention
Your child is most contagious in the first 7 days of the illness. But the virus can stay in their body for days or weeks and spread through their spit or poop. Take these steps to lower the chance of infection:
- Wash your hands carefully, especially after changing a diaper or wiping a child’s nose. Help your children keep their hands clean.
- Teach kids to cover their mouth and nose when they sneeze or cough. A tissue is best, but the sleeve of their shirt also works.
- Clean and disinfect surfaces and shared items such as toys and doorknobs.
- Don’t hug or kiss someone who has hand, foot, and mouth disease. Don’t share cups or utensils with them.
- Don’t send your child to school or day care until their symptoms are gone. Check with your doctor if you think they might still be contagious.
Hand, Foot, and Mouth Quarantine Period
Generally, isolation and quarantine can be tough to pull off since the virus can shed for weeks, and some people with hand, foot, and mouth will show no symptoms at all. If you or a family member has HFMD, try the following to limit the spread:
- During the first week of illness, try to limit family member contact with the sick person in your home, but this may be challenging for parents, siblings, and young children.
- Keep children with hand, foot, and mouth disease out of childcare 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.
Most of the time, children recover well from the virus. Not all children have pain, and the rash needs no treatment. Rashes from HFMD usually clear up in 1-2 weeks, but it's not necessary for children to stay home until the rash is gone.
HFMD is a highly contagious virus that usually strikes infants and young children, but it can impact adults, especially those with weakened immune systems. Initial symptoms include fever, sore throat, and other flu-like symptoms. Typically, sores develop in the mouth, and blisters and a rash can develop across the body from the palms of hands and the soles of feet to the buttocks and genitals. You are most contagious in the first 7 days of the illness. The virus rarely results in serious complications and clears on its own in 1-2 weeks.
Hand, Foot, and Mouth Disease FAQs
What can mimic hand, foot, and mouth disease?
HFMD can be mistaken for other viruses and illnesses, including chickenpox, mpox (monkeypox), and even insect bites or herpes.
How long is hand, foot, and mouth disease contagious?
You are most contagious during the first week of illness, but people can still spread the virus to others for days or weeks after symptoms go away, or even if they have no symptoms at all.
How common is it for adults to get hand, foot, and mouth disease?
HFMD mostly affects infants and young children, but adults can catch the disease, especially if they have a weakened immune system. Adults also are more likely to show no symptoms of the disease at all, but can still be contagious.