Common in Young Children

Hand, foot, and mouth disease is common in children under 5 years old, but anyone can get it.

The illness is usually not serious, but it is very contagious. It spreads quickly at schools and day care centers.

Not the Same as Foot-and-Mouth Disease

Hand, foot, and mouth disease is often confused with foot-and-mouth disease (also called hoof-and-mouth disease), which affects cows, sheep, and pigs.

Humans do not get the animal disease, and animals do not get the human disease.

Hand, foot, and mouth disease, or HFMD, is a contagious illness that is caused by different viruses. It is common in infants and children younger than 5 years old. However, older children and adults can also get HFMD. Symptoms include fever, mouth sores, and a skin rash. In the United States it is more common for people to get HFMD during summer and fall.

Key Facts

• Usually causes fever, painful sores in the mouth, and a rash on the hands and feet (sometimes with blisters).
• HFMD is a contagious disease.
• It mostly affects infants and children younger than 5 years old but people of any age can be infected.
• It has no specific treatment.
• Infection risk can be reduced by practicing good hygiene such as washing hands often

Preventing HFMD

Wash your hands often with soap and water for at least 20 seconds, especially after changing diapers, and help young children do the same; avoid close contact such as kissing, hugging, and sharing cups and eating utensils with people who have HFMD; and disinfect frequently touched surfaces and objects, such as toys and doorknobs, especially if someone is sick.

HFMD Treatment

There is no specific treatment for HFMD. Fever and pain can be managed with over-the-counter fever reducers and pain relievers, such as acetaminophen or ibuprofen. It is important for people with HFMD to drink enough fluids to prevent dehydration (loss of body fluids).

Is HFMD Serious?

HFMD is usually not serious. The illness is typically mild, and nearly all people recover in 7 – 10 days without medical treatment. Complications are uncommon. Rarely, an infected person can develop viral meningitis and may need to be hospitalized for few days. Other more rare complications can include polio-like paralysis or encephalitis (brain inflammation), which can be fatal.

Contagiousness

The viruses that cause HFMD can be found in an infected person's nose and throat secretions (saliva, sputum, or nasal mucus); blister fluid; and poop. People with HFMD are most contagious during their first week of illness. However, they may sometimes remain contagious for weeks after symptoms go away. Some people, especially adults, may not develop any symptoms, but they can still spread the viruses to others.

Prevention Tips

• Wash your hands often with soap and water for at least 20 seconds, especially after changing diapers.
• Avoid touching your eyes, nose, and mouth with unwashed hands.
• Avoid close contact such as kissing, hugging, and sharing cups and eating utensils with people who have HFMD.
• Disinfect frequently touched surfaces, including objects such as toys and doorknobs.

Hand, foot, and mouth disease is contagious

Hand, foot, and mouth disease is caused by viruses. A person infected with one of these viruses is contagious, which means that they can pass the virus to other people.

The virus can spread to others through an infected person’s

• Nose and throat secretions, such as saliva, sputum, or nasal mucus
• Fluid from blisters or scabs
• Feces (poop)

People with hand, foot, and mouth disease are usually most contagious during the first week that they are sick. People can sometimes spread the virus to others for days or weeks after symptoms go away or if they have no symptoms at all.

How it spreads

You can get hand, foot, and mouth disease by

• Breathing air after a sick person coughs or sneezes
• Touching a sick person or making other close contact, like kissing, hugging, or sharing cups or eating utensils
• Touching a sick person’s feces, such as changing diapers, then touching your eyes, nose, or mouth
• Touching objects and surfaces that have the virus on them, like doorknobs or toys, then touching your eyes, nose, or mouth

Rarely, you can also get the viruses by swallowing recreational water, such as water in swimming pools. This can happen if the water is not properly treated with chlorine and becomes contaminated with feces from a person who has hand, foot, and mouth disease.

Hand, Foot, and Mouth Disease is Common

• In summer and fall in the U.S., but you can get it any time of year.
• In schools and day cares. Children should stay home while they have symptoms of hand, foot, and mouth disease.

Viruses that cause hand, foot, and mouth disease

Hand, foot, and mouth disease is caused by viruses that belong to the Enterovirus family.

Common causes of hand, foot, and mouth disease are:

• Coxsackievirus A16 is typically the most common cause of hand, foot, and mouth disease in the United States. Other coxsackieviruses can also cause the illness.
• Coxsackievirus A6 can also cause HFMD and the symptoms may be more severe.
• Enterovirus 71 (EV-A71) has been associated with cases and outbreaks in East and Southeast Asia. Although very rare, EV-A71 has been associated with more severe diseases, such as encephalitis.

Animals such as cattle, pigs, sheep, and goats can get foot and mouth disease (or hoof and mouth disease), which is different than hand, foot, and mouth disease.

Hand, foot, and mouth disease is common in infants and children younger than five years old. Most children have mild symptoms for 7 to 10 days.

Symptoms include

Fever and flu-like symptoms

Children often get a fever and other flu-like symptoms three to six days after they catch the virus. Symptoms may include:

• Fever
• Eating or drinking less
• Sore throat
• Feeling unwell

Other symptoms may appear over the next few days.

Mouth sores

One or two days after the fever starts, your child may get painful mouth sores (herpangina). These sores usually start as small red spots, often in the back of that mouth, that blister and can become painful.

Signs that swallowing may be painful for your child:

• Not eating or drinking
• Drooling more than usual
• Only wanting to drink cold fluids

Skin rash

Your child may get a skin rash on the palms of the hands and soles of the feet. It may also show up on the knees, elbows, buttocks, or genital area.

The rash usually looks like flat, red spots, sometimes with blisters. Fluid in the blister and the scab that forms as the blister heals may contain the virus that causes hand, foot, and mouth disease. Keep blisters or scabs clean and avoid touching them.

Treat symptoms at home

Often the infection is mild, and symptoms can be treated at home. However, sometimes you need to see a health care provider.

When to see a healthcare provider

See a healthcare provider if

• Your child is not drinking enough to stay hydrated
• Symptoms do not improve after 10 days
• Your child has a weakened immune system or if the symptoms are severe
• Your child is very young, especially younger than 6 months

Complications from hand, foot, and mouth disease are rare.

Dehydration

Some people, especially young children, may get dehydrated if they are not able to swallow enough liquids because of painful mouth sores. Parents can prevent dehydration by making sure their child drinks enough liquids.

Fingernail and toenail loss

Very rarely, people may lose a fingernail or toenail after having hand, foot, and mouth disease. Most reports of fingernail and toenail loss have been in children. In these reported cases, the person usually lost the nail within a few weeks after being sick. The nail usually grew back on its own. Experts don’t know if hand, foot, and mouth disease caused the nail loss.

Viral (aseptic) meningitis

Although very rare, a small number of people with hand, foot, and mouth disease get viral meningitis. It causes fever, headache, stiff neck, or back pain and may require the infected person to be hospitalized for a few days.

Encephalitis or polio-like paralysis

Very rarely, a small number of people with hand, foot, and mouth disease get encephalitis (swelling of the brain) or paralysis. It is extremely rare.

Pregnant women

Pregnant women should contact their healthcare provider if they think they may have been exposed to hand, foot, and mouth disease or think they may have the disease. Although complications from it are rare, patient medical history and how far along a woman is in her pregnancy can affect the situation.

Healthcare providers can usually tell if someone has hand, foot, and mouth disease by examining the patient and considering

• How old the patient is
• What symptoms the patient has
• How the rash and mouth sores look

A healthcare professional may sometimes collect samples from the patient’s throat, blister, or feces (poop), then send them to a laboratory to test for the virus.

There is no specific medical treatment for hand, foot, and mouth disease.

You can take steps to relieve symptoms and prevent dehydration while you or your child are sick.

Treat symptoms and prevent dehydration

Take over-the-counter medications to relieve fever and pain caused by mouth sores. Never give aspirin to children.

Drink enough liquids. Mouth sores can make it painful to swallow, so your child might not want to drink much. Make sure they drink enough to stay hydrated.

When to see a healthcare provider

See a healthcare provider if

• Your child is not drinking enough to stay hydrated
• Symptoms do not improve after 10 days
• Your child has a weakened immune system or if the symptoms are severe
• Your child is very young, especially younger than 6 months

Prevent it from spreading

• Wash your hands often with soap and water for at least 20 seconds
• Stay home when you are sick

You can help prevent catching or spreading hand, foot, and mouth disease by following simple steps.

Wash your hands

Wash your hands often with soap and water for at least 20 seconds. If soap and water are not available, use an alcohol-based hand sanitizer.

Always wash your hands:

• After changing diapers
• After using the toilet
• After blowing your nose, coughing, or sneezing
• Before and after caring for someone who is sick

Help children wash their hands. Teach them how to wash their hands and make sure they wash them often.

Learn more about when and how to wash your hands.

Clean and disinfect

Clean and disinfect frequently touched surfaces and shared items, including toys and doorknobs.

Avoid touching your eyes, nose, and mouth

You can get infected with hand, foot, and mouth disease if you have the virus on your hands and then touch your eyes, nose, or mouth. To lessen your chance of getting sick, don’t touch your eyes, nose, and mouth with unwashed hands.

Avoid close contact with sick people

Avoid touching someone who has hand, foot, and mouth disease, such as hugging or kissing them.

Stay home if you are sick with hand, foot, and mouth disease. Talk with your healthcare provider if you are not sure when you should return to work or when your child should return to school or day care.

What is hand, foot, and mouth disease?

Hand, foot, and mouth disease is a contagious disease that is caused by different viruses. It usually affects infants and children under 5 years old, occasionally adults will also get the disease. Symptoms of hand, foot, and mouth disease include fever, painful blister-like sores in the mouth, and a rash that may appear as blisters. It is usually a mild disease, and nearly all infected people recover in 7 to 10 days.

Hand, food, and mouth disease spreads through close personal contact, such as kissing or hugging, coughing and sneezing, contact with feces (poop), and touching objects or surfaces that have the virus on them then putting your fingers in your eyes, nose or mouth.

Who is at risk?

Viruses that cause hand, food, and mouth disease occur worldwide and are more common in summer and fall in temperate climates. Large, severe outbreaks affecting thousands of people occur frequently in some countries in Asia.

What can travelers do to prevent hand, food, and mouth disease?

There is no vaccine to prevent hand, food, and mouth disease but you can take steps to lower your risk of getting it.

Wash your hands:

• Wash your hands often with soap and water, especially after using the bathroom and before eating. If soap and water aren't available, use an alcohol-based hand sanitizer.
• Don’t touch your eyes, nose, or mouth. If you need to touch your face, make sure your hands are clean.
• Cover your mouth and nose with a tissue or your sleeve (not your hands) when coughing or sneezing.
• Try to avoid close contact, such as kissing, hugging, or sharing eating utensils or cups with people who are sick.

Disinfect dirty surfaces and soiled items:

• If you are able, first wash items with soap and water, then disinfect them with a solution of chlorine bleach (made by mixing 1 tablespoon of bleach with 4 cups of water) or a cleaning product that contains bleach.

If you develop mouth sores and think you have hand, foot, and mouth disease:

• Take over-the-counter medications to relieve pain and fever.
  • Children should not take aspirin.
• Use mouthwashes or sprays that numb mouth pain.
• Drink plenty of liquids to stay hydrated.
• Seek medical care if
  • Your child is not drinking enough to stay hydrated
  • Symptoms do not improve after 10 days
  • Your child has a weakened immune system
  • Symptoms are severe
  • Your child is very young, especially younger than 6 months

If you traveled and feel sick, particularly if you have a fever, talk to a healthcare provider, and tell them about your travel. Avoid contact with other people while you are sick.