Diseases & Conditions

Hand-foot-and-mouth disease

Hand-foot-and-mouth disease is a mild, but highly contagious viral infection common in young children. Hand-foot-and-mouth disease is characterized by sores in the mouth and a rash on the hands and feet. It spreads from person to person, usually through unwashed hands or contaminated surfaces. The most common cause of hand-foot-and-mouth disease is coxsackievirus infection.

Hand-foot-and-mouth disease isn't related to foot-and-mouth disease (sometimes called hoof-and-mouth disease), which is an infectious viral disease found in farm animals. You can't contract hand-foot-and-mouth disease from pets or other animals, and you can't transmit it to them.

There's no specific treatment for hand-foot-and-mouth disease. You can reduce your risk of infection by practicing good hygiene, such as washing your hands often and thoroughly.

The signs and symptoms of hand-foot-and-mouth disease include:

• Fever
• Sore throat
• Painful red blister-like lesions on the tongue, mouth, palms of the hands or soles of the feet
• Headache
• Fatigue
• Irritability in infants and toddlers
• Loss of appetite

The usual period from initial infection to the onset of signs and symptoms (incubation period) is three to seven days. Fever is often the first sign of hand-foot-and-mouth disease, followed by a sore throat and sometimes a poor appetite and the feeling of being sick (malaise). One or two days after fever begins, painful sores may develop in the mouth or throat. Rash on the hands and feet can follow within one or two days, and may also appear on the buttocks. Hand-foot-and-mouth disease may cause all of the above signs and symptoms or just a few of them.

The most common cause of hand-foot-and-mouth disease is infection due to the coxsackievirus A16. The coxsackievirus belongs to a group of viruses called enteroviruses. Other enteroviruses sometimes cause hand-foot-and-mouth disease. Most cases of hand-foot-and-mouth disease aren't serious.

Oral ingestion is the main source of coxsackievirus infection and hand-foot-and-mouth disease. The illness spreads by person-to-person contact with nose and throat discharges, saliva, fluid from blisters, or the stool of someone with the infection. Hand-foot-and-mouth disease is most common in children in child care settings, where diaper changing and potty training are constant, and little hands often are in and out of the mouth frequently.

Your doctor will likely be able to distinguish hand-foot-and-mouth disease from other types of viral infections by evaluating:

• The age of the affected person
• The pattern of signs and symptoms
• The appearance of rash or sores

A throat swab or stool specimen may be taken and sent to the laboratory to determine which virus caused the illness. However, your doctor probably won't need this type of testing to diagnose hand-foot-and-mouth disease.

There's no specific treatment for hand-foot-and-mouth disease, and antibiotics aren't effective because it's a viral infection. The illness simply must run its course. To help lessen discomfort, doctors often recommend:

• Rest
• Plenty of fluids — milk-based fluids may be easier to tolerate than acidic liquids, such as juice or soda
• Over-the-counter pain relievers, such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin, others), if needed

Signs and symptoms of hand-foot-and-mouth disease usually clear up in seven to 10 days.

Certain foods and beverages that can cause burning or stinging may irritate blisters on the tongue or in the mouth or throat caused by hand-foot-and-mouth disease. Try these tips to help make blister soreness less bothersome and eating and drinking more tolerable:

• Suck on popsicles or ice chips
• Eat ice cream or sherbet
• Drink cold beverages, such as milk or ice water
• Avoid acidic foods and beverages, such as citrus fruits, fruit drinks and soda
• Avoid salty or spicy foods
• Choose foods that are soft and don't require a lot of chewing
• Rinse your mouth with warm water after meals

If your child is able to rinse without swallowing, rinsing the inside of his or her mouth with warm salt water may be soothing. Mix 1/2 teaspoon of salt with 1 cup of warm water. Have your child rinse with this solution several times a day, or as often as needed to help reduce the pain and inflammation of mouth and throat sores caused by hand-foot-and-mouth disease.