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Hand, foot, and mouth disease is a common, usually minor, viral infection, but it is extremely contagious. According to the National Center for Biotechnology Information, it is common for this viral infection to occur in child daycares or summer camps during summer and going into early fall, and it also occurs virtually equally in females and males. [3] “The majority of people infected with coxsackievirus are children under the age of 10. Because the virus is shed in the stools for many weeks, some studies indicate that family members and close contacts are also at risk for developing hand, foot and mouth disease.” [3] Although commonly associated with children, hand, foot, and mouth disease can affect anyone at any age.
Causes
Coxsackievirus is the most common cause of hand, foot, and mouth disease. Specifically, the main culprit would be coxsackievirus A16. “The coxsackievirus belongs to a group of viruses called nonpolio enteroviruses. Other types of enteroviruses sometimes cause hand-foot-and-mouth disease.” [1] Other viruses within the enterovirus family include polio and hepatitis A. “Oral ingestion is the main source of coxsackievirus infection and hand-foot-and-mouth disease.” [1] An infection or hand, foot, and mouth disease can spread by coming into contact with an afflicted person’s nasal secretions or throat discharge, saliva, fluid from blisters, stool, or respiratory droplets sprayed into the air by a cough or a sneeze. [1] There are a couple other ways one can become infected with this virus. You can also get hand, foot, and mouth disease by “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.” [2] So, now we know all the causes of hand, foot, and mouth disease and how it can be transmitted from person to person, but what are the symptoms that we should be looking out for?
Symptoms and treatment
Hand, foot, and mouth disease can be characterized by a multitude of symptoms. All or only some may show up for an infected person, but the following symptoms are what you should look out for if you believe you or someone you know has come into contact with the disease:
● Fever
● Sore throat
● Feeling generally unwell
● Painful, red, blister-like lesions on the tongue, gums, and inner cheeks
● A red rash, without itching but occasionally with blistering, on the palms of the hands, soles of the feet, and, sometimes, the buttocks
● Irritability in infants and toddlers
● Loss of appetite
Symptoms will usually begin to appear three to six days after being exposed to the disease, and the first three symptoms on the list above are usually what show up first, along with a possible loss of appetite. “One or two days after the fever begins, painful sores may develop in the front of the mouth or throat. A rash on the hands and feet and possibly on the buttocks can follow within one or two days.” [1] Although this disease is usually not considered threatening, it is still important to “contact your doctor if mouth sores or a sore throat keep [you or] your child from drinking fluids. And contact your doctor if after a few days, [you or] your child's signs and symptoms worsen.” [1]
Furthermore, the Centers for Disease Control and Prevention (CDC) recommends seeing 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
● Symptoms are severe
● Your child is very young, especially younger than 6 months [2]
Other than that, hand, foot, and mouth disease can usually be treated at home with over-the-counter medications (excluding aspirin for children) to treat any pain caused by the list of symptoms provided above. Drinking enough fluids is also extremely important. [2] With this treatment, the illness should resolve within 7 to 10 days.
Prevention
Since there is currently no vaccine that has been approved for hand, foot, and mouth disease in the United States, it is important to do what we can to lower the chances of getting or spreading the disease. The following is a list of precautions you can take:
● Wash your hands carefully
○ It is extremely important to wash your hands often, but it is especially important as a preventative measure for hand, foot, and mouth disease. “Wash your hands frequently and thoroughly, especially after using the toilet or changing a diaper and before preparing food and eating. When soap and water aren't available, use hand wipes or gels treated with germ-killing alcohol.” [1] The CDC also recommends that you wash your hands for at least 20 seconds before and after the above situations, and also “after blowing your nose, coughing, or sneezing” and “before and after caring for someone who is sick.” [2] It’s always a great idea to keep hand sanitizer with you at all times, just in case you are put in a situation where you are unable to wash your hands.
● Disinfect areas that are touched frequently
○ “Get in the habit of cleaning high-traffic areas and surfaces first with soap and water, then with a diluted solution of chlorine bleach and water.” [1] If you don’t have a chlorine and bleach solution on hand, Lysol or Lysol wipes would also be an acceptable substitute for the time being. These also work well if you’re in public spaces with surfaces that you don’t feel comfortable touching unless they’ve been disinfected.
● Practice and teach good hygiene
○ It is important to practice good hygiene habits such as not touching your face or putting your hands or fingers in your mouth, nose, and eyes. Even more importantly, it is necessary to teach these same good hygiene habits to children, whether they are your kids, your nieces or nephews, or even kids you may babysit or watch over in a daycare. Practicing good hygiene habits yourself and teaching kids the same habits are both important preventative measures to take when trying to reduce the risk of contracting or transmitting hand, foot, and mouth disease.
● Isolate contagious people
○ It cannot be stressed enough how contagious hand, foot, and mouth disease is, which is why “people with the illness should limit their exposure to others while they have active signs and symptoms. Keep children with hand-foot-and-mouth disease out of child care or school until fever is gone and mouth sores have healed. If you have the illness, stay home from work.” [1]
Hand, foot, and mouth disease is a highly contagious illness without a current vaccine to fight against it, but that does not mean we can’t do our part to lower the risk of contracting it or spreading it if we do end up contracting it. If you or someone close to you contracts the disease, you will be able to treat it easily with over-the-counter medicines, and it will usually resolve itself within 7-10 days. If it seems like symptoms are not being alleviated or are getting worse, be sure to see a healthcare provider to avoid any serious consequences from a lack of treatment.
References:
1. Mayo Clinic. (2020, September 25). Hand-foot-and-mouth disease. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/hand-foot-and-mouth-disease/symptoms-causes/syc-20353035.
2. CDC. (2021, February 2). Hand, foot, and mouth disease. Centers for Disease Control and Prevention. Retrieved January 31, 2022, from https://www.cdc.gov/hand-foot-mouth/index.html.
3. Guerra, A. M. (2021, November 7). Hand foot and mouth disease. StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK431082/.
Contributors:
Author: Lauryn Agron
Editor: Kayjah Taylor
Health scientist: Aseelah Saiyed