Hand, Foot & Mouth Disease (HFMD) Symptoms, Causes, and Treatments

If your child has been feeling unwell for the past few days, and you notice sores in their mouth and tiny blisters or red spots on their hands, feet, and diaper area, they might have hand, foot, and mouth disease (HFMD).

HFMD is a viral infection that primarily affects children under 5 years old, though teens and adults can also contract it. The incidence of HFMD often increases during the monsoon season when the virus becomes more active. While there is no specific treatment for HFMD, it usually resolves on its own within 7 to 10 days. Maintaining proper hygiene and avoiding contact with infected individuals can help prevent the spread of HFMD.

What is Hand, Foot, and Mouth Disease?

Hand, foot, and mouth disease (HFMD) is a highly contagious illness caused by the Coxsackievirus-A16 and Enterovirus-71. The virus spreads through direct contact with unwashed hands or contaminated surfaces. HFMD is characterized by a rash that can appear anywhere on the body, including the hands, feet, chest, back, genitals, and buttocks, and may also cause painful sores in the mouth.

Who is at Risk of Developing HFMD?

Infants and children under 5 are most susceptible to HFMD. This is the time when children venture out of their homes and into classrooms and nurseries. The virus therefore spreads quickly among children in schools, daycare centres, or during play since their immune systems have not developed enough. Older children, teens, and adults can also get infected, which means these are people with a weak immune system. though they typically build immunity after exposure to the virus. People with weakened immune systems are at higher risk of infection. HFMD can recur, making prevention essential.

What are the Symptoms of HFMD?

What Causes HFMD?

HFMD is caused by viruses from the Coxsackievirus and Enterovirus families. The virus can spread through:

• Saliva
• Nose secretions
• Throat discharge
• Fluid from blisters
• Stool
• Respiratory droplets
• Direct contact with blisters
• Sharing food or personal items with an infected person
• Touching contaminated surfaces

Spread of HFMD in Babies and Adults

In childcare settings, frequent diaper changes and using the toilet can facilitate the spread of HFMD among babies. Adults can also spread HFMD without showing symptoms.

What are the Complications Caused by HFMD?

While HFMD symptoms are usually mild, complications can arise, including:

• Dehydration
• Pain while swallowing
• Irritation from sores
• Watery rashes
• Nail loss (rare)

In rare cases, the enterovirus can cause serious complications such as viral meningitis (inflammation of the brain and spinal cord membranes) or encephalitis (brain inflammation).

How is HFMD Diagnosed?

Healthcare providers diagnose HFMD by examining blisters and symptoms. They may also prescribe some probationary tests such as:

• Throat swab testing
• Stool samples
• Blister samples

What are the HFMD Treatment Options?

There is no specific medication or vaccine for HFMD. Antibiotics are ineffective as HFMD is a viral disease. Treatment focuses on home care, including:

Medicines:

• Child below 6 months: Acetaminophen (Tylenol®) for fever and sore throat
• Child above 6 months: Acetaminophen (Tylenol®) or Ibuprofen (Advil®, Motrin®) for headache, fever, and sore throat

Hydration:

• Child below 1 year: Milk, formula, and Pedialyte®
• Child above 1 year: Water, milk, apple juice, and popsicles

Soothing Sore Throat:

• Children upto age 4 years: Throat lozenges or sprays without lidocaine
• Children upto age 6 years: Gargling with a mixture of ¼ to ½ teaspoon of salt in an 8-ounce glass of warm water
• Adults: Numbing spray or mouthwash

Note: Consult a healthcare provider before giving any medication.

Home Remedies for HFMD:

• Avoid spicy or acidic foods
• Take cold liquids
• Avoid hot beverages
• Keep your child hydrated
• Limit citrus fruits, fruit drinks, and soda

How to Prevent HFMD Disease?

HFMD is highly contagious, so practising good hygiene is essential to slow or stop its spread. Preventive measures include:

• Covering nose when coughing or sneezing
• Teaching children not to rub their rash or eyes
• Regularly disinfecting high-touch surfaces
• Not sharing personal items with the infected
• Avoiding putting objects or hands near the mouth
• Keeping the infected away from others
• Regularly washing hands and personal items
• Avoiding kissing and hugging the infected

Living with HFMD Disease

HFMD typically resolves in 7-10 days. During this time, keeping your child hydrated and maintaining cleanliness is crucial. Ensure they wash their hands regularly and avoid spreading the virus to others.

Hand, foot, and mouth disease is a common and contagious illness that mostly affects infants, children, and teens but can also infect adults. Initial symptoms last 2-3 days, followed by a recovery period of 7-10 days. The disease is most contagious in the first week, but the spread diminishes during recovery. If symptoms persist beyond 10 days or blisters become severely itchy, consult a healthcare provider. Children who are just starting school are at the highest risk of getting the disease. Hence it is advisable to reach out to a paediatrician at the slightest incidence of discomfort. 

Frequently Asked Questions on HFMD

What is the cause of HFMD?

HFMD is primarily caused by the Coxsackievirus, which belongs to the enterovirus family. This virus can be found in various bodily secretions, including saliva, nasal mucus, and stool. It is highly contagious and can spread through direct contact with an infected person or contaminated surfaces. Maintaining good hygiene and cleanliness is crucial to prevent the spread of this virus.

Can adults get HFMD?

Yes, adults can contract HFMD, although it is less common and often presents with milder symptoms or none at all. Adults can still spread the virus to others, even if they don’t show symptoms. This is why it is important for adults to maintain good hygiene practices, especially around children.

How does hand, foot, and mouth disease progress?

HFMD progresses through two main stages with symptoms that can cause significant discomfort, particularly in children:
The initial stage includes cold-like symptoms such as a mild fever, sore throat, and general discomfort. Within a few days, the disease progresses to the major stage, where painful sores develop in the mouth, and a rash or blisters appear on the hands, feet, and other parts of the body. 

Can I hug my child with hand, foot, and mouth disease?

It is best to avoid close physical contact, such as hugging and kissing, with your child during the initial days of HFMD infection. This period is when the virus is most contagious, and physical contact can easily spread it to others. 

Instead, focus on comforting your child through other means, such as verbal reassurance and gentle care. Once the blisters start to dry up and heal, the risk of contagion decreases significantly.

How long is HFMD contagious?

• HFMD is most contagious during the first few days of infection, often before the rash and blisters become visible. 
• The virus can continue to spread until the blisters have dried up, which usually takes about 7 to 10 days. 
• Even after visible symptoms have resolved, the virus can still be present in the stool for several weeks. 
• Continue practising good hygiene to prevent further transmission.

Can HFMD be prevented with a vaccine?

With no vaccine, prevention relies heavily on maintaining good hygiene practices, such as: 

• frequent hand washing, 
• disinfecting surfaces, and 
• avoiding close contact with infected individuals. 

Researchers are continuously studying the virus to develop potential vaccines in the future. Until then, vigilance and preventive measures are the best defence against HFMD.

How long does it take to recover from HFMD?

Recovery from HFMD typically takes about 7 to 10 days. During this period, the body’s immune system works to fight off the virus, leading to the resolution of symptoms. 

Most individuals recover fully without any long-term effects. However, maintaining hydration and comfort is essential during recovery, especially for children who may have difficulty eating and drinking due to mouth sores.

What is the difference between HFMD and chickenpox?

Both diseases are highly contagious but caused by different viruses.

HFMD causes blisters and sores on the hands, feet, and mouth. 

Chickenpox usually starts with red spots on the torso and spreads to the head, arms, and legs. They are also more widespread and can cover the entire body.

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