Hand-foot-and-mouth disease (patient information)

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Overview
Hand-foot-and-mouth disease (HFMD) is most commonly caused by coxsackievirus A16, a member of the enterovirus family.

What are the symptoms of Hand-foot-and-mouth disease?

 * Fever
 * Headache
 * Loss of appetite
 * Rash with very small blisters on hands, feet, and diaper area; may be tender or painful if pressed
 * Sore throat
 * Ulcers in the throat (including tonsils), mouth, and tongue

What causes Hand-foot-and-mouth disease?
Hand-foot-and-mouth disease (HFMD) is most commonly caused by coxsackievirus A16, a member of the enterovirus family.

The disease is not spread from pets, but it can be spread by person to person. You may catch it if you come into direct contact with nose and throat discharges, saliva, fluid from blisters, or the stools of an infected person. You are most contagious the first week you have the disease.

The time between infection and the development of symptoms is about 3 - 7 days.

Who is at highest risk?
The most important risk factor is age. The infection occurs most often in children under age 10, but can be seen in adolescents and occasionally adults. The outbreaks occur most often in the summer and early fall.

When to seek urgent medical care?
Call your doctor if there are signs of complications, such as pain in neck or arms and legs. Emergency symptoms include convulsions.

You should also call if:
 * A high fever is not reduced by medication
 * Signs of dehydration occur:
 * Dry skin and mucus membranes
 * Weight loss
 * Irritability
 * Lethargy
 * Decreased or dark urine.

Diagnosis
A history of recent illness and a physical examination, demonstrating the characteristic vesicles on the hands and feet, are usually sufficient to diagnose the disease.

Treatment options
There is no specific treatment for the infection other than relief of symptoms.

Treatment with antibiotics is not effective, and is not indicated. Over-the-counter medicines, such as Tylenol (acetaminophen) can be used to treat fever. Aspirin should not be used in viral illnesses in children under age 12 years.

Salt water mouth rinses (1/2 teaspoon of salt to 1 glass of warm water) may be soothing if the child is able to rinse without swallowing. Make sure your child gets plenty of fluids. Extra fluid is needed when a fever is present. The best fluids are cold milk products. Many children refuse juices and sodas because their acid content causes burning pain in the ulcers.

Where to find medical care for Hand-foot-and-mouth disease?
Directions to Hospitals Treating Hand-foot-and-mouth disease

What to expect (Outlook/Prognosis)?
Generally, complete recovery occurs in 5 to 7 days.

Possible complications

 * Dehydration
 * Febrile seizures

Prevention
Avoid contact with people with known illness. Practice strict hand washing if in contact with infected children.