Hand, Foot and Mouth Disease

Hand, foot, and mouth disease is a common viral illness worldwide that usually affects infants and children younger than 5 years old. It is caused by a group of viruses that are called Enteroviruses. This group of viruses includes Coxsackievirus A16 (the most common cause), Coxsackievirus B and Enterovirus D-68 and 71 that is often the cause of outbreaks. Human enterovirus 71 (HEV71) is an important cause of viral encephalitis (brain inflammation) in Southeast Asia over the past 15 years. There has been an increased number of epidemics due to HEV71 since 1997. Recently, infection with Human enterovirus D-68 (HEV D-68) has been associated with the development of paralysis in young children similar to polio.

HEV71 virus mostly affects children. However, this virus can cause more serious illness, such as meningitis (inflammation of the linings of the brain), poliomyelitis-like paralysis, and other severe disorders, including pulmonary edema (fluid in the lungs) and cardiorespiratory collapse. 

Infected persons are most contagious during the first week of the illness. The viruses that cause hand, foot, and mouth disease can remain in the body for weeks after a person’s symptoms have disappeared, so that infected people can still pass the infection to others even though they may appear well.

Susceptibility is general. 

Symptoms include fever, poor appetite, feeling unwell, and sore throat. One or 2 days after fever starts, painful sores usually develop in the mouth, starting as small red spots that blister and that often become ulcers. A skin rash develops over 1 to 2 days. The rash has flat or raised red spots, sometimes with blisters. The rash is usually on the palms of the hands and soles of the feet, but it may also appear on the knees, elbows, buttocks or genital area.

There is no special treatment other than control of symptoms and maintaining hydration (good fluid intake). 

The germs that cause hand, foot and mouth disease can be found worldwide. They are most active in the summer and fall in temperate climates but can occur year-round in the tropics.