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Medical Author:

John Mersch, MD, FAAP

John Mersch, MD, FAAP

Dr. Mersch received his Bachelor of Arts degree from the University of California, San Diego, and prior to entering the University Of Southern California School Of Medicine, was a graduate student (attaining PhD candidate status) in Experimental Pathology at USC. He attended internship and residency at Children's Hospital Los Angeles.

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Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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In this Article

• What is hand foot and mouth (HFM) disease?
• What are the symptoms and signs of hand foot and mouth disease?
• What causes hand foot and mouth disease?
• How is hand foot and mouth disease spread?
• What is the incubation period for hand foot and mouth disease?
• When does hand foot and mouth disease usually occur?
• How does hand foot and mouth disease affect pregnancy and the baby?
• What is the course of hand foot and mouth disease?
• Why haven't we heard more about hand foot and mouth disease?
• How is hand foot and mouth disease diagnosed?
• What is the treatment for hand foot and mouth disease?
• Hand Foot and Mouth (HFM) Disease At A Glance
• Patient Comments: Hand Foot and Mouth Syndrome - Treatments
• Patient Comments: Hand Foot and Mouth Syndrome - Symptoms
• Find a local Pediatrician in your town
• Hand-Foot-And-Mouth Syndrome Index

HFM is spread person to person by direct contact with the infecting virus (either Coxsackie virus A-16 or less commonly enterovirus 71). These viruses are most commonly found in the nasal and throat regions but also in the blister fluid or stool of infected individuals. Infected individuals are most contagious during the first week of their illness. HFM cannot be contracted from pets or animals.

The viruses that cause HFM may remain in the person's respiratory or intestinal tract for several weeks to months after all symptoms have resolved. It is possible, therefore, to transmit the infection even though the formally ill individual has completely recovered. Some individuals (most commonly adults) may exhibit no symptoms during their infection but may unwittingly transmit the illness to those (commonly infants and children) who are not immune.

HFM is moderately contagious and spreads from person to person. It cannot be spread by animals. Usually the virus is passed via oral secretions (nasal discharge, saliva, etc.) or via stool. There is a short four- to six-day incubation period between exposure and development of initial symptoms (fever and malaise). A person is most contagious during the first week of illness.

Spring and fall are the most frequent seasons for community epidemics of HFM. While anyone exposed to the viral causes of HFM may develop disease, not everyone infected will develop symptoms.

Commonly HFM is an illness of children less than 10 years of age; adults generally were exposed during childhood and maintain a natural immunity. Information regarding fetal exposure to HFM during pregnancy is limited. No solid evidence exists that maternal enterovirus infection is associated with complications such as spontaneous abortion or congenital defects. However, should a baby be born to a mother with active HFM symptoms, the risk of neonatal infection is high. Typically, such newborns have a mild illness. Rarely, overwhelming infection involving vital organs such as liver, heart, and brain can be lethal.