Hand, Foot, and Mouth Disease (HFMD)

  • Medical Author:
    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.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    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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What are the risk factors for hand, foot and mouth disease?

Risk factors for developing HFMD include

  1. spring and fall seasons,
  2. the toddler age range is most likely to develop the disease,
  3. high-risk exposure location (such as daycare and preschool), and
  4. ineffective hygiene -- infrequent soap and water hand-washing or not wearing disposable gloves when changing stool-containing diapers.

An individual with a compromised immune system is more likely to develop HFMD.

Is hand, foot, and mouth disease contagious? How does HFMD spread?

HFMD is spread person to person by direct contact with the infecting virus (either Coxsackievirus A16 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. HFMD cannot be contracted from pets or animals.

The viruses that cause HFMD 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 formerly ill individual has completely recovered. Some individuals (most commonly adults) may exhibit no symptoms or signs during their infection but may unwittingly transmit the illness to those (commonly infants and children) who are not immune.

How long is hand, foot, and mouth disease contagious?

Once exposed to the virus, those who develop symptoms and signs will do so within four to six days. They are most contagious during the first week of the illness. However, the virus may continue to be shed in respiratory secretions (saliva and/or nasal mucous) or in the stool for several weeks to months.

Can adults get hand, foot, and mouth disease?

An adult who was never exposed to the viruses that cause HFMD as a child could develop the characteristic symptoms and physical signs (vesicular rash with the characteristic distribution) if infected by the virus. Interestingly, an individual can also have the infection but develop no symptoms or signs. Unfortunately, he is still contagious even though he lacks objective physical findings.

Medically Reviewed by a Doctor on 6/20/2016

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