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.

Quick GuideCommon Childhood Skin Disorders

Common Childhood Skin Disorders

What is the contagious period for hand, foot, and mouth disease?

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

What is the incubation period for hand, foot, and mouth disease?

HFMD 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 and saliva, etc.) or via stool. There is a short one- to three-day incubation period between exposure and development of initial symptoms (fever and malaise). A person is most contagious during the first week of illness.

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, the majority of adults exposed to enteroviruses will remain without symptoms. Unfortunately, he is still contagious even though he lacks objective physical findings.

What are the symptoms and signs of hand, foot, and mouth disease?

HFMD is most commonly an illness of the summer and fall seasons.

  • Initial symptoms of mild fever (101 F-102 F) and malaise are followed within one or two days by a characteristic skin rash.
  • Small (2 mm-3 mm) red spots that quickly develop into small blisters (vesicles) appear on the palms, soles, and oral cavity.
    • The gums, tongue, and inner cheek are most commonly involved in the mouth.
    • The foot lesions may also involve the lower calf region and rarely may appear on the buttocks.
    • Oral lesions are commonly associated with a sore throat, uncomfortable eating and drinking, and as a result, a diminished appetite. It is very rare for an infected child to become dehydrated due to oral discomfort.
  • It is estimated that approximately 50% of those infected with enterovirus never develop symptoms. Symptoms are much more common in infants, toddlers, and young children. Older children, teens, and adults are more likely to incur no symptoms.
Medically Reviewed by a Doctor on 1/23/2017

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