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 symptoms and signs of hand, foot, and mouth disease?

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

  • Initial symptoms of mild fever (101 F-102 F) and malaise are followed within one or two days by a characteristic 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.

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 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.

When does hand, foot, and mouth disease usually occur?

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

What is the course of hand, foot, and mouth disease?

The illness is characteristically self-limited and is usually resolved within a week, particularly when due to its most common cause, Coxsackievirus A16. In those outbreaks due to enterovirus 71, the illness may be more severe with complications such as infection of the heart muscle and/or viral meningitis and encephalitis and paralytic disease. As a rule, HFMD is generally a mild and self-limited illness.

Medically Reviewed by a Doctor on 6/20/2016

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