Hand, Foot and Mouth Disease (Coxsackie viral infection)

What is hand, foot and mouth disease?

Hand, foot and mouth disease is a viral infection caused by a strain of Coxsackie virus. It causes a blister-like rash that, as the name implies, involves the hands, feet and mouth. (Hand, foot and mouth disease is different than foot-and-mouth disease, which is an infection of cattle, pigs, sheep, goats and deer and is caused by a different virus.)

Who gets hand, foot and mouth disease?

Usually this occurs in children under 10 years old, but occasionally can occur in young adults.

How is it spread?

The virus is spread by direct contact with nose and throat discharges, blisters and feces of infected people.

What are the symptoms and when do they start?

Symptoms of fever, poor appetite, runny nose and sore throat can appear three to five days after exposure. A blister-like rash on the hands, feet and in the mouth usually develops one to two days after the initial symptoms.

When and how long can someone spread the disease?

A person is contagious when the first symptoms appear and may continue until the blister-like skin lesions disappear. The virus has been known to be shed in the stool for up to several weeks.

How is hand, foot and mouth disease diagnosed?

The diagnosis is generally suspected on the appearance of blister-like rash on hands and feet and mouth in a child with a mild febrile illness. Although specific viral tests are available to confirm the diagnosis, they are rarely performed due to expense and length of time needed to complete the tests.

Does a prior infection with Coxsackie virus make a person immune?

Specific immunity can occur, but a second episode is possible from a different strain of Coxsackie virus.

What is the treatment?

There is no specific treatment. Treatment is aimed at fever control and maintaining good oral hydration.

Can there be complications associated with hand, foot and mouth disease?

The illness is typically mild, complications are rare. More serious infections have been seen recently with a certain strain of Coxsackie viral infection in Indonesia.

What can be done to prevent the spread of this disease?

Children who feel ill or have a fever should be excluded from group settings until the fever is gone and the child feels well. Thorough handwashing and care with diaper changing practices is important as well.