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Hand, Foot, and Mouth Disease

Viruses that can cause blisters on the hand, foot, and mouth


Updated June 12, 2014

Hand, foot, and mouth disease (HFMD) is a common and contagious childhood infection characterized by blister-like rashes on the hands, feet, and inside the mouth. It is commonly associated with outbreaks in child-care facilities, but difficult to prevent because of long-lasting presence of the virus even after symptoms disappear.

Name: Coxsackie A Virus or Enterovirus 71 are the most common causes of HFMD, but it can also be caused by Coxsackie B or other enteroviruses.

Type of Microbe: Virus

How it spreads: The virus is spread through secretions from the nose and throat, saliva, blister fluid, and stool of infected persons. The most common cause of infection is through contact with contaminated hands or surfaces. Infected people are most contagious during the first week, but can continue to spread the virus after the symptoms resolve. In some cases, the infected individual may not have any symptoms, but he can still spread the disease.

Who’s at risk? Mostly infants and children under 10, but all people can get infected. The infection is more common in the summer and early winter. Major outbreaks have been reported in Asia and Australia, although they also occur worldwide.

Symptoms: Symptoms usually appear 3 to 7 days after contact with the virus. They include fever lasting up to 3 days, poor appetite, and sore throat, followed by development of painful mouth sores on the tongue, gums, and inside of cheeks. A non-itchy skin rash develops 1 to 2 days after the fever begins and appears as flat or raised red spots with or without blisters on the palms of the hand, soles of the feet, and diaper area.

Diagnosis: Symptoms such as mouth sores and rash. Other tests are available for determining viral strain, but are generally not available or used by most doctors, since it can take several weeks to get results and most cases have resolved by then.

Prognosis: The disease usually resolves on its own within 7 to 10 days without any treatment.

Treatment: No antiviral treatments are available, but fever and pain can be managed with acetaminophen (Tylenol) or ibuprofen (Motrin), as recommended by your doctor. Dehydration can be prevented by increasing fluids. More severe cases of dehydration may require hospitalization.

Prevention: Good hygienic practices, such as frequent hand washing, disinfecting contaminated surfaces with 10% bleach solutions, and avoiding close contact with infected people.

Complications: Complications are rare, but may include mild cases of viral meningitis. More severe complications can include paralysis or encephalitis (which can be fatal).


Hand, Foot, & Mouth Disease (HFMD). CDC National Center for Immunization and Respiratory Diseases. Division of Viral Diseases.

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