Dr. Timothy Lefeber

Hand, foot, and mouth disease is a common viral infection that affects mostly infants and children age five and younger. Sometimes, it occurs in adults too. Children may experience fever, mouth sores, and a skin rash. Reduce your child's risk of infection by encouraging frequent handwashing and other good hygiene practices. WVU Medicine pediatrician Timothy Lefeber, MD, gives you more information about the disease.

What causes hand, foot, and mouth disease?
It’s caused by a group of viruses known as enteroviruses. The two most common viruses that cause it are Coxsackie A16 and Enterovirus 71.

What are the symptoms?
Children typically develop a fever for one to two days followed by sore throat, blistering ulcers on the lining of the mouth, and a red, blistering rash on the palms of the hands and soles of the feet. The rash can spread to other areas of the body, including the arms, buttocks, genitals, and legs. Children will feel run down, have a decreased appetite, and experience pain from oral blisters. Shedding skin on the fingers and toes or shedding fingernails and toenails may also occur.

How is it spread?
The virus can be spread from person to person by saliva, nasal and oral respiratory secretions, fluid from ulcers and blisters of the rash, and through a person’s stool (changing a diaper or a child getting stool on their hands). The viruses that cause hand, foot, and mouth disease can live on surfaces long enough to spread to people who aren’t in direct contact with those who are infected. Children with hand, foot, and mouth disease leave germs behind the most during the first few days of infection, but can continue to be contagious in their stool weeks to months after the symptoms are gone. Adults can get the virus without any symptoms, but still spread it to others through body fluids and stool. The viruses that cause hand, foot, and mouth disease tend to be present in our population the most during the late summer and fall seasons. It often results in outbreaks in public places like daycares and schools.

How is it diagnosed?
The signs and symptoms mentioned above help clinicians identify it. Lab tests are not necessary in most cases, but can be used when the diagnosis is not clear.

How is it treated?
Currently, there is no treatment for hand, foot, and mouth disease. Most therapies are directed at the symptoms like fever, dehydration, and mouth pain. Over-the-counter pain relievers/fever reducers are helpful. Hydration is very important as children often have little interest in drinking or mouth pain prevents them from doing so. Caution should be used with numbing medicines (topical anesthetics) to help reduce the pain of mouth sores. Ask your doctor or pharmacist if the medicine is safe for your child.

Can it be prevented?
There are no vaccines for the viruses that cause hand, foot, and mouth disease. The best way to prevent spread of the infection is through avoiding close contact with those infected, frequent handwashing, and cleaning contaminated surfaces. Children should only return to school when fevers have stopped and no new blisters or rashes are developing.

Should I be worried if my child gets hand, foot, and mouth disease?
For most children, the disease usually resolves in seven to ten days. There are very rare cases where the virus can cause greater disease that affects organs like the brain, heart, and lungs. Children should be re-evaluated by a physician if they experience abdominal pain, any increased neurologic symptoms (headaches, stiff neck, confusion, loss of function), persistent high fevers, signs of breathing problems, and vomiting.

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