Hand, Foot, and Mouth Disease

What is hand, foot, and mouth disease?

Hand, foot, and mouth disease (HFMD) is a rash illness caused by viruses that belong to the Enterovirus genus (group). This group of viruses includes polioviruses, coxsackieviruses, echoviruses, and enteroviruses.

Who gets HFMD?

HFMD is a common viral illness that usually affects infants and children younger than five years old. However, it can sometimes occur in older children and adults.

How is HFMD spread?

HFMD is spread from person to person by direct contact with the viruses that cause this disease. These viruses are found in the nose and throat secretions (such as saliva, sputum, or mucus from the nose), fluid in blisters, and stool of infected persons. The viruses can also be spread when infected persons touch objects (such as toys) and surfaces that are then touched by others.

What are the symptoms of HFMD?

HFMD usually starts with a fever, poor appetite, a general feeling of being unwell (malaise), and sore throat. One or two days after fever starts, painful sores usually develop in the mouth and a skin rash might appear. The rash is usually on the palms of the hands and soles of the feet, but might also appear on the knees, elbows, buttocks or genital area.

How soon after exposure do symptoms appear?

Symptoms usually appear 3–5 days after exposure.

How is HMFD diagnosed?

HFMD is one of many infections that cause mouth sores. Healthcare providers determine whether the mouth sores are caused by HFMD by considering the age of the patient, what other symptoms are reported, and what the mouth sores look like. Depending on how severe the symptoms are, samples from the throat or stool might be collected and sent to a laboratory to test for the virus.

How long is a person able to spread the disease?

Infected persons are most contagious during the first week of illness. The viruses that cause HMFD can remain in the body for weeks after symptoms have gone away. This means that infected people can still pass the infection to others, even though they appear well. Some people who are infected, especially adults, might have no symptoms but are still able to pass the virus to others.

What is the treatment for HFMD?

There is no specific treatment for HFMD. Treatments might be given to relieve fever or pain, and ill persons should drink plenty of fluids. People who are concerned about their symptoms should contact their healthcare provider.

What can be done to prevent the spread of HFMD?

A person can lower the risk of being infected by:

  • Washing hands often with soap and water, especially after changing diapers, using the toilet, blowing your nose, coughing or sneezing, and before or after caring for someone who is sick.
  • Disinfecting dirty surfaces and soiled items, including toys. First wash the items with soap and water, then disinfect them with a bleach solution (made by following the directions on the bleach container).
  • Avoiding close contact such as kissing, hugging, or sharing eating utensils or cups with people who have HFMD.

Should a person with HFMD be excluded from work or school/child care?

HFMD can cause outbreaks in settings that involve a lot of close contact, such as child care settings. To prevent spread to others, children with HFMD should not go to school or child care for at least 24 hours after fever is gone without the use of a fever-reducing medicine. If the rash is still present, talk to the child’s healthcare provider about how long to wait for the rash to clear up before it is okay to go back to school or child care. A child with sores that are draining fluids should not go to school or child care.

How can I get more information about HFMD?

  • If you have concerns about HFMD, contact your healthcare provider.
  • Call your local health department. A directory of local health departments is located at the VDH Local Health Districts page.
  • Visit the Centers for Disease Control and Prevention website at the CDC page on HFMD.

August 2023

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