Have your kids ever had a coxsackievirus A16 infection?
Don’t think so?
What about Hand, Foot, and Mouth Disease (HFMD)?
Symptoms of Hand, Foot, and Mouth Disease
Hand, Foot, and Mouth Disease is a very common childhood disease that most of us end up getting at some point, typically before we are about five years old. At least you hope you do, because you don’t want to get it as an adult…
Most people are familiar with the classic symptoms of HFMD, which can include:
- a few days of fever, often up to about 102 degrees F
- red spots that can turn into blisters on the child’s palms (hand) and soles (foot), but often also on their knees, elbows, and buttocks
- sores or ulcers in a child’s mouth which are often painful, causing mouth pain or a sore throat and excessive drooling
- a reduced appetite, which can sometimes lead to dehydration
Symptoms which can last up to 7 to 10 days.
Although that’s the end of it for most kids, a few weeks after the other symptoms have gone away, some kids will have peeling of the skin on the child’s fingers and toes. They might even lose their fingernails and toenails (nail shedding). This is only temporary though, and new nails should quickly grow back.
To confuse matters though, like other viral infections, not all kids have classic symptoms when they get HFMD. Some don’t have a fever, while others don’t have the rash on their hands and feet, which can make it easy to confuse with other viral infections that cause mouth ulcers, like herpangina.
Some kids don’t have any symptoms at all, but surprisingly, they can still be contagious.
Facts About Hand, Foot, and Mouth Disease
HFMD is caused by the coxsackievirus A16 virus and a few other enteroviruses, including enterovirus 71 and coxsackievirus A6. Because more than one virus can cause HFMD, it is possible to get it more than once.
Other things to know about HFMD include that:
- it is very contagious, especially if you have close contact with nose and throat secretions, fluid from blisters, and feces of someone infected with HFMD, especially during their first week of illness
- the incubation period for HFMD, the time when you were exposed to someone to when you develop symptoms, is about 3 to 7 days
- people with HFMD disease can continue to be contagious for days or weeks after their symptoms have stopped, although this isn’t a reason to keep them out of school or daycare. In fact, as long as they don’t have fever and feel well, kids with HFMD can likely go to daycare or school.
- there is no specific treatment for HFMD, except symptomatic care, including pain relief, fever reducers if necessary, and extra fluids
- unlike other viruses which are common in the winter, HFMD season is during the spring, summer, and fall
- complications of HFMD disease are rare, but can include viral meningitis, encephalitis, and a polio-like paralysis
- HFMD is not the same as foot-and-mouth or hoof-and-mouth disease that affects animals
- there is currently no vaccine to prevent you from getting HFMD, although cross reactivity between polio vaccines and enterovirus 71 might lead to milder symptoms if you are vaccinated and an EV-71 vaccine is approved in China
Most importantly, to avoid getting HFMD, wash your hands after changing your child’s diaper, teach them to cover their coughs and sneezes, and don’t share cups or other personal items.
Although many of us had HFMD when we were kids, remember that there are multiple viruses that can cause it. When outbreaks occur and we see more cases in adults, it is likely because it isn’t being caused not by coxsackievirus A16, but by a less commonly seen enterovirus that we aren’t immune to, like coxsackievirus A6.
More on Hand, Foot, and Mouth Disease
- Hand, foot and what disease?!
- Is hand, foot, mouth disease in your daycare?
- Let’s learn something: Hand Foot and Mouth Disease!
- CDC – Hand, Foot, and Mouth Disease
- WHO – Hand, Foot and Mouth Disease (HFMD)
- AAP – Hand, Foot & Mouth Disease: Parent FAQs
- AAP – Coxsackieviruses and Other Enterovirus Infections
- Hand, Foot, and Mouth Disease
- Pregnancy & Non-Polio Enterovirus Infection
- Notes from the Field: Outbreak of Hand, Foot, and Mouth Disease Caused by Coxsackievirus A6 Among Basic Military Trainees — Texas, 2015
- Notes from the Field: Atypical Presentations of Hand, Foot, and Mouth Disease Caused by Coxsackievirus A6 — Minnesota, 2014
- Notes from the Field: Severe Hand, Foot, and Mouth Disease Associated with Coxsackievirus A6 — Alabama, Connecticut, California, and Nevada, November 2011–February 2012
- Hand, Foot, and Mouth Disease Caused by Coxsackievirus A6, Japan, 2011
- Deaths Among Children During an Outbreak of Hand, Foot, and Mouth Disease — Taiwan, Republic of China, April-July 1998
- Hand-foot-mouth disease mimicking diaper dermatitis
- Hand, foot and mouth disease – a short case report
- Study – The Risk Factors of Acquiring Severe Hand, Foot, and Mouth Disease: A Meta-Analysis.
Last Updated on October 20, 2018 by Vincent Iannelli, MD