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coxsackievirus A16 (Hand–Foot–Mouth Disease, HFMD) ICD-9 074.3; ICD-10 B08.4

What you need to know about: Hand, Foot & Mouth Disease

What is Hand, Foot, and Mouth Disease (HFMD)?

Not to be confused with Foot and Mouth disease (a disease of cattle, sheep, and swine), HFMD is a common rash illness of infants and children caused by several viruses.  The vast majority of cases, however, are caused by the coxsackievirus A16.

What are the symptoms of HFMD?

Symptoms of fever, poor appetite, runny nose, and sore throat can appear three to five days after the person becomes infected. One or 2 days after the fever begins, the rash appears as blisters or ulcers in the mouth, on the inner cheeks, gums, sides of the tongue, and as bumps or blisters on the hands, feet, and, sometimes, other parts of the skin. The skin rash may last for 7 to 10 days.

How common is HFMD?

HFMD is fairly common; most cases occurring in the summer and early fall.

Who should be especially careful about HFMD? Who is likely to get HFMD?

Young children under 10 years of age are primarily affected, but it may be seen in adults. Outbreaks may occur among groups of children, especially in childcare centers or nursery schools.

How is HFMD spread? How do people get HFMD?

HFMD is moderately contagious. The spread of the disease can occur through direct contact with nasal discharge, saliva, feces, and fluid from the blisters. It can also spread indirectly through contact with toys, books, eating utensils, towels, and other articles used by an infected individual. The infection is spread most easily when people are feeling ill and sores are present in the mouth, but the virus can be spread for several weeks after that.

How do I protect myself from HFMD?

Preventive measures include frequent handwashing, especially after diaper changes; disinfection of contaminated surfaces by household cleaners (such as diluted bleach solution made by mixing 1 capful of chlorine bleach with 1 gallon water); and, washing soiled articles of clothing. 

How do I protect others from HFMD?

Children are often excluded from childcare programs, schools, or other group settings during the first few days of the illness. 

What do I do if I think my child has HFMD?

Notify the child's healthcare provider. The disease is usually mild and short lasting. However, among younger children, the virus can cause rare complications such as inflammation of the brain and heart. Seek prompt treatment when there are signs of complications, such as pain in neck or arms and legs, decrease in alertness, high fever not reduced by medication, dehydration, or worsening of general condition.

How is HFMD diagnosed?

Usually, the physician can distinguish between HFMD and other causes of mouth sores based on the age of the patient, the pattern of symptoms, and the appearance of the rash and sores on examination.  A throat swab or stool specimen may be sent to a laboratory to determine which virus caused the illness; however, these tests usually take 2 to 4 weeks to obtain a final answer, so the physician usually does not order them. 

How is HFMD treated?

There is currently no effective treatment for the infection, and, in most cases, specific treatment is not necessary. The fever, rash, and ulcers should subside spontaneously in one week, and full recovery is usual. Treatment of symptoms is given to provide relief from fever, aches, or pain from the ulcers. Antiseptic mouth washes and simple analgesics such as paracetamol relieve the discomfort of eating.

Should I worry about HFMD when I travel out of the country?

Although individual cases and outbreaks of HFMD occur worldwide, there are no specific precautions against HFMD.

Last Updated: Saturday, October 01, 2005

Texas Department of State Health Services - Infectious Disease Control Unit
1100 West 49th Street, Suite T801, Mail Code: 1960 PO BOX 149347 - Austin, TX 78714-9347
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