Hand-foot-and-mouth disease is an enterovirus infection (such as coxsackieviruses) that causes fever and a rash on the hands, feet, and mouth, most often in young children.
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Hand-foot-and-mouth disease is caused by various enteroviruses and is usually spread by coming into contact with contaminated objects, surfaces, or air droplets.
Symptoms include fever, painful mouth sores, and a rash.
The diagnosis is based on an examination of the mouth sores and rash.
Treatment includes measures to relieve pain and fever.
Good hand hygiene can help prevent the infection.
This disease can be caused by many different enteroviruses, such as coxsackieviruses, and is most common among young children. Hand-foot-and-mouth disease is more common in the spring, summer, and fall but can occur in winter.
People become infected when they come into contact with any of the following:
An infected person with open skin lesions
Droplets spread through the air when an infected person coughs or sneezes
Feces, such as changing diapers of an infected person, then touching the eyes, nose, or mouth before washing hands
Contaminated objects and surfaces, such as doorknobs, then touching the eyes, mouth, or nose before washing hands
People are most contagious during the first week of illness.
Symptoms of Hand-Foot-and-Mouth Disease
DR P. MARAZZI/SCIENCE PHOTO LIBRARY
A common symptom of hand-foot-and-mouth disease is fever. This disease affects the skin and mucous membranes, causing painful sores to appear inside the mouth. The rash typically appears on the hands and feet, and occasionally on the arms, upper legs, buttocks, or genitals and less commonly on the torso and face. Children have a sore throat or mouth pain and may refuse to eat. The sores usually heal quickly.
DR P. MARAZZI/SCIENCE PHOTO LIBRARY
Depending on which virus causes this disease, children rarely develop central nervous system infections such as aseptic meningitis, acute flaccid myelitis (AFM), or encephalitis.
A strain of coxsackievirus that causes atypical forms of hand-foot-and-mouth disease can cause the sores to appear on different parts of the body. The sores vary in size and sometimes are severe. Aseptic meningitis may also occur with these atypical forms, but most people recover completely.
Diagnosis of Hand-Foot-and-Mouth Disease
A doctor's evaluation
To diagnose hand-foot-and-mouth disease, doctors examine the sores.
Doctors may send samples of material taken from the throat or stool to a laboratory for culture and testing.
Treatment of Hand-Foot-and-Mouth Disease
Symptom relief
Treatment of hand-foot-and-mouth disease is aimed at relieving symptoms, including controlling pain, treating mouth sores and inflammation, and staying hydrated.
Medications such as acetaminophen or ibuprofen can relieve pain and fever. (CAUTION: Medications such as acetaminophen or ibuprofen can relieve pain and fever. (CAUTION:Aspirin should not be given to children because of the risk of Aspirin should not be given to children because of the risk ofReye syndrome.) It is important to drink enough liquids to avoid dehydration, even if mouth sores are painful.
Prevention of Hand-Foot-and-Mouth Disease
Good hygiene
A simple and effective way to help prevent hand-foot-and-mouth disease is handwashing. Caregivers should wash their hands after changing diapers. Because most infections that cause hand-foot-and-mouth disease are transmitted by person-to-person contact, particularly through direct or indirect contact with infected stool, good handwashing with soap and water after a bowel movement is an important means of prevention.
Diaper-changing areas should be disinfected with a freshly prepared solution of household bleach (¼ cup [60 mL] bleach diluted in 1 gallon [3.79 L] of water). Frequently touched surfaces and soiled items, including toys, should be cleaned and disinfected.
People should avoid close contact, such as kissing and hugging, and sharing eating utensils or cups with infected people.
Three vaccines for one of the enteroviruses that causes hand-foot-and-mouth disease (EV-A71) are currently available in China. There is currently no vaccine approved for use in the United States against the viruses that cause hand-foot-and-mouth disease.
