Public Health Guidance: Hand, Foot, and Mouth Disease

Hand, foot, and mouth disease is a common childhood illness caused by viruses—most often by a virus called coxsackievirus A16—found in the fluids from the nose, throat, skin blisters, and feces (poop) of an infected person.

Though it usually is not serious, HFMD is very contagious and can spread quickly at schools and day care centers. It occurs mainly in children under age 5, but older kids and adults also can get it. (In adults, symptoms tend to be less severe than in young children.) The virus can spread through:

• contact with respiratory droplets after a sick person coughs, sneezes, or talks.
• contact with infected saliva, nasal discharge, or fluid from the blisters caused by the illness.
• close contact with an infected person through kissing, hugging, or sharing cups or eating utensils.
• contact with an infected person’s feces (can occur when changing a child’s diaper and then touching your eyes, nose, or mouth before washing hands, or when using the toilet without washing hands afterwards).
• contact with objects and surfaces that have the virus on them, like doorknobs, toys, or cell phones.

SYMPTOMS
Symptoms usually develop within 3 to 6 days of becoming infected. Typically, the first symptoms include fever, feeling unwell, sore throat, and poor appetite. About two days after the first signs of sickness, a child may get painful small sores in and around the mouth, and a skin rash of blister-like sores on the palm of hands and soles of feet (and sometimes in other areas). People with hand, foot, and mouth disease are most contagious during the first week of illness.

HFMD can be uncomfortable, but it rarely causes long-term issues and usually resolves on its own in about 7-10 days without medical treatment. However, if you think your child has the virus, it’s always best to contact a healthcare professional for proper diagnosis and guidance, including information on any over-the-counter medications to help ease your child’s discomfort.

Contact a healthcare provider if your child is not drinking enough fluids, has a fever lasting longer than 3 days, is less than 6 months old, has illness lasting longer than 10 days, or has severe symptoms.

PREVENTION
Practicing healthy hand hygiene is the best way to help prevent getting the virus. To protect your family from HFMD, health officials recommend the following:

• Wash hands with soap and water frequently (at least 20 seconds each time) especially after changing diapers, using the toilet, blowing your nose, coughing/sneezing, and before and after caring for a sick person.
• Discourage your children from sharing anything that goes in and around the mouth or nose, such as toys, cups, glasses, and utensils.
• Clean and disinfect frequently touched surfaces and shared objects, like doorknobs and toys. HFMD does not require specific disinfecting products.
• Avoid touching your eyes, nose, and mouth with unwashed hands.
• Avoid coming in close contact with infected persons.

GUIDELINES ON RETURNING TO SCHOOL
Please notify your child’s school or day care if your child has hand, foot, and mouth disease. Keep your child at home until he or she is:

• fever-free for a full 24 hours without the use of fever-reducing medication.
• has no open sores that cannot be covered.

Your child’s school or day care may have a different policy about when your child can return, so be sure to contact the school and follow any guidelines it may have. In addition, your child’s healthcare provider can help determine what is best based on your child’s individual needs.

NEED MORE INFORMATION?
Please call your county health department for further guidance or information about HFMD or other contagious illnesses that begin circulating this time of year.