Hand, foot and mouth disease

Hand, foot and mouth disease (HFMD) is a common viral infection that mostly only affects children. It generally affects children under 10 years of age, causing mild symptoms in most.

While it sounds similar, it is not related to foot-and-mouth disease found in farm animals.

Rarely, infection in pregnant women during the last few months of pregnancy can severely affect their unborn babies.

Symptoms

The classic sign of hand, foot and mouth disease is the appearance of red spots that develop into fluid-filled blisters; first inside the mouth and then on the hands and soles of the feet. These may be painful but should not be itchy.

Other signs and symptoms include:undefined

  • mild fever
  • loss of appetite
  • sore throat
  • malaise
  • headache
  • occasionally, a rash on the buttocks.

The illness lasts for seven to 10 days, although it may be possible to identify the virus in the person’s saliva or faeces for another 2 to 3 weeks.

Hand, foot and mouth disease is sometimes confused with chickenpox.

In chickenpox similar blisters are also found, so the two conditions are sometimes confused. Clues to the right diagnosis may be where the spots first appear and the colour of the blisters (sometimes yellow or red with HFMD and usually clear with chickenpox). In addition, the blisters in chickenpox tend to be itchy, while the blisters in HFMD may be painful.

Causes 

HFMD is caused by one of a family of viruses called enteroviruses, with the most common culprit being Coxsackie A.

The condition is highly infectious and is passed on via any bodily substance that contains the virus. This includes:

  • saliva, through coughing
  • nasal fluids, through sneezing
  • fluid from the blisters
  • faeces
  • transfer due to poor hand washing.

HFMD most commonly spreads during autumn and spring.

Once a person has been infected, it takes about three to six days for the virus to multiply before symptoms begin to appear.

The disease is most infectious during the first week after symptoms appear, and while the blisters contain fluid so keep away from kindy, school, or other children and pregnant women.

When a person develops hand, foot and mouth disease, he or she usually becomes immune to the virus that caused the infection. However, because other viruses can cause the same symptoms, the person is not immune to hand, foot and mouth disease itself.

Treatment

Because HFMD is caused by a virus, there is no cure. In most cases, symptoms are mild and the treatment of symptoms include:

  • paracetamol for management of any pain or fever
  • saltwater mouth rinses to ease the pain of the blisters in the mouth
  • rest
  • plenty of clear fluids - or ice chips if they are easier to take - to maintain fluid levels.

Complications

Most children with HFMD are only mildly unwell and recover fully over the course of 7 to 10 days. In rare cases, life-threatening complications such as encephalitis (inflammation of the brain) and pneumonitis (inflammation of the lung tissue) can occur.

Get medical assistance if your baby or child has the following signs and symptoms in addition to the typical HFMD symptoms:

  • vomiting
  • light sensitivity
  • stiff neck
  • difficulty waking
  • problems walking
  • trouble breathing
  • high fever.

In rare cases, babies exposed to enteroviruses (such as HFMD) through their mother in the last trimester of pregnancy become very ill once born, with any of the following:

  • inflammation of the liver (hepatitis)
  • disease of the heart muscle (cardiomyopathy)
  • low blood platelets (thrombocytopaenia)
  • inflammation of the brain and its membranes (meningoencephalitis).

Women in the third trimester of pregnancy who have been exposed to HFMD should tell their doctor, so they may be referred to a specialist team to monitor their condition and that of their baby.

Prevention 

There is no vaccine for HFMD, so prevention involves the usual common sense approaches, such as:

  • when coughing, cover your mouth, then wash your hands
  • regular hand washing
  • no sharing of food or drinks
  • if pregnant, avoid direct contact with the infected person.

To avoid passing HFMD on, it is a good idea to keep your child away from school or the childcare centre until the blisters have dried up.

Reviewed By: Dr Bronwyn Lloyd GP, November 2009. Latest review by Health Navigator May 2015