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Hand, Foot, and Mouth Disease is a viral disease that is extremely common in children. In most cases, the symptoms are mild and self-limiting although, in a small percentage of cases, some serious complications can occur. Read on to find out more.

What is Hand, Foot and Mouth Disease?

Hand, Foot, and Mouth Disease — or HFMD — is an extremely common, highly contagious viral infection. It is seen most commonly in children below five years of age but can occur in older children and adults as well. It is commonly confused with the foot and mouth disease seen in cattle but there is no similarity between these two diseases. They are caused by two completely different sets of viruses.

Causes and spread of Hand, Foot and Mouth Disease

It is most commonly caused by the Coxsackievirus belonging to the Enterovirus group. Sometimes other Enteroviruses have also been shown to have caused HFMD.

This infection is highly contagious and the virus is present in the infected child’s saliva, spit, nasal mucus, and feces. The disease can be transmitted by being in close contact with the infected child. Kissing an infected child, or touching a doorknob on which the infected child just sneezed or coughed are common methods of infection. Fecal contamination while changing an infected child’s diaper can also occur.

Infection due to playing with toys contaminated with saliva, spit or nasal mucus of an infected child are all common ways of contracting HFMD. It commonly spreads like an epidemic in schools and daycares, starting with one child. So if you suspect that your child may be suffering from HFMD — please don’t send the child to school or daycare.

Signs and symptoms of Hand, Foot and Mouth Disease

  • Low-grade fever and a general feeling of dullness and lethargy usually appear first.
  • One or two days later, rashes or blisters on palms of hands and soles of feet which are accompanied by blisters or ulcers in the mouth as well. There may be rashes on the buttocks as well. The presence of these rashes is considered as the classic symptom for this kind of viral infection.
  • An itchy sensation may be present in the area of the rashes.
  • Sore throat or even the presence of blisters present in the back of the mouth or throat.
  • Reduced appetite as the child is unable to enjoy food due to mouth ulcers

It is not necessary that all symptoms be present together. Mild cases may present with just rash or redness with no other symptoms.

Diagnosis of Hand, Foot and Mouth Disease

The pediatrician will carry out a clinical examination and usually, this and the history is enough to diagnose HFMD. However, laboratory examination of samples from the patient’s throat and feces can confirm the presence of the virus. Since the mode of treatment is unlikely to change, lab investigations are seldom carried out.

Complications of Hand, Foot and Mouth Disease

Dehydration is a common complication of HFMD, as the child may find it uncomfortable to eat and drink. Making sure that the fluid intake is adequate is very important or else IV fluids may be required. Other Complications of HFMD are rare, however, but they could include:

  • Encephalitis
  • Viral meningitis can occur along with HMFD
  • Rare cases show loss of toenails and fingernails.

Treatment Of Hand, Foot, and Mouth Disease

It is a self-limiting disease and only symptomatic treatment is required.

  • Over the counter drugs like acetaminophen for fever and Ibuprofen for pain may be given. Aspirin should never be given to children because of its anti-platelet properties which can increase the tendency for bleeding.
  • Mouth gels may be applied locally on the mouth blisters for pain relief.

Soft and cold food like mashed potatoes, yogurt, and ice cream may be easier for the child to eat. Nutrition can be maintained by mashing healthy foods and including them in smoothies.

HFMD is usually most contagious in the first week to ten days of the infection, but in some children, it may stay contagious for longer as well. The child must not be sent to school or daycare during the infective period so as to prevent any interaction with other children and any spread of infection.

Prevention Of Hand, Foot And Mouth Disease

Unfortunately, there is no vaccine to prevent HFMD yet, but researchers are working on it. The disease is highly contagious in nature, so the only way to prevent its spread is to follow stringent hygiene practices.

  • Teach your child the importance of washing hands frequently, especially after using the restroom, or coming back home from any public area, or before eating. Hands must always be washed thoroughly using water and soap for at least twenty seconds each time.
  • Teach your child not to touch contaminated or dirty-looking things.
  • All toys, playmats, gym mats, and other surfaces at school and daycare must be washed regularly.
  • Teach your child not to share items of personal hygiene like towels, handkerchiefs etc with other children.


HFMD may be a part of the first five years of your child’s life but it is not a cause of any major concern. It can be prevented by following good hygiene practices at home and in school. Recognizing the symptoms early and ensuring that the child is quarantined during the infective phase of the infection is perhaps the most important aspect in dealing with this problem.

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