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hand foot mouth disease

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"Hand, Foot and Mouth Disease"[MeSH Terms]

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CDC hand foot and mouth disease symptoms treatment when to seek medical care

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https://www.cdc.gov/hand-foot-mouth/about/index.html

Hand-foot-and-mouth disease (HFMD) is a common, contagious viral infection, usually in children younger than 5, though adults can get it too. It is most often caused by enteroviruses such as coxsackievirus. It is not the same as foot-and-mouth disease in animals.

Typical symptoms

  • Fever, sore throat, tiredness, reduced appetite
  • Painful red spots or blisters inside the mouth, tongue, gums, or throat
  • Red spots or small blisters on the palms and soles
  • Rash can also appear on buttocks, legs, or arms
It usually clears on its own within 7 to 10 days. Textbook descriptions emphasize mouth erosions plus papulovesicles on palms and soles, with most cases resolving without serious effects. Fitzpatrick's Dermatology, Vol. 1-2, lines 510-518.

Treatment

There is no specific antiviral treatment for routine HFMD. Care is mainly supportive:
  • Encourage frequent fluids. Cold drinks, ice pops, and soft foods may hurt less.
  • Use age-appropriate acetaminophen/paracetamol or ibuprofen for fever and pain, following the package label or a clinician's advice.
  • Do not give aspirin to children.
  • Avoid acidic, spicy, or salty foods that sting mouth ulcers.
  • Keep blisters clean and avoid picking them.
The main complication to watch for is dehydration, because mouth sores can make swallowing painful. The CDC HFMD overview says most people recover with minimal treatment, while adequate fluid intake is important.

How it spreads

HFMD spreads easily through saliva and nasal secretions, fluid from blisters, stool, and contaminated surfaces. Reduce spread by:
  • Washing hands well, especially after diaper changes or toilet use
  • Cleaning shared toys and frequently touched surfaces
  • Not sharing cups, utensils, towels, or food
  • Avoiding close contact such as kissing while symptomatic

Seek medical care promptly if

  • The child cannot drink, has very few wet diapers/urinates much less, dry mouth, no tears, or unusual sleepiness
  • Fever is high, persistent, or the child seems very unwell
  • There is severe headache, stiff neck, confusion, breathing difficulty, or rapidly worsening rash
  • The child is an infant, immunocompromised, or symptoms are not improving after about 7 to 10 days
  • You are pregnant and believe you were exposed
The CDC symptoms guidance also highlights dehydration as the most important common complication.
Recent reviews identify increasing recognition of atypical skin patterns, especially with some viral strains. This does not change the usual supportive treatment, but unusual, widespread, severe, or very painful lesions should be assessed by a clinician. Relevant recent review: PMID 37877202.
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