Merck Manual

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Hand-Foot-and-Mouth Disease

By

Brenda L. Tesini

, MD, University of Rochester School of Medicine and Dentistry

Reviewed/Revised Jun 2023
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Topic Resources
  • Hand-foot-and-mouth disease is caused by various enteroviruses and is usually spread by coming into contact with contaminated material 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 coxsackievirus, 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 (for example, by hugging)

  • 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

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.

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.

Drugs such as acetaminophen or ibuprofen can relieve pain and fever. (CAUTION: Aspirin should not be given to children because of the risk of Reye syndrome Reye Syndrome Reye syndrome is a very rare but life-threatening disorder that causes inflammation and swelling of the brain and impairment and loss of function of the liver. The cause of Reye syndrome is... read more .) Teeth should be brushed gently with a soft toothbrush and rinsed with salt water. People should eat a soft diet and avoid acidic or salty foods. 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.

There is currently no vaccine approved for use in the United States against the viruses that cause hand-foot-and-mouth disease.

Drugs Mentioned In This Article

Generic Name Select Brand Names
7T Gummy ES, Acephen, Aceta, Actamin, Adult Pain Relief, Anacin Aspirin Free, Apra, Children's Acetaminophen, Children's Pain & Fever , Comtrex Sore Throat Relief, ED-APAP, ElixSure Fever/Pain, Feverall, Genapap, Genebs, Goody's Back & Body Pain, Infantaire, Infants' Acetaminophen, LIQUID PAIN RELIEF, Little Fevers, Little Remedies Infant Fever + Pain Reliever, Mapap, Mapap Arthritis Pain, Mapap Infants, Mapap Junior, M-PAP, Nortemp, Ofirmev, Pain & Fever , Pain and Fever , PAIN RELIEF , PAIN RELIEF Extra Strength, Panadol, PediaCare Children's Fever Reducer/Pain Reliever, PediaCare Children's Smooth Metls Fever Reducer/Pain Reliever, PediaCare Infant's Fever Reducer/Pain Reliever, Pediaphen, PHARBETOL, Plus PHARMA, Q-Pap, Q-Pap Extra Strength, Silapap, Triaminic Fever Reducer and Pain Reliever, Triaminic Infant Fever Reducer and Pain Reliever, Tylenol, Tylenol 8 Hour, Tylenol 8 Hour Arthritis Pain, Tylenol 8 Hour Muscle Aches & Pain, Tylenol Arthritis Pain, Tylenol Children's, Tylenol Children's Pain+Fever, Tylenol CrushableTablet, Tylenol Extra Strength, Tylenol Infants', Tylenol Infants Pain + Fever, Tylenol Junior Strength, Tylenol Pain + Fever, Tylenol Regular Strength, Tylenol Sore Throat, XS No Aspirin, XS Pain Reliever
Advil, Advil Children's, Advil Children's Fever, Advil Infants', Advil Junior Strength, Advil Migraine, Caldolor, Children's Ibuprofen, ElixSure IB, Genpril , Ibren , IBU, Midol, Midol Cramps and Body Aches, Motrin, Motrin Children's, Motrin IB, Motrin Infants', Motrin Junior Strength, Motrin Migraine Pain, PediaCare Children's Pain Reliever/Fever Reducer IB, PediaCare Infants' Pain Reliever/Fever Reducer IB, Samson-8
Anacin Adult Low Strength, Aspergum, Aspir-Low, Aspirtab , Aspir-Trin , Bayer Advanced Aspirin, Bayer Aspirin, Bayer Aspirin Extra Strength, Bayer Aspirin Plus, Bayer Aspirin Regimen, Bayer Children's Aspirin, Bayer Extra Strength, Bayer Extra Strength Plus, Bayer Genuine Aspirin, Bayer Low Dose Aspirin Regimen, Bayer Womens Aspirin , BeneHealth Aspirin, Bufferin, Bufferin Extra Strength, Bufferin Low Dose, DURLAZA, Easprin , Ecotrin, Ecotrin Low Strength, Genacote, Halfprin, MiniPrin, St. Joseph Adult Low Strength, St. Joseph Aspirin, VAZALORE, Zero Order Release Aspirin, ZORprin
NOTE: This is the Consumer Version. DOCTORS: VIEW PROFESSIONAL VERSION
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