Hand Foot And Mouth Disease

Hand-foot-and-mouth disease (HFMD) is a mild, but highly contagious viral infection. It is caused by a virus, most commonly the coxsackievirus and often affects children, although it can affect people of all ages. It is spread via direct contact (skin to skin) with an infected person or surfaces contaminated with feces. It can also be transmitted through contact with a person’s saliva, stool, or respiratory secretions. 

Symptoms of HFMD include blisters or sores in the mouth and a rash on the hands and feet. Treatment of HFMD is supportive, as there is no targeted medication for HFMD. It’s generally a mild condition that is self-limiting and often only last around 7-10 days.   

There are ways to lower you and your child’s risk of infection and that is by practicing frequent hand-washing and of course by avoiding close contact with people who have HFMD.  

What are the symptoms of hand, foot, and mouth disease?

Hand-foot-and-mouth disease may cause all of the following symptoms or only some of them. They include: 


  • Fever. 
  • Sore throat. 
  • Headache. 
  • Malaise (feeling unwell)  
  • Painful, blister-like lesions or sores on the tongue, gums and inside of the cheeks. 
  • A rash on the palms, soles and sometimes the buttocks. The rash is not itchy, but sometimes it has blisters. Depending on skin tone, the rash may appear red, white, gray, or only show as tiny bumps. 
  • Drooling. 
  • Fussiness in infants and toddlers. 
  • Loss of appetite. 


Symptoms appear around 3-6 days after getting infected by the virus (known as the incubation period). The typical first symptoms of HFMD are fever and sore throat. This may be associated with a decrease in appetite and a general feeling of being sick or unwell.  

The characteristic blisters and rashes usually show up around 1-2 days after the fever. These painful blisters or sores is typically seen in the front of the mouth or throat followed by a rash on the hands and feet and sometimes even on the buttocks.  

What causes hand, foot, and mouth disease?

The most common cause of HFMD is a virus called coxsackievirus A16. This coxsackievirus belongs to a group of viruses called nonpolio enteroviruses. However, other types of enteroviruses can still cause hand-foot-and-mouth disease. 

Mode of transmission of this virus include contact with an infected person’s:  

  • saliva 
  • fluid from blisters 
  • feces/stool 
  • nose secretions or throat discharge 
  • respiratory droplets that are sprayed into the air after coughing or sneezing 


HFMD can also be transmitted through direct contact with unwashed hands or a surface containing traces of the virus. 

Additionally, HFMD is also common in child care setting. A reason for this is because young children often need diaper changes and assistance in using the toilet.  And as we know full well, children also tend to put their hands in their mouths frequently. 

If your child is diagnosed with HFMD, bear in mind that he/she is most contagious during the first week of infection. However, it important to note that they can still be infectious for weeks after their symptoms go away. This is because the virus can linger in the body post infection.  

Unfortunately, in some cases, especially in infected adults, they can pass the virus without exhibiting any symptoms of the disease. 

Who is at risk for hand, foot, and mouth disease?

The main risk factor for HFMD is age. Statistically, young children have the highest risk for getting HFMD. That risk doubles if they go to school or are in day care centers, as these facilities are particularly susceptible to the spread of the virus. The disease mostly affects children younger than ages 5 to 7 years. 

Again, HFMD typically affects young children, but is not limited to one age group. Adolescents and adults sometimes still get hand-foot-and-mouth disease. Though they have often built antibodies after exposure to the viruses that cause HFMD, it is not unheard of for adults to still become infected, especially if they have weakened immune systems. 

What are the complications of hand, foot, and mouth disease? 

The most common complication of hand-foot-and-mouth disease is dehydration. Due to HFMD’s characteristic sores in the mouth and throat, swallowing can be very painful. Therefore, it is best to urge your child to drink fluids frequently during the illness so as to avoid dehydration. If severely dehydrated, they may have to be hospitalized and intravenous (IV) fluids administered.  

In most cases, HFMD is a minor, self-limiting disease that usually only causes fever and mild symptoms for a few days and does not develop into anything more serious. However, in some rare occasions, some enteroviruses that cause HFMD enters the brain and causes serious complications such as: 

  • Viral meningitis: A rare infection and inflammation of the membranes (meninges) and cerebrospinal fluid surrounding the brain and spinal cord. 
  • Encephalitis: A rare but severe and potentially life-threatening disease that involves brain inflammation.  

What is the treatment for hand, foot and mouth disease?

As mentioned earlier, HFMD is often a self-limiting disease, and can even resolve on its own without treatment in 7 to 10 days. There is also no specific treatment for HFMD, instead treatment is only supportive, which means that your doctor may recommend certain treatments to help you’re your symptoms until the disease has run its course. These can include: 

  • prescription or over-the-counter topical oral anesthetic ointments to soothe mouth sores   
  • prescription or over-the-counter topical ointments to relieve painful or itchy blisters and rashes 
  • pain medication, such as acetaminophen or ibuprofen, to relieve headaches 
  • medicated syrups or lozenges to ease painful sore throats 

About The Author

Dr. Hannah is a highly-skilled and compassionate physician who completed her medical degree at Pamantasan ng Lungsod ng Maynila in 2014. She passed the Physician Licensure Exam in 2015, and has since gained experience working in various hospitals and clinics throughout Metro Manila. For three years, she served as a physician on duty at a dialysis institute, caring for patients with chronic lifestyle diseases. 


As a primary care physician, Dr. Hannah is dedicated to providing patient-centered care that takes into account the whole person, not just their illness. She believes in empowering her patients to take an active role in their healthcare, and believes that this type of doctor-patient relationship is key to achieving optimal health. 

Experience EVA Teleconsult