Hand, Foot and Mouth Disease

What is hand, foot, and mouth disease?

Hand, foot and mouth disease (HFMD) is due to an infection that usually causes a typical illness, including a typical rash. It is most commonly caused by the Coxsackie A16 virus. 

 Some cases are caused by a different, but related, virus called enterovirus 71. Rarely, the same

illness is caused by other strains of Coxsackie virus

What are the symptoms?

 HFMD most commonly affects children under 10 years of age. Older children and adults are sometimes affected. Adults and older children with HFMD tend to develop a milder form of the illness compared with younger

children.  But adults can sometimes have quite severe

symptoms.

Like many viral infections, the illness often starts with a feeling of being unwell for a day or so. This might include a high temperature (fever). After this, a sore throat commonly occurs, quickly followed by small spots that develop inside the mouth. These soon progress into small mouth ulcers.

In about 3 in 4 cases, spots also develop on the skin. This is typically a day or so after the mouth ulcers develop. The spots are small lumps that are a few millimetres in diameter and usually appear on the hands and feet. Spots sometimes also appear on the buttocks, legs and genitals. They rarely develop on other parts of the body. The spots are similar to chickenpox, but are smaller. Unlike chickenpox, they are not usually itchy but can be quite tender.

Is hand, foot and mouth disease infectious?

 Yes. The incubation period is 3-5 days. This means it takes 3-5 days to develop symptoms after  being infected from another person. Most cases are passed on by coughing and sneezing which transmits the virus into the air. It is mainly infectious until the spots and mouth ulcers have gone.

However, children can still be mildly infectious for several weeks longer, as the virus may be passed out with the faeces (stools) for several weeks after the symptoms have gone.

Therefore, it is sensible to maintain good hygiene to reduce the chance of passing on the virus.

 For example:

· Make sure that children wash their hands thoroughly after using the toilet.

· Aim to keep mouth and nose covered when coughing and sneezing. Wipe the nose and mouth with disposable tissues.

· Adults should take particular care when handling nappies and tissues. Wash hands thoroughly after handling nappies and tissues.

What about going to school?

Guidance from the Health Protection Agency is that children should not routinely be kept from school if they have hand, foot and mouth disease, if they are well enough in themselves to attend. Although there is a risk of passing it on to others, the illness is usually mild