- Common clinical syndrome caused by enterovirus serotypes
- Classic appearance of oral enanthem along with exanthem of hands and feet (classically) and potentially located elsewhere
- Exanthem (rash) may be macular, maculopapular, and/or vesicular.
- Synonym(s): herpangina (when affecting oral mucosa and posterior pharynx)
- Self-limiting illness resolves in 7 to 10 days
- Moderately contagious
- Infection is spread by direct contact with nasal secretions, saliva, blister fluid, or stool.
- Infected individuals are most contagious during the 1st week of the illness but may continue to spread illness for days to weeks after. Some exposed individuals (especially adults) may be asymptomatic but still contagious.
- The viruses that cause hand-foot-and-mouth disease (HFMD) can persist for weeks after symptoms have resolved, most commonly in stool, allowing transmission following resolution of symptoms.
- The incubation period is 3 to 7 days (1).
Etiology and Pathophysiology
- HFMD is not the same as foot (hoof) and mouth disease found in cattle, and there is no cross species infectious concern (3).
- Transmission by the fecal–oral route or contact with skin lesions or oral secretions; caused by viruses that belong to the Enterovirus genus and replicated in the GI tract, most commonly coxsackievirus A16 and enterovirus 71.
- Also coxsackie viruses A5, A7, A9, A10, B2, B5
- More severe cases are associated with enterovirus 71 (4).
- Hand washing, especially around food handling or diaper changes
- Exclusion of children from group settings during the first few days of the illness in the presence of open lesions in the mouth or on the skin may reduce the spread of infection.
- Hand hygiene measures are effective in reducing transmission.
- Pregnant woman should avoid contact with infected individuals.
- New vaccine showing promise in clinical trials to decrease the incidence and prevalence (5)
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Domino, Frank J., et al., editors. "Hand-Foot-and-Mouth Disease." 5-Minute Clinical Consult, 27th ed., Wolters Kluwer, 2020. www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/816160/all/Hand_Foot_and_Mouth_Disease.
Hand-Foot-and-Mouth Disease. In: Domino FJF, Baldor RAR, Golding JJ, et al, eds. 5-Minute Clinical Consult. Wolters Kluwer; 2020. https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/816160/all/Hand_Foot_and_Mouth_Disease. Accessed May 27, 2023.
Hand-Foot-and-Mouth Disease. (2020). In Domino, F. J., Baldor, R. A., Golding, J., & Stephens, M. B. (Eds.), 5-Minute Clinical Consult (27th ed.). Wolters Kluwer. https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/816160/all/Hand_Foot_and_Mouth_Disease
Hand-Foot-and-Mouth Disease [Internet]. In: Domino FJF, Baldor RAR, Golding JJ, Stephens MBM, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2020. [cited 2023 May 27]. Available from: https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/816160/all/Hand_Foot_and_Mouth_Disease.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Hand-Foot-and-Mouth Disease ID - 816160 ED - Domino,Frank J, ED - Baldor,Robert A, ED - Golding,Jeremy, ED - Stephens,Mark B, BT - 5-Minute Clinical Consult, Updating UR - https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/816160/all/Hand_Foot_and_Mouth_Disease PB - Wolters Kluwer ET - 27 DB - 5-Minute Clinical Consult DP - Unbound Medicine ER -