What is hand, foot, and mouth disease?

Hand, foot, and mouth disease is a highly contagious infection. It’s caused by viruses from the Enterovirus genus, most commonly the coxsackievirus. These viruses can spread from person-to-person through direct contact with unwashed hands or surfaces contaminated with feces. It can also be transmitted through contact with an infected person’s saliva, stool, or respiratory secretions.

Hand, foot, and mouth disease is characterized by blisters or sores in the mouth and a rash on the hands and feet. The infection can affect people of all ages, but it usually occurs in children under age 5. It is generally a mild condition that goes away on its own within several days.

The symptoms begin to develop three to seven days after the initial infection. This period is known as the incubation period. When symptoms do appear, you or your child may experience:

A fever and sore throat are usually the first symptoms of hand, foot, and mouth disease. The characteristic blisters and rashes show up later, usually one or two days after the fever begins.

Hand, foot, and mouth disease is often caused by a strain of coxsackievirus, most commonly coxsackievirus A16. The coxsackievirus is part of a group of viruses called enteroviruses. In some cases, other types of enteroviruses can cause hand, foot, and mouth disease.

Viruses can be easily spread from person-to-person. You or your child may contract hand, foot, and mouth disease through contact with an infected person’s:

  • saliva
  • fluid from blisters
  • feces
  • respiratory droplets sprayed into the air after coughing or sneezing

Hand, foot, and mouth disease can also be transmitted through direct contact with unwashed hands or a surface containing traces of the virus.

Young children have the highest risk of getting hand, foot, and mouth disease. Risk increases if they attend daycare or school, as viruses can spread quickly in these facilities. Children usually build up immunity to the disease after being exposed to the viruses that cause it. This is why the condition rarely affects people over age 10. However, it’s still possible for older children and adults to get the infection, especially if they have weakened immune systems.

A doctor can often diagnose hand, foot, and mouth disease simply by performing a physical exam. They’ll check the mouth and body for the appearance of blisters and rashes. The doctor will also ask you or your child about other symptoms.

The doctor may take a throat swab or stool sample that can be tested for the virus. This will allow them to confirm the diagnosis.

In most cases, the infection will go away without treatment in seven to 10 days. However, your doctor may recommend certain treatments to help ease symptoms until the disease has run its course. These can include:

  • prescription or over-the-counter topical ointmentsto soothe blisters and rashes
  • pain medication, such as acetaminophen or ibuprofen, to relieve headaches
  • medicated syrups or lozengesto ease painful sore throats

Certain at-home treatments can also provide relief from hand, foot, and mouth disease symptoms. You can try the following home remedies to help make blisters less bothersome:

  • Suck on ice or popsicles.
  • Eat ice cream or sherbet.
  • Drink cold beverages.
  • Avoid citrus fruits, fruit drinks, and soda.
  • Avoid spicy or salty foods.

Swishing warm salt water around in the mouth may also help relieve the pain associated with mouth blisters and throat sores. Do this several times a day or as often as needed.

You or your child should feel completely better within five to seven days after the initial onset of symptoms. Re-infection is uncommon. The body usually builds up immunity to the viruses that cause the disease.

Call a doctor immediately if symptoms get worse or don’t clear up within ten days. In rare cases, coxsackievirus can cause a medical emergency.

Practicing good hygiene is the best defense against hand, foot, and mouth disease. Regular hand-washing can greatly reduce your risk of contracting this virus.

Teach your children how to wash their hands using hot water and soap. Hands should always be washed after using the restroom, before eating, and after being out in public. Children should also be taught not to put their hands or other objects in or near their mouths.

It’s also important to disinfect any common areas in your home on a regular basis. Get in the habit of cleaning shared surfaces first with soap and water, then with a diluted solution of bleach and water. You should also disinfect toys, pacifiers, and other objects that may be contaminated with the virus.

If you or your child experience symptoms such as a fever or sore throat, stay home from school or work. You should continue avoiding contact with others once the telltale blisters and rashes develop. This can help you avoid spreading the disease to others.


My daughter has hand, foot, and mouth disease. How long is she contagious and when can she start going back to school?

Anonymous patient


Persons with HFMD are most contagious during the first week of the illness. They can sometimes remain contagious, though to a lesser degree, for a few weeks after symptoms go away. Your child should stay at home until her symptoms resolve. She may then return to school, but still needs to try and avoid close contact with her peers, including allowing others to eat or drink after her. She also needs to wash her hands frequently and avoid rubbing her eyes or mouth, as the virus can be transmitted through body fluids.

Mark Laflamme, M.D.Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.