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Hand, Foot, Mouth Disease

February 17, 2010 by Staff  
Filed under Health Conditions / Ailments

Hand, foot and mouth disease (HFMD) (not to be confused with Foot-and-mouth disease) is a human syndrome caused by intestinal viruses of the Picornaviridae family. The most common strains causing HFMD are Coxsackie A virus and Enterovirus 71 (EV71).

HFMD usually affects infants and children, and is quite common. It is moderately contagious and is spread through direct contact with the mucus, saliva, or feces of an infected person. It typically occurs in small epidemics in nursery schools or kindergartens, usually during the summer and autumn months. The usual incubation period is 3–7 days.

It is extremely uncommon in adults; however, still a possibility. Most adults have strong enough immune systems to defeat the virus, but those with immune deficiencies are very susceptible. HFMD is not to be confused with foot-and-mouth disease (also called hoof-and-mouth disease), which is a disease affecting sheep, cattle, and swine, and which is unrelated to HFMD (but also caused by a member of the Picornaviridae family).

Signs and symptoms

Symptoms of HFMD include:

  • Fever
  • Headache
  • Vomiting
  • Fatigue
  • Malaise
  • Referred ear pain
  • Sore throat
  • Painful oral lesions
  • Non-itchy body rash, followed by sores with blisters on palms of hands and soles of feet
  • Oral ulcer
  • Sores or blisters may be present on the buttocks of small children and infants
  • Irritability in infants and toddlers
  • Loss of appetite.
  • Diarrhea

The common incubation period (the time between infection and onset of symptoms) is from three to seven days.

Early symptoms are likely to be fever often followed by a sore throat. Loss of appetite and general malaise may also occur. Between one and two days after the onset of fever, painful sores (lesions) may appear in the mouth and/or throat. A rash may become evident on the hands, feet,mouth,tongue,inside of the cheeks, and occasionally the buttocks (but generally, the rash on the buttocks will be caused from the diarrhea.) Not all symptoms will be present in all cases.


There is no specific treatment for hand, foot and mouth disease. Individual symptoms, such as fever and pain from the sores, may be eased with the use of medication. HFMD is a viral disease that has to run its course; many doctors do not issue medicine for this illness, unless the infection is severe. Infection in older children, adolescents, and adults is normally very mild and lasts around 1 week or sometimes more. Fever reducers will help to control high temperatures. Luke-warm baths will also help bring temperature down.

Only a very small minority of sufferers require hospital admission, mainly as a result of neurological complications (encephalitis, meningitis, or acute flaccid paralysis) or pulmonary edema/pulmonary hemorrhage.

Recorded outbreaks of a deadly strain


  • In 1997, 31 children died in an outbreak in the Malaysian state of Sarawak.


  • In 1998, there was an outbreak in Taiwan, affecting mainly children. There were 405 severe complications, and 78 children died. The total number of cases in that epidemic is estimated to have been 1.5 million.


  • In 2006, 7 people died in an outbreak in Kuching, Sarawak (according to the New Straits Times, March 14).
  • In 2006, after an outbreak of Chikungunya in southern and some western parts of India, cases of HFMD were reported.


  • An outbreak in China, beginning in March in Fuyang, Anhui, lead to 25,000 infections, and 42 deaths, by May 13. Similar outbreaks were reported in Singapore (more than 2,600 cases as of April 20, 2008), Vietnam (2,300 cases, 11 deaths), Mongolia (1,600 cases,and Brunei (1053 cases from June – August 2008)


  • 17 children died in an outbreak in during March and April 2009 in China's eastern Shandong Province, and 18 children died in the neighboring Henan Province. Out of 115,000 reported cases in China from January to April, 773 were severe and 50 were fatal.
  • In Indonesia, where the disease is often called Singaporean influenza or flu Singapura, the disease was reported in the Jakarta area, starting with eight young children. By late April, Jakartan health agencies were warning community health centers and advocating preventive steps, including the use of thermal scanners in airports and avoiding travel to Singapore.
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