5 Things You Should Know About Hand, Foot, and Mouth Disease

JULY 20, 2017
Hand, foot, and mouth disease (HFMD) is a contagious viral infection common in infants and young children. It is often confused with foot-and-mouth disease (also known as hoof-and-mouth disease), which affects cattle, sheep, and swine.  Pharmacists can play an important role in counseling patients on symptoms and prevention strategies. Check out these 5 things pharmacists should know about HFMD.

HFMD generally affects infants and children younger than 5 years of age.
Young children are usually affected since they to do not yet have the immunity to the viruses that cause HFMD.1  Coxsackievirus A16 is the most common cause of HFMD. However, enterovirus 71 has been associated with some cases.2  Older children and adults can still become infected with HFMD. Infection is most likely to occur during spring, summer, and fall months in the United States.Generally, HFMD is a mild illness with a complete recovery expected in 7 to 10 days without medical treatment.1

Symptoms include painful sores in the mouth and rash on the hands and feet.
Other HFMD symptoms include the following:
  • Fever
  • Reduced appetite
  • Sore throat
  • Malaise
The symptoms generally appear in stages and the incubation period is usually 3 to 6 days.2 The most common complication is dehydration. The sore throat can cause swallowing to be painful for children. Counsel parents to make sure their child frequently sips fluid. If dehydration is severe, then intravenous (IV) fluids may be necessary.
HFMD rarely causes the following complications:
  • Viral meningitis resulting in symptoms of fever, headache, stiff neck, lethargy, and tiredness
  • Encephalitis (brain inflammation) causing flu-like symptoms, confusion, and seizures
HFMD is contagious.
Individuals are most likely to spread HFMD during the first week of illness. However, people can sometimes remain contagious for weeks after symptoms dissipate. The illness is common in child care settings due to frequent diaper changes, and children are constantly placing hands in their mouths. The virus can be spread through an infected person’s saliva, sputum, or nasal mucus, blister fluid, and feces. 
Individuals may spread HFMD through the following activities:
  • Close contact such as kissing, hugging, or sharing cups and eating utensils
  • Coughing and sneezing
  • Contact with feces, such as diaper changes
  • Touching contaminated objects or surfaces
There is no specific treatment for HFMD.
Fever and pain can be managed with over-the-counter medications such as acetaminophen or ibuprofen. Counsel parents that aspirin should not be used due to the risk of Reye’s syndrome. Children should also drink plenty of fluids to prevent dehydration.

There are strategies to reduce the risk of HFMD.
There is no vaccine to protect patients against HFMD.  However, the following strategies can reduce the risk of becoming infected with HFMD:
  • Wash your hands with soap and water for at least 20 seconds, especially after changing diapers1
  • Teach children to wash their hands
  • Avoid touching your eyes, nose, and mouth with unwashed hands
  • Avoid close contact with individuals infected with HFMD
  • Disinfect frequently touched surfaces and objects such as toys and doorknobs
  1. Hand, foot, & mouth disease.  CDC website.  https://www.cdc.gov/features/handfootmouthdisease/index.html.  Accessed June 27, 2017.
  2. Hand-foot-and-mouth disease.  Mayo Clinic website.  http://www.mayoclinic.org/diseases-conditions/hand-foot-and-mouth-disease/basics/causes/con-20032747.  Accessed June 27, 2017.

Jennifer Gershman, PharmD, CPh
Jennifer Gershman, PharmD, CPh
Jennifer Gershman, PharmD, CPh, received her PharmD degree from Nova Southeastern University (NSU) College of Pharmacy in 2006 and completed a 2-year drug information residency. She served as a pharmacy professor at NSU’s College of Pharmacy for 6 years, managed the drug information center, and conducted medication therapy management reviews. Dr. Gershman has published research on prescription drug abuse, regulatory issues, and drug information in various scholarly journals. Additionally, she received the Sheriff’s Special Recognition Award for her collaboration with the Broward, Florida Sheriff’s Office to prevent prescription drug abuse through a drug disposal program. She has also presented at pharmacist and physician continuing education programs on topics that include medication errors, prescription drug abuse, and legal and regulatory issues. Dr. Gershman can be followed on Twitter @jgershman2
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