Causes of hand foot and mouth disease

Hand, foot and mouth disease is a viral illness that characteristically leads to fever, sore throat and blisters over the mouth, hands, feet, buttocks and genitalia.

Viruses that cause hand foot and mouth

Hand-foot-and-mouth disease (HFMD) is most commonly caused by a virus belonging to the enterovirus family.

Coxsackie virus A16 is the commonest implicated virus. Other implicated viruses are the Coxsackievirus A5, A7, A9, A10, B2 and B5, or the enterovirus 71. (1-8)

How is hand foot and mouth transmitted?

Transmission of the disease is usually through pets or from direct contact with an infected person. Usually a person is most infective the first week after acquiring the infection.

However, the virus may persist in the body for weeks after symptoms have resolved. This means an infected child can pass the disease to others even when they appear well and recovered.

During this time any person or child exposed to the infected discharge from the throat, nose, ruptured blisters over the hand and foot, saliva or faeces is at risk of catching the infection.

The time between infection and the development of symptoms is called the incubation period and usually lasts between 3 and 7 days. (1-8)

Air borne spread usually occurs when an infected child coughs or sneezes and releases the millions of tiny droplets from its mouth and nose bearing the virus. These droplets hang suspended in the air for a while, then land on surfaces.

People around the infected person may inhale the droplets or may catch it by touching the surfaces where the discharge has landed and then touching their mouth and nose with unwashed hands.

The virus remains in the stools of the infected child for about four weeks after the complete recovery. Hand washing after using the toilet or handling the soiled nappies and diapers of infected children is important to contain the spread of infection.

The disease may spread most easily in child care settings and other places where children are close together like schools and day cares.

Preventing hand, foot and mouth disease

Hand washing, cleaning surfaces vigorously after changing diapers and before serving or eating food around children helps prevent transmission. (1-8)

Risk factors for hand, foot and mouth disease

Risk factors of getting the infection include age of the person. Children below 10 years of age are most susceptible to the infection.

Teenagers and adults rarely get the infection since they have a stronger immunity against the infection being exposed to it at children.

In adults the symptoms of the disease is milder than in children. The outbreaks occur most often in the summer and autumn in temperate climates. The outbreaks may often turn into wider spread epidemics. (1-8)

Further Reading

Last Updated: Jun 14, 2023

Dr. Ananya Mandal

Written by

Dr. Ananya Mandal

Dr. Ananya Mandal is a doctor by profession, lecturer by vocation and a medical writer by passion. She specialized in Clinical Pharmacology after her bachelor's (MBBS). For her, health communication is not just writing complicated reviews for professionals but making medical knowledge understandable and available to the general public as well.


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  1. Maiara Coimbra Maiara Coimbra Brazil says:

    minha filha de 2 anos e 4 mais , tem essa doença !!!!!

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