What is Hand, Foot, and Mouth Disease? Hand, foot and mouth disease (HFMD) is a common disease in infants and children. It is characterized by fever, mouth ulcers and herpes. The initial symptoms are low-grade fever, loss of appetite, malaise and often sore throat. After 1-2 days of fever, oral ulcers appear, starting as small red herpes and often becoming ulcers. Oral herpes is common on the tongue, gums, and buccal mucosa of the mouth. 1-2 days later, skin macules, some of which are herpes, are visible. Some patients only have a rash or mouth ulcers. Is HFMD serious? It is usually not serious. Almost all patients recover without treatment. HFMD usually resolves within 7-10 days. Complications are uncommon. Rarely, patients may develop aseptic or viral meningitis, which is characterized by fever, headache, straight neck or back pain, and requires a period of hospitalization. How does HFMD occur? There are several viruses that can cause HFMD. The most common is coxsackievirus A16. In addition, other strains of coxsackievirus A or enterovirus 71 can also cause HFMD. Coxsackievirus is a type of enterovirus. Enteroviruses include poliovirus, coxsackievirus and echovirus. Is hand, foot and mouth disease contagious? Yes. HFMD is moderately contagious. Person-to-person transmission is through direct contact with nasal and pharyngeal secretions or feces of an infected person. It is most contagious in the first week of illness. HFMD is not transmitted between humans and animals or pets. How long does it take for a person to become infected? The incubation period from the time of infection to the onset of symptoms is usually 3-6 days. Fever is a common first symptom of HFMD. Who is susceptible to HFMD? HFMD occurs mainly in children under 10 years of age, but adults can also get the disease, so it can be said that everyone is susceptible. There is no cross-immunity to other types of viruses, i.e. HFMD can be re-infected by other types of viruses after infection. When and where does HFMD occur? There are outbreaks of HFMD all over the world, with summer and early fall being the most common. How is HFMD diagnosed? HFMD is only one of many infectious diseases that can cause mouth ulcers. Another common cause of mouth ulcers is oral herpes virus infection, which causes inflammation of the mouth and gums (sometimes called stomatitis). Physicians can usually identify HFMD from other causes of oral ulcers based on the age of the patient, the patient’s or parent’s complaints of symptoms, and examination of the rash and ulcers. A throat swab or stool specimen can be sent to a laboratory for viral testing, but viral testing takes 2-4 weeks to produce results, so doctors usually do not offer to do this test. How is HFMD treated? Can it be prevented? There is no specific treatment for HFMD. Symptomatic treatment is given to reduce fever, headache and pain from mouth ulcers. Preventive measures include frequent hand washing, especially after diaper changes; disinfecting potentially contaminated surfaces; and washing soiled clothing. Children should not attend kindergarten and school or other gatherings for the first few days of illness. The above measures can greatly reduce transmission, but they cannot yet completely stop it.