Highlights & Basics
- Hand-foot-and-mouth disease is a highly contagious childhood viral infection.
- Diagnosis is usually clinical, based on a typical history and characteristic clinical features.
- Infection typically resolves spontaneously within 10 to 14 days, and treatment is mainly supportive.
- In East and Southeast Asian countries, enterovirus 71 (EV71) is responsible for a more severe version of the disease with serious complications; however, this is uncommon in the US and Europe.
Quick Reference
History & Exam
Key Factors
Other Factors
Diagnostics Tests
Treatment Options
Definition
Epidemiology
Etiology
Pathophysiology
Images
Hand, foot and mouth disease. Rash around the mouth of a 1 year old boy with hand foot and mouth disease (HFMD). HFMD is caused by intestinal viruses of the picornaviridae family. The most common strains causing HFMD are coxsackie A virus A16 and enterovirus 71 (EF-71).
Hand, foot and mouth disease. Close-up of a blisters (known as vesicles) on the hand of a 3 year old boy with hand foot and mouth disease (HFMD). HFMD is caused by intestinal viruses of the picornaviridae family. The most common strains causing HFMD are coxsackie A virus A16 and enterovirus 71 (EF-71).
Citations
Alsop J, Flewett TH, Foster JR. "Hand-foot-and-mouth disease" in Birmingham in 1959. Br Med J. 1960;2:1708-1711.[Abstract][Full Text]
Ishimaru Y, Nakano S, Yamaoka K, et al. Outbreaks of hand, foot, and mouth disease by enterovirus 71. High incidence of complication disorders of central nervous system. Arch Dis Child. 1980;55:583-588.[Abstract][Full Text]
Saguil A, Kane SF, Lauters R, et al. Hand-foot-and-mouth disease: rapid evidence review. Am Fam Physician. 2019 Oct 1;100(7):408-14.[Abstract][Full Text]
Chang LY, Tsao KC, Hsia SH, et al. Transmission and clinical features of enterovirus 71 infections in household contacts in Taiwan. JAMA. 2004;291:222-227.[Abstract][Full Text]
Chang LY, Lin TY, Huang YC, et al. Comparison of enterovirus 71 and coxsackie-virus A16 clinical illnesses during the Taiwan enterovirus epidemic, 1998. Pediatr Infect Dis J. 1999;18:1092-1096.[Abstract]
1. Robinson CR, Doane FW, Rhodes AJ. Report of an outbreak of febrile illness with pharyngeal lesions and exanthem: Toronto, summer 1957; isolation of group A Coxsackie virus. Can Med Assoc J. 1958;79:615-621.[Abstract][Full Text]
2. Alsop J, Flewett TH, Foster JR. "Hand-foot-and-mouth disease" in Birmingham in 1959. Br Med J. 1960;2:1708-1711.[Abstract][Full Text]
3. Miller GD, Tindall JP. Hand-foot-and-mouth disease. JAMA. 1968;203:827-830.[Abstract]
4. Chang LY, King CC, Hsu KH, et al. Risk factors of enterovirus 71 infection and associated hand, foot, and mouth disease/herpangina in children during an epidemic in Taiwan. Pediatrics. 2002;109:e88.[Abstract]
5. Ishimaru Y, Nakano S, Yamaoka K, et al. Outbreaks of hand, foot, and mouth disease by enterovirus 71. High incidence of complication disorders of central nervous system. Arch Dis Child. 1980;55:583-588.[Abstract][Full Text]
6. Saguil A, Kane SF, Lauters R, et al. Hand-foot-and-mouth disease: rapid evidence review. Am Fam Physician. 2019 Oct 1;100(7):408-14.[Abstract][Full Text]
7. Chang LY, Tsao KC, Hsia SH, et al. Transmission and clinical features of enterovirus 71 infections in household contacts in Taiwan. JAMA. 2004;291:222-227.[Abstract][Full Text]
8. Chang LY, Huang LM, Gau SS, et al. Neurodevelopment and cognition in children after enterovirus 71 infection. N Engl J Med. 2007;356:1226-1234.[Abstract][Full Text]
9. Chang LY, Lin TY, Huang YC, et al. Comparison of enterovirus 71 and coxsackie-virus A16 clinical illnesses during the Taiwan enterovirus epidemic, 1998. Pediatr Infect Dis J. 1999;18:1092-1096.[Abstract]
10. Lee TC, Guo HR, Su HJ, et al. Diseases caused by enterovirus 71 infection. Pediatr Infect Dis J. 2009;28:904-910.[Abstract]
11. Chang LY, King CC, Hsu KH, et al. Risk factors of enterovirus 71 infection and associated hand, foot, and mouth disease/herpangina in children during an epidemic in Taiwan. Pediatrics. 2002;109:e88.[Abstract][Full Text]
12. Centers for Disease Control and Prevention. CDC Yellow Book 2024: health Information for international travel. Section 5: travel-associated infections & diseases - hand, foot & mouth disease. May 2023 [internet publication].[Full Text]
13. Zhu P, Ji W, Li D, et al. Current status of hand-foot-and-mouth disease. J Biomed Sci. 2023 Feb 24;30(1):15.[Abstract][Full Text]
14. Qiu J, Yan H, Cheng N, et al. The clinical and epidemiological study of children with hand, foot, and mouth disease in Hunan, China from 2013 to 2017. Sci Rep. 2019 Aug 12;9(1):11662.[Abstract][Full Text]
15. Zhu FC, Meng FY, Li JX, et al. Efficacy, safety, and immunology of an inactivated alum-adjuvant enterovirus 71 vaccine in children in China: a multicentre, randomised, double-blind, placebo-controlled, phase 3 trial. Lancet. 2013;381:2024-2032.[Abstract]
16. Zhu F, Xu W, Xia J, et al. Efficacy, safety, and immunogenicity of an enterovirus 71 vaccine in China. N Engl J Med. 2014;370:818-828.[Abstract]
17. Li R, Liu L, Mo Z, et al. An inactivated enterovirus 71 vaccine in healthy children. N Engl J Med. 2014;370:829-837.[Abstract]
18. Tsao KC, Chang PY, Ning HC, et al. Use of molecular assay in diagnosis of hand, foot and mouth disease caused by enterovirus 71 or coxsackievirus A 16. J Virol Methods. 2002;102:9-14.[Abstract]
19. Chow KC, Lee CC, Lin TY, et al. Congenital enterovirus 71 infection: a case study with virology and immunohistochemistry. Clin Infect Dis. 2000;31:509-512.[Abstract]
20. Ogilvie MM, Tearne CF. Spontaneous abortion after hand-foot-and-mouth disease caused by Coxsackie virus A16. Br Med J. 1980;281:1527-1528.[Abstract][Full Text]
