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This fall, multiple states including Maryland, Virginia, Tennessee and Wisconsin have reported outbreaks of hand, foot and mouth disease, a contagious virus that commonly infects children under 5 but can also cause symptoms in older kids and adults, too.
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“This year, [cases seem] to be out of control,” said Dr. Allison Agwu, a professor of adult and pediatric infectious diseases at Johns Hopkins University School of Medicine in Baltimore. For example, in Agwu’s state of Maryland, cases are at “four to five times what they saw this time last year,” she said.
Dr. Matthew Thomas, a pediatric infectious diseases specialist at WVU Medicine Golisano Children’s in West Virginia, said spikes typically happen in cycles. “Some years you’ll see a lot of cases, like we’re seeing this year, and then it kind of fades away, where you don’t hear about it for a while,” Thomas said.
With cases higher than normal, it’s important to know the signs of the virus and what to do if you (or your kids) get sick. Here’s what to know:
As the name suggests, symptoms include blisters on the hands, feet and mouth.
Hand, foot and mouth is a virus within the family of enteroviruses, explained Dr. Jennifer Duchon, an associate professor in the divisions of pediatric infectious disease and newborn medicine at Mount Sinai Hospital in New York.
Enteroviruses can present with a range of symptoms. In the case of hand, foot and mouth, “people can have symptoms like a common cold,” according to Thomas. This includes a fever, Agwu added, in addition to respiratory symptoms such as a runny nose.
“But then a common feature is that they will have a rash, typically on the hands and feet, as well as ulcers or blisters within the mouth,” Thomas said.
The blisters in the mouth are generally at the back of the throat and are often really painful, according to Duchon.
On the hands and feet, the rash may appear as little red bumps. “Those show up a couple days after the fever,” Agwu noted.
“Sometimes people’s hands will start to peel when the rash starts to go away, their feet will start to peel after the rash goes away,” Duchon said. “In really dramatic cases, sometimes your fingernails can fall off.”
Jill Lehmann Photography via Getty Images
The disease spreads through respiratory droplets and fecal matter and can live on surfaces.
Hand, foot and mouth disease is “super contagious,” Agwu said.
It spreads through respiratory droplets that go out in the air when someone coughs or sneezes, according to Thomas. It can also spread via the fluid from the blisters or via infected surfaces. So if a child who has the virus drools on toys at daycare, other kids could get sick from those toys.
“It’s also spread in stool, so particularly for our infants who are not yet potty trained, someone who’s changing diapers is often putting themselves at risk,” Thomas said. For parents or caretakers changing dirty diapers, good hand hygiene is particularly important.
Most children and adults recover easily at home.
While the virus certainly can be gruesome, and often painful, most people do recover at home with the help of symptomatic care such as fever-reducing medications.
There are no specific medications for hand, foot and mouth, and since it’s a viral illness, “no antibiotics are going to get rid of it,” Agwu said.
If you or your children do get sick, you should “try to avoid spreading it to anyone else,” Thomas said.
Anyone who is sick with hand, foot and mouth should isolate from others so they don’t pass on the virus, while also hydrating and eating enough nutrients. The virus tends to last for about a week in most people, Thomas said.
“If you’re having more severe symptoms, like if you’re having a lot of ulcers in your mouth, it may take up to 10 to 14 days to resolve fully,” Thomas added.
Some people require additional care, though. If you aren’t able to hydrate, or keep your sick child hydrated, you should seek medical care, Thomas noted. The same is true if whoever is sick isn’t able to eat enough.
Duchon added, “If you’ve had hand, foot and mouth and afterwards, or towards the end of the illness, you’re feeling really, really tired or having trouble breathing, those are things that are really serious to look for that can mean that the heart has been affected. That’s a very rare but serious complication.”
Hand-washing is a good way to protect yourself from catching this virus.
There are a number of things you can do to keep yourself from getting sick with hand, foot and mouth and other viruses that are currently circulating such as the common cold and COVID-19.
“The way to prevent it is going to be always the same thing — washing hands … if you’re touching something that’s problematic, like stool or what have you, making sure you’re doubling down on using good hand hygiene,” Agwu said.
If you’re out and about, a “good alcohol-based hand sanitizer” is a fine option, too, but hand-washing with soap and water is ideal, Thomas said.
It’s also helpful to avoid touching your face as much as you can, Agwu noted.
As a general rule of thumb for virus prevention of any kind, staying away from sick people and wearing a mask to protect yourself from virus shed are also good ways to stay healthy.