Hand-foot-and-mouth disease
By Springfield Pediatrics- Dr. Diji Vaughan
July 01, 2012


Parental anxiety rises and deservedly so whenever someone shares the discovery of an  illness, let alone a communicable one in their child with another parent. The words: hand-foot-and-mouth disease linked together in that sequence certainly evokes a suite of reactions from respect to bounding fear in the other parent listening. “Will my child catch it?”, “Oh! he had a fever last night too- he probably has caught it already!”. We want to address concerns like this in this post and share recent trends and disease patterns with this condition as we approach the fall season.

The town of Coxsackie NY will forever be embellished in the medical literature. This community of 9,000 people has the distinct recognition of being the discovery place of the family of viruses responsible for most forms of the hand-foot-and-mouth disease(HFAMD). These viruses are called Coxsackie viruses and have different numbers tethered to their names to reflect their many different types.

Humans are the only known reservoir for these viruses and their transmission from person to person is possible year round, but gets to epidemic proportions in the summer/fall seasons. Most of the transmission occurs through close contact through the respiratory airways, fecal-oral route, within families, daycare center, summer camps etc. The Coxsackie virus can survive outside a human host and this confers an advantage to the germ making environmental surfaces contamination and subsequent spread easy. Wet soil, swimming pools etc are possible sources of spread too although less common.

Children aged less than 5-years are more readily affected, though infection in all age groups is possible. The affected child develops fever (temp=100.4F or higher) usually, cases without a fever accompanying presentation are not uncommon. The mouth cavity has reddish shallow lesions on the tongue and lining of the mouth cavity, this is often accompanied with the apperance of fluid-filled or tiny pustule-like painful lesions on the back of the hands and feet. These lesions sometimes occur on the palm and soles too. Affected children often begin to eat less and less from the painful oral lesions and severe cases may tip them towards dehydration. Medical evaluation and assessment is recommended.These skin lesions resolve in about a week and the signs gradually fade away subsequently. Complications following hand-foot-and-mouth disease can occur though rarely and it is usually a self-limited condition where therapeutic efforts are largely supportive with comfort measures under the supervision of your medical provider.

Universal infection control precautions, especially with appropriate hand washing, and avoidance of overcrowded situations have been shown to reduce transmission and control outbreaks. The CDC reports in March 2012, the emergence of unusually severe cases of HFAMD caused by a different member of the Coxsackie virus family which has now been isolated from every geographic region of the USA. The vast majority of cases of HFAMD seen so far still follow the typical course described above. The CDC affirms, “HFMD is spread from person to person by contact with saliva, respiratory secretions, fluid in vesicles, and feces. Transmission of HFMD can be reduced by maintaining good hygiene, including handwashing and disinfection of surfaces in child care settings”.