Hand, foot and mouth disease on the rise in certain areas: doctors explain symptoms, if it's contagious and risks for adults and children

Chicago — Health officials in the Mid-Atlantic region recently reported an increase in cases of hand-foot-and-mouth disease (HFMD).

According to the District of Columbia Department of Health, there were 197 emergency department visits related to the disease in September, mostly among children under 5 years old. The Virginia Department of Health has also reported a significant increase in emergency room and urgent care visits due to hand, foot and mouth disease. Virginia and West Virginia have seen a significant increase in reported outbreaks compared to previous years, with schools and day care centers accounting for the majority of outbreaks.

See also: More than 150 unvaccinated students in South Carolina quarantined after measles infection

What is hand, foot, and mouth disease? What causes it? How is it spread? What are the symptoms and how long do they last? Can adults also get it? How is it diagnosed and treated? Should parents keep their children home from school or daycare? What steps can families take to prevent infection?

CNN Wellness Expert Dr. Leana Wen, an emergency physician and clinical associate professor at George Washington University, previously served as the health commissioner for the city of Baltimore.

CNN: What is hand, foot and mouth disease?

Dr. Wen: Hand, foot, and mouth disease is a highly contagious viral disease that primarily affects infants and young children. It is caused by a group of viruses known as enteroviruses, most commonly coxsackievirus A16. This is different from foot-and-mouth disease, which infects livestock such as cows, sheep, pigs, and goats, but not humans.

Hand, foot, and mouth disease gets its name from the small blister-like sores that appear on the hands, feet, and mouth. Although the disease can be unpleasant, it is usually mild and resolves on its own.

CNN: How does it spread and who is most at risk?

Wen: Hand, foot, and mouth disease spreads very easily through close human contact and contaminated surfaces. You can become infected if you are exposed to droplets when someone with the disease coughs, sneezes, or speaks. It can also be spread through contact with an infected person, such as hugging, kissing, or sharing cups or eating utensils.
The virus is also present in stool, so not washing your hands thoroughly when changing a diaper or helping a sick child use the bathroom can lead to infection.

It can also spread if someone touches an object or surface that has the virus on it, such as a toy or doorknob, and then touches their eyes, nose, or mouth. In rare cases, people can become infected by swallowing contaminated recreational water, such as from pools that have not been properly treated.

Young children are most at risk because their immune systems are still developing and they are more likely to struggle with personal hygiene, share toys, and be in close contact with others.

CNN: What are the symptoms and how long do they last?

Wen: The first sign of the disease is usually a fever, followed by a sore throat and general feeling unwell. These flu-like symptoms usually begin 3 to 5 days after contracting the virus. After a day or two, small painful spots may develop in the mouth, often on the tongue, gums, or inside of the cheeks. These spots can turn into small blisters or ulcers, making it uncomfortable for the child to eat and drink.

At about the same time, a rash appears on the hands and feet, and sometimes on the buttocks, legs, and arms. The rash may look like flat red spots or small bumps that form blisters, but it is usually not itchy.
Some children have canker sores without a rash, and some children have a rash without canker sores.

Most cases are mild and resolve on their own within a week to 10 days. During this time, it's important to keep your child well hydrated, as sore mouths can make them reluctant to drink fluids.

CNN: Can adults also get it?

Wen: Yes, but it is more common in young children. Because most people are first infected in childhood, adults often have some immunity. Still, people who have never been infected or have a weakened immune system can become infected through close contact with someone who is sick.

When teenagers and adults get hand, foot, and mouth disease, symptoms are usually mild or not present at all. Some adults may only have a sore throat or a mild rash without the typical canker sores and blisters. But you can still spread the virus to others, including young children.

CNN: How is hand, foot, and mouth disease diagnosed and treated?

Wen: Health care providers usually diagnose the disease based on characteristic symptoms and recent contact with other sick children. A physical exam is usually sufficient to confirm the diagnosis. In rare cases, if the illness appears unusual or severe, a clinician may take a throat swab or stool sample to test for certain viruses.

There is no specific drug to cure hand, foot and mouth disease. Antibiotics are not effective because it is caused by a virus. Treatment focuses on reducing symptoms. Over-the-counter painkillers such as acetaminophen and ibuprofen can reduce fever and mouth sores, and cold, soft foods and cold drinks can make eating and drinking more comfortable.

Staying hydrated is the most important part of care, as canker sores can cause pain when swallowing, and dehydration can develop rapidly in young children. Most cases resolve on their own without complications, but parents should consult a doctor if their child is unable to drink fluids, has a high fever for more than a few days, or is unusually sleepy or irritable.

CNN: Should parents send their children home from school or daycare?

Wen: Because hand, foot, and mouth disease is often mild, children do not need to stay home throughout their illness. Guidance from the Centers for Disease Control and Prevention says children can return to school or day care once their fever has subsided, they feel well enough to participate in normal activities, and they can manage the canker sore without excessive drooling.

Parents should also check with the school or daycare, as specific policies may vary. The CDC warns that in some circumstances, such as during an outbreak, local health departments may ask families to temporarily keep infected children at home to prevent further spread.

CNN: Are there any measures my family can take to prevent infection?

Wen: yes. Regular and thorough hand washing is one of the most effective preventive measures. Wash your hands with soap and water for at least 20 seconds, especially after using the toilet or changing a diaper, before preparing or eating food, and after blowing your nose or coughing.

Covering your coughs and sneezes, ideally using a disposable tissue or the crook of your elbow, can help prevent the spread of virus-laden droplets. Clean and disinfect frequently touched surfaces and objects. You should also avoid close contact with infected people. This means not sharing drinks, eating utensils, toothbrushes, or towels, and minimizing hugs and kisses if someone is sick.

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