Hand, Foot, and Mouth Disease (HFMD) is a common viral illness that frequently affects young children, though it can occur at any age. This contagious condition often raises questions about its nature and, particularly, the possibility of experiencing it more than once.
What is Hand, Foot, and Mouth Disease
Hand, Foot, and Mouth Disease is a viral infection characterized by a distinctive rash and sores. It is primarily caused by viruses belonging to the enterovirus family, most commonly coxsackievirus A16, but also other coxsackieviruses and enterovirus 71. Symptoms typically appear three to six days after exposure, beginning with flu-like signs such as a mild fever, sore throat, and reduced appetite.
A day or two after these initial symptoms, painful sores can develop in the mouth, often appearing on the tongue, gums, and inside the cheeks. Subsequently, a rash emerges, usually on the palms of the hands and soles of the feet, which can manifest as flat red spots or small blisters. The rash may also appear on other areas, including the buttocks, knees, and elbows.
HFMD is highly contagious and spreads through close personal contact. This includes respiratory droplets from coughing or sneezing, saliva, blister fluid, or stool. Contaminated surfaces and shared items like toys can also transmit the virus. While most contagious during the first week of illness, the virus can persist in stool for several weeks after symptoms resolve.
Why Reinfection Can Occur
Reinfection with Hand, Foot, and Mouth Disease is possible because the illness is not caused by a single virus but rather by several different strains of enteroviruses. When an individual contracts HFMD, their immune system develops specific antibodies that provide immunity against that particular viral strain.
However, this acquired immunity does not protect against other distinct strains of the viruses that cause HFMD. For example, while Coxsackievirus A16 is a frequent cause, other strains like Coxsackievirus A6 and Enterovirus 71 can also lead to the disease. If someone who previously had HFMD caused by Coxsackievirus A16 later encounters Enterovirus 71, they can develop HFMD again.
The variety of circulating viral strains explains why some individuals, especially young children in group settings, may experience multiple episodes of HFMD throughout their lives, each typically due to exposure to a different enterovirus type. Although subsequent infections can occur, the symptoms may sometimes be less severe than the initial encounter.
Living with and Preventing Hand, Foot, and Mouth Disease
Managing Hand, Foot, and Mouth Disease primarily involves alleviating symptoms, as there is no specific antiviral treatment for the condition. Over-the-counter pain relievers, such as acetaminophen or ibuprofen, can help reduce fever and soothe painful mouth sores. Maintaining hydration is important, especially for young children, as mouth sores can make swallowing difficult; offering cool fluids, ice chips, or popsicles can encourage fluid intake. Avoid acidic, spicy, or salty foods that might irritate mouth sores.
Preventing the spread of HFMD relies heavily on consistent hygiene practices. Frequent and thorough handwashing with soap and water for at least 20 seconds is crucial, especially after using the toilet, changing diapers, and before eating. Teaching children proper handwashing techniques is an effective preventative measure.
Disinfecting frequently touched surfaces and shared items, such as toys, doorknobs, and countertops, helps eliminate virus particles. Avoiding close contact, including hugging, kissing, and sharing eating utensils or cups with infected individuals, can reduce transmission risk. Children who are sick with HFMD should stay home from school or daycare until their fever subsides and blisters have dried to prevent further spread within the community.