Hand, Foot, and Mouth Disease (HFMD) is a common, highly contagious viral illness. While less frequent in adults, exposure—often through contact with children—can lead to infection. Adult cases are often reported as more uncomfortable and occasionally more severe than those seen in pediatric populations. Since there is no specific cure, management focuses on relieving symptoms and preventing the virus from spreading further.
Identifying Hand Foot and Mouth Disease in Adults
The disease is primarily caused by viruses from the Enterovirus genus, mainly Coxsackievirus A16 and Enterovirus 71. Coxsackievirus A6 is also linked to a growing number of adult cases, often associated with more extensive skin findings. The illness often begins with non-specific flu-like symptoms, including fever, headache, and malaise. These initial symptoms can last for a day or two before the characteristic rash appears.
The presentation of HFMD in adults can vary significantly from the classic pattern seen in children. Adults frequently report more intense body aches and severe joint pain. The hallmark rash, consisting of small red spots, blisters, or bumps, typically appears on the palms and soles.
In adults, the rash may be less pronounced in these areas or can extend to atypical locations like the trunk, arms, legs, or genital area, sometimes making diagnosis challenging. Painful sores, called herpangina, develop in the mouth, usually on the tongue, gums, or inside the cheeks, which makes swallowing difficult. Some adults may experience only a severe sore throat and malaise without developing a visible skin rash.
Strategies for Home Symptom Relief
Treatment focuses on supportive care to manage discomfort until the body clears the infection. Over-the-counter medications are the primary strategy for managing systemic symptoms. Acetaminophen or ibuprofen can be used to control fever and alleviate the muscle aches and joint pain frequently experienced by adults.
Relief for the painful oral sores is a major focus, as they can interfere with eating and drinking. Numbing mouthwashes or rinses containing ingredients like lidocaine or diphenhydramine can temporarily reduce ulcer pain, but consulting a pharmacist before use is recommended. Gargling with warm saltwater can also provide a soothing effect on irritated tissues.
Maintaining hydration is paramount, especially when mouth pain makes swallowing difficult, increasing the risk of dehydration. Cold liquids, such as ice water, milk, or popsicles, are often easier to consume than warm beverages because the cold temperature can mildly numb the mouth. Avoid acidic fluids, such as fruit juices, and spicy or salty foods, as these can irritate and exacerbate the mouth sores.
For the skin rash and blisters, keeping the affected areas clean and dry is important to prevent secondary bacterial infection. While the rash is typically non-itchy, a mild over-the-counter corticosteroid cream might be considered for accompanying itchiness, and scratching should be avoided. If blisters rupture, applying a thin layer of antibiotic ointment and covering with a bandage can help promote healing.
Understanding Recovery Time and Complications
For most adults, HFMD symptoms are self-limiting and resolve within seven to ten days. The fever and malaise typically subside first, followed by the gradual healing of the mouth sores and the fading of the skin rash. Complete recovery usually does not require medical intervention beyond supportive home care.
Certain warning signs indicate the need to seek professional medical attention, as they can signal a rare but serious complication. These include:
- Signs of severe dehydration, such as significantly decreased urination, extreme dizziness, or a dry mouth and tongue.
- Persistent high fever above 101°F that does not respond to medication.
- The onset of severe neurological symptoms like a stiff neck, intense headache, confusion, or seizures.
In the weeks following recovery, a late-stage complication known as onychomadesis can occur. This involves the temporary, non-painful shedding of fingernails or toenails. While alarming, the nails will regrow normally, as this is considered a benign side effect of the infection.
Stopping the Spread of the Virus
The viruses that cause HFMD are highly contagious and spread through respiratory droplets, contact with blister fluid, and fecal-oral transmission. An infected person is most contagious during the first week of the illness. Staying home from work or avoiding close contact is recommended during this acute phase, though the virus can shed in stool for several weeks after all visible symptoms have disappeared.
Hand hygiene is the most effective measure to curtail transmission. Hands should be washed frequently with soap and water, particularly after using the restroom, changing diapers, or before preparing food. Because the virus can survive on surfaces, cleaning and disinfecting frequently touched objects and shared surfaces, like doorknobs, countertops, and remote controls, is an important preventative step.
Avoidance of close personal contact, such as hugging or sharing eating utensils and cups, with anyone who has symptoms will help limit the spread. Consistent, diligent hygiene practices are important in all communal settings, as adults without symptoms may still be shedding the virus.