Hand, Foot, and Mouth Disease (HFMD) is a common viral illness primarily caused by enteroviruses, most frequently coxsackievirus A16. While often associated with young children, it can affect people of any age. The illness typically resolves within 7 to 10 days. It spreads easily through contact with respiratory droplets, blister fluid, or stool from an infected person.
Common Symptoms in Children
In children, HFMD usually begins with a fever, sore throat, and reduced appetite. These initial signs are followed by painful, blister-like lesions in the mouth, particularly on the tongue, gums, and inside the cheeks. A distinctive rash typically appears on the palms of the hands and soles of the feet. This rash can manifest as flat red spots or small blisters and may also be present on the buttocks.
HFMD Manifestation and Severity in Adults
Adults who contract HFMD often experience more pronounced and uncomfortable symptoms. Initial flu-like symptoms, including fever and malaise, can be more intense, leading to significant fatigue. The characteristic rash in adults may be more widespread and painful, extending beyond the hands and feet to areas such as the arms, legs, trunk, and face. This rash can also be intensely itchy.
Mouth sores can be particularly severe in adults, causing extreme pain and making eating, drinking, and swallowing difficult. Some adults also report muscle aches and joint pain. While some adults may experience milder symptoms, those who develop symptoms often find the illness debilitating. The recovery period for adults can sometimes feel longer due to heightened symptom severity.
Factors Contributing to Adult Severity
The adult immune system’s response plays a role in the increased severity of HFMD. When encountering a novel viral strain, the immune system may mount a more robust inflammatory response. Adults may also lack prior immunity to specific enterovirus strains, particularly Coxsackievirus A6, which is frequently associated with more severe HFMD presentations in adults.
The immune system’s ability to fight off infections can change with age, making adults more susceptible to a more intense illness.
Serious Health Risks
While typically a mild illness, HFMD can lead to more serious health complications. Dehydration is a concern, especially when painful mouth sores make it difficult to consume adequate fluids. Complications include viral meningitis, an inflammation of the protective membranes surrounding the brain and spinal cord.
Encephalitis, a swelling of the brain, can also occur. Myocarditis, an inflammation of the heart muscle, is another potential complication. Some individuals may experience temporary nail shedding (onychomadesis) weeks after the infection, where fingernails or toenails detach, though they typically regrow. Individuals with weakened immune systems or pregnant individuals may face a higher risk of these complications.
Care and Prevention
There is no specific antiviral treatment for HFMD, so care focuses on managing symptoms. Over-the-counter pain relievers, such as acetaminophen or ibuprofen, can help reduce fever and alleviate pain from mouth sores and body aches. Staying well-hydrated is important; consuming plenty of fluids, especially cold liquids like water or popsicles, can soothe a sore throat.
Eating soft foods and avoiding hot, spicy, or acidic items can minimize discomfort. Saltwater rinses or numbing mouthwashes and sprays can provide temporary relief for painful oral lesions. Preventing the spread of HFMD involves frequent and thorough handwashing with soap and water for at least 20 seconds. It is also advisable to avoid close contact, such as hugging or sharing utensils, with infected individuals, and to regularly disinfect commonly touched surfaces.