Hand, Foot, and Mouth Disease (HFMD) is a common viral illness that primarily affects young children, though people of any age can contract it. This contagious condition typically manifests with a fever, followed by a sore throat and a characteristic rash. The rash often appears as spots or blisters on the hands, feet, and sometimes in the mouth, on the buttocks, or in the diaper area.
How Hand, Foot, and Mouth Disease Is Diagnosed
A healthcare provider typically diagnoses Hand, Foot, and Mouth Disease based on a patient’s age, reported symptoms, and the distinct appearance of the rash and mouth sores during a physical examination. The lesions in the mouth often present as yellow spots with red borders, located on the tongue, gums, inner cheeks, or tonsils, while skin lesions are usually not itchy but can be painful. This clinical assessment is usually sufficient because HFMD has a recognizable set of symptoms, allowing differentiation from other viral infections. Laboratory testing is generally not necessary, as the illness is typically mild and resolves on its own within 7 to 10 days.
When Specific Tests Are Used
Laboratory testing for Hand, Foot, and Mouth Disease may be utilized in specific situations, such as when the diagnosis is unclear, symptoms are unusually severe, or when public health officials need to investigate outbreaks or monitor the spread of the virus. Identifying the specific virus strain can be important during large-scale outbreaks.
Tests available include polymerase chain reaction (PCR) assays, which detect the viral genetic material (RNA or DNA) from various samples. Samples can be collected from throat swabs, stool specimens, or fluid from blisters. PCR is a highly sensitive method that can identify common causative agents like Coxsackievirus A16, Enterovirus 71, and increasingly, Coxsackievirus A6 and A10. Viral culture, where samples are grown in a laboratory to isolate and identify the virus, is also used, though it can be time-consuming. Oral specimens often have a high isolation rate for the virus.
Understanding Test Results and Implications
A positive test result for Hand, Foot, and Mouth Disease confirms the presence of the virus but typically does not change the course of treatment. Since there is no specific antiviral medication for most cases of HFMD, management focuses on relieving symptoms such as fever and pain. Over-the-counter pain relievers and ensuring adequate fluid intake to prevent dehydration are common recommendations.
Testing is generally not performed for routine cases because the illness is often mild and self-limiting. The time and cost involved in obtaining test results often outweigh the benefits, as the diagnosis typically does not alter the supportive care provided. Even if a test confirms HFMD, the primary approach remains focused on alleviating discomfort until the illness passes.