Hand, Foot, and Mouth Disease (HFMD) is a common, highly contagious viral illness that typically affects infants and children younger than five years old. It is caused by viruses belonging to the enterovirus family, most commonly Coxsackievirus A16. While HFMD is generally mild and resolves on its own, specific laboratory tests do exist. However, a healthcare provider usually diagnoses HFMD without requiring formal testing.
Clinical Identification of Hand, Foot, and Mouth Disease
Healthcare providers primarily rely on a thorough physical examination and patient history to diagnose HFMD. The illness presents with a highly characteristic pattern of symptoms distinctive enough for a clinical diagnosis. Diagnosis begins with general viral symptoms, such as a low-grade fever and sore throat, which usually precede the visible signs.
The most telling feature is the appearance of a rash and sores in specific locations. Painful mouth sores develop inside the mouth, often on the tongue, gums, and cheeks. These sores can make eating and drinking difficult, particularly for young children.
A non-itchy, blister-like rash typically appears simultaneously on the palms of the hands and the soles of the feet. This rash may also emerge on the buttocks or genital area. Observing this unique combination of symptoms allows a provider to confidently confirm the diagnosis without further testing.
Specific Laboratory Testing Options
Although most cases are diagnosed visually, specific laboratory tests are available to identify the exact virus causing the infection. These tests analyze biological samples to confirm the presence of the enterovirus family members responsible for HFMD.
Sample collection methods include swabbing the throat or rectum, or collecting fluid directly from a skin blister. These specimens are sent to a specialized lab for analysis. One common method is Polymerase Chain Reaction (PCR), which quickly detects the viral genetic material within the sample.
Types of Tests
In some instances, a viral culture may be performed, where the virus is allowed to grow in a cell line to isolate and identify the specific strain. These methods can distinguish between the various causative agents, such as Coxsackievirus A16 or Enterovirus 71. Serologic testing, which looks for antibodies in the blood, is also available but is used less frequently for acute diagnosis.
Why Routine Testing Is Not Recommended
Despite the availability of precise laboratory methods, routine testing for HFMD is not recommended for most patients. The primary reason is that test results do not change the course of treatment, as there is no specific antiviral medication for this illness. Management for HFMD is supportive, focusing entirely on relieving symptoms.
Laboratory tests can take several days or even weeks to yield a result, especially for viral culture or specialized PCR assays. By the time confirmation is received, the patient has usually recovered, rendering the result irrelevant for immediate care. Testing is typically reserved for severe cases requiring hospitalization, atypical presentations, or public health tracking during large outbreaks.
Managing Symptoms and Recovery
Once HFMD is diagnosed, the focus shifts entirely to supportive care during the typical seven to ten-day recovery period. Managing pain is a priority, using over-the-counter medications like acetaminophen or ibuprofen for fever and sore discomfort. Never give aspirin to children due to the risk of Reye’s syndrome.
Maintaining adequate hydration is particularly important because painful mouth sores often make swallowing difficult. Offering cool liquids, such as water or electrolyte solutions, can be soothing. Acidic drinks like fruit juice should be avoided, and soft foods that do not require much chewing are recommended.
Children can generally return to school or daycare once their fever has resolved for 24 hours without medication. They must also be well enough to participate in normal activities, and any open sores causing excessive drooling should have dried up. Good hand hygiene remains the most effective way to prevent the virus from spreading in the community.