Hand, Foot and Mouth disease

February 7, 2017

Hand, foot and mouth disease is generally a mild illness caused by a number of enteroviruses, particularly coxsackieviruses. It is usually not a serious illness, and occurs mainly in children under 10 years of age but can also occur in older children and adults. It is not related to the foot-and-mouth disease that affects cattle.

What is Coxsackie virus?

Coxsackieviruses is a member of the Picornaviridae family of viruses in the genus termed Enterovirus. Coxsackie viruses are subtype members of Enterovirus that have a single strand of ribonucleic acid (RNA) for its genetic material. The enteroviruses are also referred to as picornaviruses (pico means “small,” so “small RNA viruses”). Coxsackie virus was first isolated from human feces in the town of Coxsackie, N.Y., in 1948 by G. Dalldorf. Coxsackie virus is also written as coxsackievirus in some publications.

Coxsackie viruses are separable into two groups, A (CVA) and B (CVB), which are based on their effects on newborn mice (coxsackie A results in muscle injury, paralysis, and death; coxsackie B results in organ damage but less severe outcomes.) There are over 24 different serotypes of the virus (having distinct proteins on the viral surface). Coxsackie viruses infect host cells and cause host cells to break open (lyse).

These viruses live in the body’s digestive tract and spread from person to person, usually on unwashed hands and surfaces contaminated by feces (poop). Kids 1 to 4 years old are most at risk for the disease, as infections are common in childcare centers, preschools, and other places where kids are in close quarters. The illness typically lasts 3-5 days.

Outbreaks are most common during the warm summer and early fall months, but can happen year-round in tropical parts of the world. Hand, foot, and mouth disease is not the same as hoof and mouth disease, which is an unrelated illness that affects barnyard animals and livestock.

Hand foot and mouth disease is also called enteroviral vesicular stomatitis.


Hand, foot, and mouth disease is caused by viruses that belong to the Enterovirus genus (group), including polioviruses, coxsackieviruses, echoviruses, and enteroviruses.

Coxsackievirus A16 is the most common cause of hand, foot, and mouth disease in the United States, but other coxsackieviruses can also cause the illness.

Enterovirus 71 has also been associated with cases and outbreaks of hand, foot, and mouth disease.  Less often, enterovirus 71 has been associated with severe disease, such as encephalitis.

The viruses that cause hand, foot, and mouth disease can be found in an infected person’s –

  • nose and throat secretions (such as saliva, sputum, or nasal mucus),
  • blister fluid, and
  • feces (stool)

An infected person may spread the viruses that cause hand, foot, and mouth disease to another person through –

  • Close personal contact,
  • The air (through coughing or sneezing),
  • Contact with feces,
  • Contact with contaminated objects and surfaces.


Mild fever is usually the first sign of hand, foot and mouth disease. This starts 3–5 days after your child has been exposed to the disease.

After the fever starts, your child may develop other symptoms, including –

  • Painful red blisters on their tongue, mouth, palms of their hands, or soles of their feet
  • Loss of appetite
  • A sore throat and mouth
  • A general feeling of weakness or tiredness.

The disease is usually mild and lasts 3–7 days.

It can be confused with –

  • Chickenpox (but the chickenpox rash is all over the body)
  • Cold sores in a child’s mouth.


  • Loss of body fluids (dehydration)
  • Seizures due to high fever (febrile seizures)


There is no specific treatment for hand, foot, and mouth disease. However, some things can be done to relieve symptoms, such as –

  • Taking over-the-counter medications to relieve pain and fever
  • Using mouthwashes or sprays that numb mouth pain

People who are concerned about their symptoms should contact their health care provider.

Lifestyle Changes

A person can lower their risk of being infected by –

  • Washing hands often with soap and water, especially after changing diapers and using the toilet. Visit CDC’s Clean Hands Save Lives! for more information.
  • Cleaning and disinfecting frequently touched surfaces and soiled items, including toys.
  • Avoiding close contact such as kissing, hugging, or sharing eating utensils or cups with people with hand, foot, and mouth disease.

Alternative Treatment

Probiotics maximize the benefits of a healthy diet by supporting normal absorption and assimilation of nutrients in the gut. It boosts the immune system and is used as a natural antibiotic.

Lemon Balm Tea – Contains anti-viral properties which speed the recovery of viral infections.

Elderberry Syrup – Strengthens the immune system.

Golden Echinacea – This is an herbal supplement that helps support healthy fuction of the immune system.

Vitamin is known to help the body heal tissues and is known to boost immunity.


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