Hand, Foot, and Mouth Disease Contagiousness Period
Hand, foot, and mouth disease (HFMD) is contagious from the onset of symptoms until the fever resolves and blisters have dried up, typically 7-10 days after symptom onset.
Understanding HFMD Transmission
Hand, foot, and mouth disease is a highly contagious viral illness primarily affecting young children under 5 years of age. It is caused by enteroviruses, most commonly coxsackieviruses A6, A10, A16, and enterovirus 71 1, 2.
The disease spreads through:
- Fecal-oral contact
- Oral-oral contact
- Respiratory droplets
- Contact with contaminated surfaces and objects
Incubation and Contagious Period
- Incubation period: 3-10 days from exposure to symptom onset 2
- Most contagious period: During the first week of illness when fever and blisters are present
- Total contagious period: From symptom onset until fever resolves and all blisters have dried up (typically 7-10 days) 3
Clinical Presentation and Diagnosis
HFMD typically presents with:
- Low-grade fever
- Sore throat
- Maculopapular or papulovesicular rash on hands and feet
- Painful oral ulcerations/sores
- Possible rash on buttocks
The diagnosis is primarily clinical, based on the characteristic distribution of lesions and symptoms.
Prevention of Transmission
To prevent spreading HFMD to others, patients should:
Practice good hand hygiene
- Wash hands frequently with soap and water (more effective than hand sanitizer) 3
- Wash hands especially after diaper changes and using the toilet
Avoid close contact during contagious period
- Avoid kissing, hugging, and sharing utensils
- Stay home from school, daycare, or work until fever is gone and mouth sores have healed
Clean and disinfect
- Regularly disinfect frequently touched surfaces
- Avoid sharing personal items like towels, utensils, and cups
Special Considerations
High-Risk Settings
People in professions with high transmission potential (healthcare workers, childcare providers) should be especially cautious and consider staying home during the contagious period 4.
Complications
While HFMD is usually self-limiting, be aware of rare but serious complications:
- Neurological complications (meningitis, encephalitis)
- Cardiopulmonary complications
- Nail changes (onychomadesis) occurring weeks after infection 2, 5
Treatment
Treatment is supportive and focuses on symptom relief:
- Adequate hydration
- Pain relief with acetaminophen or ibuprofen as needed
- Soft, cold foods for oral comfort
There is no specific antiviral treatment or vaccine currently available for HFMD in the United States 3.
When to Return to School/Work
Children and adults with HFMD may return to school or work when:
- Fever has resolved for at least 24 hours without fever-reducing medication
- Mouth sores have healed enough to allow normal eating and drinking
- The person feels well enough to participate in normal activities
Remember that some viral shedding may continue for weeks after symptoms resolve, so continued good hygiene practices are important.