Age Group Most Commonly Affected by Hand, Foot, and Mouth Disease
Hand, Foot, and Mouth Disease (HFMD) most commonly affects children under 5 years of age. 1, 2
Epidemiology of HFMD
HFMD demonstrates a clear age predilection with the following characteristics:
- Primary affected population: Children under 5 years of age 1, 2, 3
- Average age of infection: Around 3 years (3.10 years in a Serbian outbreak study) 1
- Age range: Most cases occur in patients younger than 10 years 3
- Seasonal pattern: Most common during late spring, early summer, and fall months 1
Risk Factors and Transmission
HFMD is highly contagious and spreads through:
- Fecal-oral contact
- Oral-oral contact
- Respiratory droplets 3
Children are particularly vulnerable due to:
- Immature immune systems
- Close contact in daycare and school settings
- Less developed hygiene practices
Clinical Presentation in Children
The typical presentation includes:
- Low-grade fever
- Maculopapular or papulovesicular rash on hands and feet
- Painful oral ulcerations/vesicles 3
- Lesions usually resolve within 7-10 days 3
Causative Agents
HFMD is caused by human enteroviruses, most commonly:
- Coxsackievirus A16 (CV-A16) - traditionally most common 4
- Enterovirus A71 (EV-A71)
- Recent shift toward Coxsackievirus A6 and A10 5
Complications
While most cases resolve spontaneously without complications, severe cases can lead to:
- Neurologic complications (rare)
- Cardiopulmonary complications (rare)
- Brain stem encephalitis (particularly in children under 3 years) 5
Prevention
The most effective prevention methods include:
- Handwashing
- Disinfecting potentially contaminated surfaces and fomites 3
- Implementing surveillance systems to prevent outbreaks 1
Diagnostic Approach
Diagnosis is primarily clinical, but laboratory confirmation can be obtained through:
- Reverse transcriptase PCR (RT-PCR) targeting the 5′non-coding regions 4
- Samples from vesicle fluid, respiratory specimens, or stool 4
Management
Treatment is supportive and focuses on:
- Maintaining hydration
- Pain relief with acetaminophen or ibuprofen as needed
- No specific antiviral therapy is available 3
HFMD is highly infectious until blisters have disappeared, though the virus may remain present in feces for several weeks 6.