Can Hand, Foot, and Mouth (HFMD) disease last up to 10 days?

Hand, Foot, and Mouth Disease Duration

Hand, foot, and mouth disease (HFMD) typically lasts 7-10 days, with lesions usually resolving within this timeframe, though in some cases it can persist for up to 10 days. 1, 2

Clinical Course and Duration

HFMD follows a predictable pattern:

1. Initial phase (Days 1-2):

   • Low-grade fever appears first
   • Malaise and sore throat may be present
   • Oral lesions begin to develop

2. Rash development (Days 2-5):

   • Characteristic rash appears 1-5 days after fever onset
   • Initially presents as maculopapular lesions
   • Evolves to vesicular eruptions on hands, feet, and in the mouth
   • May also involve buttocks and groin areas

3. Resolution phase (Days 7-10):

   • Lesions typically resolve within 7-10 days 2
   • Fever subsides earlier than the rash

Factors That May Affect Duration

• Viral strain: Coxsackievirus A6 (CVA6) infections tend to cause more severe disease with potentially longer duration than typical strains 3
• Age: Adults with HFMD (particularly those infected with CVA6) may experience higher fever and longer duration of disease 3
• Severity: More severe cases with widespread rash distribution may take longer to resolve completely

Complications That May Extend Illness

While rare, complications can extend the duration of illness:

• Onychomadesis: Loss of nails occurring up to two months after initial symptoms (particularly with CVA6 infections) 4
• Neurological complications: In rare cases, particularly with Enterovirus 71 (EV71) infections 5

Management During Extended Duration

If HFMD symptoms persist beyond 7 days:

• Continue supportive care focused on hydration and pain relief with acetaminophen or ibuprofen as needed 2
• Avoid oral lidocaine as it is not recommended 2
• Monitor for any signs of rare complications (high fever, severe headache, altered mental status)
• Maintain good hand hygiene and disinfection of surfaces to prevent spread to others 1

When to Seek Additional Medical Care

Seek medical attention if:

• Fever persists beyond 3-4 days
• Signs of dehydration develop (dry mouth, decreased urination)
• Any neurological symptoms occur (unusual drowsiness, severe headache)
• Symptoms worsen after 7 days instead of improving

Prevention

The best prevention methods include:

• Thorough handwashing, especially after diaper changes
• Disinfecting potentially contaminated surfaces
• Isolation during the acute phase of illness 1

Remember that while HFMD typically resolves within 10 days, the patient remains contagious during this period, so continued hygiene measures are important to prevent spread to others.