Am I still contagious with Hand, Foot, and Mouth Disease (HFMD) if I have no respiratory symptoms and no blister drainage, but the blisters are still spreading?

Yes, You Are Still Contagious with Hand, Foot, and Mouth Disease

You remain contagious with HFMD even without respiratory symptoms or draining blisters, especially since your blisters are still spreading, which indicates active viral replication. You should not return to work, school, or other activities until specific criteria are met 1.

Understanding Your Contagious Status

Active Viral Shedding Despite Lack of Symptoms

• The spreading of new blisters indicates ongoing viral activity and active contagiousness, regardless of whether you have respiratory symptoms or visible drainage 1.
• HFMD spreads through multiple routes: direct contact with respiratory secretions, saliva, fluid from blisters, and importantly, through contaminated surfaces (fomites) 1, 2.
• You don't need visible drainage for transmission to occur—the virus is present in the lesions themselves and can be transferred through direct contact 1.

Duration of Contagiousness

• The contagious period lasts from 1-2 days before symptoms appear until all blisters have dried and crusted over, typically 7-10 days from symptom onset 1.
• Since your blisters are still spreading, you have not yet reached the end of this contagious window 1.
• Viral shedding continues in stool for several weeks after symptoms resolve, meaning fecal-oral transmission remains possible even after skin lesions heal 1.
• You should be considered potentially contagious for at least 10-14 days total 1.

When You Can Safely Return to Normal Activities

You must meet all three of these criteria before returning to work, school, or other activities 1:

1. All blisters have dried and crusted over (not just stopped draining—they must be completely crusted)
2. At least 7 days have passed since symptom onset
3. Fever has resolved without fever-reducing medications

Since your blisters are still spreading, you have not met criterion #1, and therefore remain contagious 1.

Critical Prevention Measures You Must Follow Now

Hand Hygiene is Essential

• Practice thorough handwashing with soap and water—this is the most important preventive measure 1, 2.
• Alcohol-based hand sanitizers alone are insufficient against enteroviruses that cause HFMD; you must use soap and water 1.
• Wash hands after touching any lesions, after using the bathroom, and before any contact with others 1.

Isolation and Contact Precautions

• Avoid close contact with others during this contagious period, particularly children under 5 years, pregnant women, and immunocompromised individuals 1.
• Do not share drinking vessels, eating utensils, towels, or any personal items 1.
• Properly dispose of tissues containing any secretions 1.

Environmental Cleaning

• Enteroviruses can remain viable on surfaces for up to 28 days, making environmental disinfection critical 1.
• Disinfect frequently touched surfaces (doorknobs, countertops, toys, phones) regularly 1, 2.
• This is a commonly overlooked aspect that can perpetuate transmission 1.

Common Pitfalls to Avoid

• Do not assume you're no longer contagious just because blisters aren't draining—the virus is still present and transmissible 1.
• Do not rely solely on absence of fever as an indicator that you can return to activities; all three criteria must be met 1.
• Do not underestimate fecal-oral transmission—continue strict hand hygiene after bathroom use for several weeks 1.
• Returning to work or school prematurely can trigger outbreaks, particularly in childcare or healthcare settings 1.