What causes Hand, Foot, and Mouth (HFM) disease?

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Last updated: May 1, 2025View editorial policy

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From the Guidelines

You can get Hand, Foot, and Mouth (HFM) disease through direct contact with an infected person's saliva, nasal secretions, fluid from blisters, or feces, as well as by touching contaminated objects and then touching your eyes, nose, or mouth. HFM disease is typically caused by enteroviruses, most commonly coxsackievirus A16 and enterovirus 71, which enter the body through the digestive tract and spread to other areas 1. The disease is most contagious during the first week of illness, though the virus can remain in the body for weeks after symptoms disappear. Some key ways to contract HFM disease include:

  • Close personal contact with an infected person
  • Touching contaminated objects and then touching your eyes, nose, or mouth
  • Consuming contaminated food or water Common settings for transmission include:
  • Childcare centers
  • Schools
  • Households with young children To prevent infection, it is essential to practice good hygiene, such as:
  • Washing hands frequently with soap and water, especially after changing diapers and using the toilet
  • Disinfecting frequently touched surfaces
  • Avoiding close contact with infected individuals
  • Not sharing eating utensils or cups 1.

From the Research

Causes of HFM Disease

  • HFM disease is caused by human enteroviruses and coxsackieviruses 2
  • The disease can be transmitted by fecal-oral, oral-oral, and respiratory droplet contact 2

Risk Factors

  • Outbreaks can occur in the spring to fall and are common in North America 2
  • Most cases occur in patients younger than 10 years, with children younger than 5 years being most commonly affected 2, 3

Prevention

  • The best methods to prevent the spread of HFM disease are handwashing and disinfecting potentially contaminated surfaces and fomites 2
  • Vaccination of susceptible individuals in high-risk areas and good personal hygiene are also important preventative measures 3

Transmission

  • HFM disease is highly contagious and can be spread through close contact with an infected person 2, 3
  • The disease can also be spread through contaminated surfaces and objects 2

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Hand-Foot-and-Mouth Disease: Rapid Evidence Review.

American family physician, 2019

Research

Hand, Foot, and Mouth Disease: A Narrative Review.

Recent advances in inflammation & allergy drug discovery, 2022

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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