How does hand, foot, and mouth disease spread?

Written by Yan Xin Liang

Pediatrics

Updated on July 04, 2025

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Hand, foot, and mouth disease is an acute febrile illness caused by enterovirus infection, primarily characterized by herpetic or rash lesions on the hands, feet, mouth, and buttocks. The disease can present with recurring fever during its acute phase, or no fever, along with blisters or red papular rashes on the hands, feet, mouth, and buttocks. Transmission routes include droplets and saliva, as well as close respiratory contact. It can also be spread by hand-to-mouth contact and contact with the secretions from the blisters.

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Written by Yan Xin Liang

Pediatrics

44sec

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Hand, foot, and mouth disease is spread through:

Hand, foot, and mouth disease is an infectious disease caused by enteroviruses. There are more than 20 types of enteroviruses that can cause the disease, among which Coxsackievirus A16 and Enterovirus 71 are the most common. It frequently occurs in children under the age of 5 and manifests as mouth pain, loss of appetite, low fever, and small blisters or ulcers on the hands, feet, and mouth. Most affected children can recover within about a week. The main routes of transmission for hand, foot, and mouth disease can include the gastrointestinal tract, as well as respiratory transmission, and close contact such as through saliva, cough droplets, etc. Sharing utensils can also spread the disease.

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Written by Yan Xin Liang

Pediatrics

46sec

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How to prevent hand, foot, and mouth disease?

Hand, foot, and mouth disease is an infectious disease caused by enteroviruses, with over 20 types, commonly Coxsackievirus A16 and Enterovirus 71. These viruses are mainly transmitted through respiratory and digestive tracts, such as through droplets, hand-mouth contact, and lack of hygiene, leading to infection. To prevent this disease, first, avoid contact with individuals infected with hand, foot, and mouth disease. Second, ensure good ventilation in rooms and avoid crowded places. Additionally, it's best to clean and disinfect utensils and daily necessities. During the epidemic period, try to minimize visits to public places.

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Written by Yan Xin Liang

Pediatrics

52sec

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Symptoms of hand, foot, and mouth disease in children

Hand, foot, and mouth disease is an acute febrile illness caused by an intestinal virus infection. It is primarily characterized by vesicles or papulovesicular rashes on the hands, feet, mouth, and buttocks. There are over 20 types of intestinal viruses that can cause the disease, with the most common being Coxsackievirus A16 and Enterovirus 71. The main symptoms include recurrent fever, although some cases may not present with fever. There may also be symptoms such as drooling, and vesicles or papulovesicular rashes on the hands, feet, mouth, and buttocks. Additionally, some patients may exhibit lethargy, limb tremors, startle reactions, and vomiting. In severe cases, symptoms can include shortness of breath and coughing up pink frothy sputum, among others.

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Written by Yao Li Qin

Pediatrics

1min 37sec

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Symptoms of hand, foot, and mouth disease

Hand, foot, and mouth disease is caused by an intestinal virus infection. It primarily manifests as a disseminated rash of maculopapules or vesicular papules on the hands, feet, mouth, and buttocks. The main symptoms of hand, foot, and mouth disease start with a fever in children, accompanied by a sore throat, reluctance to eat, and some children may have mild cough and runny nose. During a physical examination, small vesicles can be found on the oral mucosa, or they may have already ulcerated into shallow ulcers. Subsequently, rashes appear on the hands and feet, starting as maculopapules and slowly transforming into vesicular papules, about 3 to 7mm in size, with a firm base. The skin of the vesicle is slightly thicker, surrounded by erythema, and the rash is mostly located at the extremities. Sometimes, it can extend to the arms, legs, buttocks, and perineum, showing a centrifugal distribution. The number of rashes is relatively small, typically ranging from a few to several dozen. Most of them resolve on their own in 2 to 3 days without scaling, scarring, or pigmentation. Vesicles or ulcers in the mouth mostly heal within a week. Most cases of hand, foot, and mouth disease have a short duration and mild condition, with generally good prognosis.

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Written by Feng Hai Tao

Pediatrics

1min 43sec

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Symptoms of Hand, Foot, and Mouth Disease in Children

The symptoms of hand, foot, and mouth disease in children primarily result from viral infections of the intestine, a common communicable disease particularly prevalent among children under five, especially those under three years of age. The symptoms can be categorized into typical cases where most children experience a sudden onset of illness, often accompanied by upper respiratory tract infection symptoms such as fever, nasal congestion, runny nose, sneezing, loss of appetite, nausea, and vomiting. Some may also experience headaches. Additionally, rashes or vesicles may appear on the hands, feet, mouth, and buttocks, typically surrounded by inflammatory red skin with little fluid inside the vesicles. These lesions are characterized by being painless, non-itchy, non-crusted, and non-scarring. It is important to note that not all children will have simultaneous rashes on their hands, feet, and mouth areas. In severe cases, while most children experience only mild symptoms and can be isolated at home, some may develop complications involving the nervous system and impairment of respiratory and circulatory functions. This can manifest as muscle spasms, encephalitis, acute flaccid paralysis, cardiopulmonary failure, and neurogenic pulmonary edema. Therefore, once a severe case is identified, hospitalization is recommended to prevent potential fatalities or long-term sequelae.