You felt under the weather with a mild fever and sore throat, but soldiered on with over-the-counter pain medicine. Now you’ve got a few pink spots dotting your hands. Where did they come from? The answer: From the same virus that caused your other symptoms. In hand, foot and mouth disease, coxsackievirus 16 is the usual suspect; less often, other enteroviruses are to blame.
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“Fever and feeling ill are the worst of it until you see vesicles in your mouth and on your hands; that’s what gives it away,” says family medicine specialist Neha Vyas, MD.
These tiny, fluid-filled blisters can develop in your throat, your tongue or your inner cheek, as well as on your hands and feet.
“While kids usually have vesicles, adults don’t always get them — so their hand, foot and mouth disease often goes unrecognized,” she notes.
How often do adults get hand, foot and mouth disease? More often than you’d think. Anyone who has contact with kids or with others who have the disease is susceptible.
How contagious is hand, foot and mouth disease?
“Hand, foot and mouth disease spreads really quickly, especially in the spring, summer and early fall,” says Dr. Vyas.
It catches on like wildfire in crowded living conditions (think college dorms). “So it’s possible to get it all year long — even in the winter months,” she adds.
Why does hand, foot and mouth disease literally “go viral” so quickly? Because it’s passed on in three different ways:
- From mouth to mouth — not just by kissing, but also by being close.
- From inhaling respiratory droplets.
- From touching fecal matter, which then finds its way into your mouth.
“The other reason it’s so easily transmitted is that you can pass it on to others before you have symptoms, because you don’t realize you’re ill,” says Dr. Vyas.
How long do symptoms last?
Symptoms like fever and sore throat last for a week or so.
Hand lesions can last for two weeks, throat lesions can last for a few weeks, and foot lesions can last for several weeks, notes Dr. Vyas.
“The blisters can be painful, so when you have them in your mouth, as kids do, it can hurt to swallow,” she adds.
How is hand, foot and mouth disease treated?
Doctors generally do not treat hand, foot and mouth disease, says Dr. Vyas. Instead, they recommend supportive care, such as using acetaminophen (Tylenol®) and ibuprofen (Advil®) for fever and pain.
Can doctors give you antivirals to shorten the duration of your symptoms, as they do for flu?
Unfortunately, no. “If antivirals are to be effective, you have to give them within the first couple of days,” says Dr. Vyas.
“We usually know right away when someone has flu. But by the time we know we’re dealing with hand, foot and mouth disease, it’s usually too late — the illness has subsided.”
Also, no studies have found antivirals like acyclovir to be effective for hand, foot and mouth disease. And antibiotics only help when you have a bacterial infection, not a virus.
Is this illness ever dangerous?
“The long and short of it is that hand, foot and mouth disease can be problematic,” says Dr. Vyas.
“Meningitis is a big worry, because, like all viruses, it can cross the blood-brain barrier. It can also infect the heart and cause myocarditis.”
She hastens to add that those who are susceptible to complications are usually sick to begin with — for example, they may be elderly or frail, or have cancer or other diseases that weaken the immune system.
But hand, foot and mouth disease is also risky for healthy pregnant women because it increases the risk of stillbirth. Also, late in pregnancy, the baby can become infected in the womb even if the mother is not.
All that being said, the likelihood of complications from hand, foot and mouth disease is low, she stresses.
How can you avoid spreading the illness?
When you’re diagnosed with hand, foot and mouth disease, it’s important to take universal precautions:
- Wash your hands before you eat.
- Disinfect all surfaces you touch, especially doorknobs, faucets and toilet handles.
- Stay home from work, school and social events.
And because you can have hand, foot and mouth disease without knowing it, “avoid people who are elderly or immunocompromised at the first sign of a fever,” notes Dr. Vyas.
“It’s also important to stay away from pregnant women, especially in the last few weeks of pregnancy.”