Gajendra Singh Godara
Sep 18, 2025
8
mins read
HFMD is a highly contagious viral infection, mostly caused by non-polio enteroviruses such as Coxsackie A virus and Enterovirus 71.
It primarily affects children under five years but can also infect older children and adults.
The disease is named for its blister-like rash on the hands, feet, and mouth, but rashes can also appear on the chest, back, arms, legs, buttocks, and genitals.
HFMD spreads through direct contact with saliva, nasal mucus, fluid from blisters, feces, or contaminated surfaces and objects.
Multiple viruses can cause HFMD, so reinfections are possible.
It is distinct from foot-and-mouth disease of livestock, which affects animals and is caused by different viruses.
The infection is typically mild and self-limiting but occasionally can cause severe complications.
Hand, Foot, and Mouth Disease (HFMD) has seen a surge in cases across metros like Delhi, Mumbai, and Kolkata since 2024, mostly affecting children under 5 years. The outbreaks, commonly linked to Coxsackievirus and Enterovirus strains, prompted health advisories, school isolation protocols, and highlighted the disease’s rapid spread during the monsoon season.
Table of content
Transmission routes are important for policy and containment. HFMD spreads through:
Direct contact with saliva, nasal mucus, or fluid from blisters.
Faecal-oral transmission, via contact with contaminated hands or surfaces.
Respiratory droplets during close contact.
Mild fever, sore throat, and general malaise often appear in early stages.
Painful mouth ulcers develop on the tongue, gums, and inside cheeks, sometimes reducing appetite.
A blister-like rash forms on the palms, soles, and sometimes on buttocks, arms, and legs; usually not itchy.
Children may become irritable and have difficulty eating or drinking due to mouth pain.
Symptoms usually last 7-10 days and improve without scarring; rare complications can affect the nervous system.
Diagnosis is mainly clinical. Laboratory confirmation uses PCR from throat swabs, blister fluid or stool to detect enteroviral RNA. In routine primary care, lab tests are reserved for atypical or severe cases and for epidemiological surveillance.
Treatment and prevention
There is no specific antiviral treatment or widely used vaccine for HFMD in most countries. Care is supportive:
Maintain hydration; give oral rehydration solutions if needed.
Pain control with paracetamol or ibuprofen for fever and mouth pain. Avoid aspirin in children because of the risk of Reye's syndrome.
Topical oral anaesthetics or medicated syrups may ease feeding or throat pain in older children.
Isolate until fever resolves and mouth sores improve, especially in childcare settings.
Prevention relies on hygiene and public health measures: frequent handwashing, surface disinfection, exclusion policies in schools and day care for symptomatic children, and public awareness during outbreaks.
Comparative analysis: HFMD versus other rash-fever illnesses
Candidates often confuse HFMD with measles, chickenpox or foot-and-mouth disease of livestock. The table below highlights key differentiators.
Feature | HFMD | Chickenpox | Measles | Foot-and-mouth disease (animals) |
Typical age | Infants and young children | Any age, common in children | Any age, common in unvaccinated children | Livestock |
Rash distribution | Hands, feet, mouth, buttocks | Trunk, face, spreads all over | Face then trunk; Koplik spots | Mouth, feet of animals |
Agent | Non-polio enteroviruses | Varicella zoster virus | Measles virus | Different aphthovirus; not related to human HFMD |
Vaccine available | Generally no | Yes | Yes | Not relevant to humans |
The Integrated Disease Surveillance Programme (IDSP) monitors HFMD outbreaks, ensuring timely detection and reporting at local and state levels.
Health advisories have been issued for schools and childcare centres to promote hygiene practices such as regular handwashing and surface disinfection to reduce transmission.
Temporary closure or division of affected school classes is recommended when multiple cases are reported to prevent outbreaks.
Designated hospitals have been identified for managing severe HFMD cases, with training provided to healthcare staff for early detection and intervention.
Public awareness campaigns and information leaflets are circulated to educate parents and communities about signs, symptoms, and preventive measures.
Q: Is Hand, Foot, and Mouth contagious disease?
A: Yes. HFMD spreads through direct contact with nasal or throat discharges, blister fluid, and stool. It is most contagious during the first week of illness.
Q: Can adults get HFMD and transmit it to children?
A: Adults can be infected, often with milder symptoms, and may transmit the virus to children. Good hygiene lowers this risk.
Q. Is there any specific cure or vaccine available for Hand, Foot, and Mouth Disease (HFMD)?
A: There's no cure for HFMD and no vaccine to prevent it.
Hand, Foot, and Mouth Disease remains a contagious viral disease primarily affecting young children with mostly mild symptoms but potential for severe complications in rare cases. Strengthening early detection, enhancing public awareness, and improving hygiene in schools and childcare centres are critical to containing outbreaks. Future efforts should focus on developing specific antiviral treatments and vaccines, along with robust surveillance systems to quickly identify and respond to new outbreaks, ensuring better preparedness and protection for vulnerable populations.
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