Hand, Foot and Mouth Disease (HFMD)

What is Hand, Foot and Mouth Disease(HFMD)?

Hand, foot and mouth disease (HFMD) is primarily caused by different types of enteroviruses (EV). Although the patients of HFMD are mostly children, the disease can actually affect people of all ages. While the annual peak period of HFMD in Hong Kong is generally from May to July, a smaller peak may also occur from October to December. Among the various kinds of enteroviruses, enterovirus 71 (EV71) has a greater chance of causing serious complications such as viral meningitis, encephalitis, poliomyelitis-like paralysis, etc.

What are the common symptoms of HFMD?

Most patients of HFMD have mild symptoms and can recover in about 7 to 10 days. During the initial stage, they will generally suffer from high fever, loss of appetite, tiredness, and sore throat. After a day or two, small red spots or blisters may appear inside the oral cavity on the tongue, gum, and both sides of the cheeks. There may also be some non-itchy rash on the palms, soles, buttocks, and genital area. Sometimes the rash may also be accompanied by blisters. Meanwhile, some patients may not have any symptoms or just have some skin rash and mouth ulcers.

How is HFMD transmitted?

HFMD is mainly transmitted through oral secretions, including patients’ saliva, nasal or throat discharges, or contact with patients’ broken blisters, faeces, or other contaminated objects.

Enteroviruses are highly contagious, especially in the first week after the patients have become infected. The virus may even continue to spread for several weeks through the patients' faeces.

Is it true that only children will develop HFMD?

People of any age can suffer from HFMD at any time. While there may occasionally be adult cases, children are more likely to suffer from HFMD when compared to adults. The reason is that children relatively frequently put their hands in their mouth or directly touch their nose or eyes. If the children's hands have contacted the virus and are not cleaned in time, they will be susceptible to infection. Moreover, as schools are places for social and group activities, children often come into contact with each other. This will in turn increase the chance for them to be infected by the viruses.

Since there is currently no medication for treating HFMD, patients mainly rely on replenishment of sufficient water and rest to recover. Moreover, doctors will also use medications to relieve the pain caused by oral ulcers. Children who are infected with HFMD should stay home and avoid participating in group activities. Meanwhile, children who had been infected with EV71 should rest at home for an additional two weeks after recovery before returning to school in order to avoid passing the virus to others.

Does lifelong immunity develop after a patient has recovered from HFMD?

Our body normally produces antibodies to the corresponding enterovirus after recovering from HFMD. However, since HFMD can be caused by different types of enteroviruses, patients will not have any immunity towards infections caused by other enteroviruses in the future.

As there is no vaccine to prevent HFMD, people can take the following measures to maintain personal and environmental hygiene:

1. Cultivate good habits on personal hygiene

Wash hands frequently. Use liquid soap to wash your hands for at least 20 seconds or use 70% alcohol-based hand rub. Always keep your hands clean.
Cover your mouth and nose with a tissue when sneezing or coughing. Dispose of the used tissues in covered rubbish bins and clean your hands afterwards.
Avoid sharing food or personal belongings with others.
If you feel sick, you should consult a doctor and avoid going to crowded places.

2.Maintain environmental hygiene

Use 1:99 diluted bleach to wipe and disinfect frequently contacted surfaces. Use 1:49 diluted bleach to disinfect areas contaminated by respiratory secretions, vomitus, or faeces.
Avoid group activities as much as possible during HFMD outbreaks at school.

Late Updated: July 2020

Please note that all medical health articles featured on our website have been reviewed by Quality Healthcare doctors. The articles are for general information only and are not medical opinions nor should the contents be used to replace the need for personal consultation with a qualified health professional on the reader’s medical condition.