Hand, foot and mouth disease: consult a doctor by instant messaging

What is hand, foot and mouth disease (HFMD)?

Hand, foot and mouth disease (HFMD) mainly affects young children, and more rarely adults. It is a common viral infectious disease that presents with characteristic skin lesions (or blisters) and mild systemic symptoms. Caused by a virus of the Enterovirus genus, in the Picornaviridae family, HFMD is highly contagious. Among the viruses involved, the main culprits are Coxsackievirus A16 (CVA16) and Enterovirus 71 (EV-A71). These pathogens generally infect the epithelial cells of the skin and mucous membranes, which leads to vesicular lesions on the hands, feet and mouth. Neurological or cardiac complications can occasionally occur in rare cases, particularly with EV-A71, but the disease is otherwise usually mild. Highly contagious, HFMD spreads through direct contact with bodily secretions (nasal secretions, saliva, blister fluid and stool). In 80% of cases, children under 5 are affected by the disease. It is indeed often observed in community settings such as nurseries and pre-schools. Lastly, it is worth noting that HFMD outbreaks, just like flu, follow a marked seasonal pattern. Most often, they occur during the warm, humid months, such as spring and summer. In tropical areas, the condition can be present year-round; seasonal peaks are generally more subtle. According to studies, young boys appear to be more affected than girls, although the exact reasons remain uncertain. Most infections resolve spontaneously to a full recovery without requiring treatment, but newborns and immunocompromised children are at higher risk of serious complications, notably encephalitis or aseptic meningitis.

What are the symptoms of hand, foot and mouth disease?

The symptoms of hand, foot and mouth disease mainly include mouth ulcers as well as skin rashes. Indeed, the inflammatory response caused by infection of the oral epithelial cells and keratinocytes leads to characteristic lesions. The infection triggers the release of pro-inflammatory cytokines and cell destruction. Regarding systemic symptoms, these include:

  •A moderate fever;

  •Fatigue;

  •Sometimes, vomiting or convulsions, caused by a heightened immune response.

Studies show that the disease generally follows a mild course, with spontaneous recovery in 7 to 10 days. Severe cases may nevertheless require hospital monitoring. If needed, online consultation on Feeli ensures patients receive care in under 2 hours.

Hand, foot and mouth disease: contagion and risk factors

Hand, foot and mouth disease (HFMD) is highly contagious and is mainly transmitted through direct contact with infected respiratory secretions, such as droplets released when sneezing. Faecal-oral transmission is also another common route of infection. Scientific studies highlight that viral particles can persist in stool for several weeks after symptoms disappear. Late-stage contagion is therefore possible, even after the illness has resolved. Furthermore, nurseries, schools and other group settings favour outbreaks because of often-limited hygiene practices and close contact between children. Lastly, seasonality is also a predisposing factor for the disease, with a peak in spring and summer. For more information, a diagnosis or suitable treatment, you can easily consult a GP or a paediatrician on Feeli.

Diagnosing hand, foot and mouth disease

Diagnosing hand, foot and mouth disease relies on various clinical examinations, including laboratory tests. PCR tests use the polymerase chain reaction, which makes it possible to identify the viruses responsible for the infection, such as Coxsackievirus A16 or Enterovirus 71. Testing can be carried out using nasopharyngeal, skin or stool samples. Serological tests are sometimes used to detect a specific immune response. Generally, the location of the blisters and how many there are allow the doctor to differentiate HFMD from other similar conditions such as herpes or chickenpox. Lastly, HFMD specifically affects the hands, feet and mouth (oral mucosa).

How is hand, foot and mouth disease treated?

Treatment for hand, foot and mouth disease is mainly symptomatic: managing the symptoms is possible, but there is currently no specific antiviral treatment recommended for this condition. Medical recommendations include:

  1- Measures to manage fever and pain:

    •Using pain-relief medication to reduce fever, such as paracetamol;

    •Applying topical anaesthetics to relieve mouth ulcers, such as lidocaine gel, particularly to make eating more comfortable;

  2- Drink plenty of water: painful mouth ulcers may make it difficult to take in fluids, which can lead to dehydration. It is therefore important to stay alert and keep hydrating properly;

  3- Symptom progression and monitoring: severe forms of the disease, although rare, may require hospital care, particularly in cases of cardiovascular (myocarditis) or neurological (encephalitis) involvement. In more critical cases, assisted ventilation is sometimes required;

  4- Clinical recommendations: supportive care is effective in reducing patient discomfort, but medical interventions, such as immunoglobulin infusion, are very rare and reserved for severe cases. Isolating contagious patients is essential to limit the spread of infection.

Prevention strategies and public health measures for hand, foot and mouth disease (HFMD)

Preventing hand, foot and mouth disease (HFMD) relies on:

  1- Hygiene and disinfection: frequent handwashing with soap, surface disinfection, etc.;

  2- Isolating infected patients;

  3- Vaccines in development: some vaccines in development have shown promising results, notably against Enterovirus 71 (EV71), the main cause of severe forms of hand, foot and mouth disease. They could reduce severe cases and deaths, although they are not yet available in Europe. Some clinical trials have taken place in Asia;

Awareness campaigns focused on early recognition of symptoms are essential to reduce the prevalence of the disease. For more information, teleconsultation on Feeli is an excellent option.

Is hand, foot and mouth disease contagious for adults?

Mainly associated with children, HFMD can also affect adults. Here is what we can say about hand, foot and mouth disease in adults:

  1- Causes and transmission:

    • Infection in adults is often linked to contact with infected children. The viruses most often involved are Enterovirus 71 and Coxsackievirus A16, and they are transmitted via the respiratory route, through direct contact with contaminated secretions, or via the faecal-oral route;

  2- Clinical symptoms: sometimes asymptomatic, HFMD in adults can cause:

    • A skin rash on the palms of the hands, soles of the feet and oral mucosa, in addition to pain;

    • Headaches, fever and generalised fatigue, often more severe than in children;

    • Very rarely, cardiac (myocarditis) or neurological (encephalitis) conditions.

  3- Treating HFMD in adults:

    • There is no specific antiviral treatment. Patients can manage their symptoms by taking fever medication (antipyretics), local anaesthetics and moisturising care to soothe the blisters;

  4- Preventive measures:

    • Follow health measures, such as disinfecting surfaces and washing hands frequently.

In conclusion, HFMD is rare in adults but can lead to more severe clinical forms. For more information, you can consult a doctor without an appointment on Feeli.