Hand-foot-and-mouth disease is a common childhood illness caused by coxsackievirus A16. In many people, infection with the virus causes mild or no symptoms. In others, infection may result in painful blisters in the mouth, on the gums and tongue, on the palms and fingers of the hand, or on the soles of the feet. The fluid in these blisters contains the virus, and symptoms may last for 7 to 10 days. The infection usually goes away without any serious complications.

Hand-foot-and-mouth disease can be spread when the virus present in the blisters is passed to another person. The virus can be passed through saliva from blisters in the mouth, through the fluid from blisters on the hands and feet, or through the infected person's feces.

Outbreaks in childcare facilities usually coincide with an increased number of cases in the community. If an outbreak occurs in the child care setting:

Make sure that all children and adults use good hand washing technique. (See "hand washing" in chapter on "Protective Practices.")

Do not exclude ill persons because exclusion may not prevent additional cases since the virus may be excreted for weeks after the symptoms have disappeared. Also, some persons excreting the virus may have no symptoms. However, some benefit may be gained by excluding children who have blisters in their mouths and drool or who have weeping lesions on their hands.

© January 1997