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What Causes Hand, Foot and Mouth Disease?

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  • Written By: Tricia Ellis-Christensen
  • Edited By: Jessica Seminara
  • Last Modified Date: 16 September 2016
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Hand, foot and mouth disease (HFMD) is a virus that can result from contagion with several viruses. These derive from a group called the enterovirus genus. For the virus to cause contagion it has to enter the mouth or be breathed in. Behavior should therefore be considered a cause in the spread of HFMD.

A number of viruses in the enterovirus group are responsible for hand, foot, and mouth disease. Undoubtedly, the most common is the coxsackievirus A 16 type. Enterovirus or EV 71 is also indicated in a large number of breakouts of this illness.

The virus type can be important because EV 71 may produce a more severe illness with a higher risk of complications. Coxsackievirus A 16 sometimes causes viral meningitis, though this is rare. In contrast, EV 71 can more often cause viral meningitis, and has also been linked to encephalitis and paralysis.

Though hand, foot and mouth disease is often a relatively benign illness, its potential for complications suggests it needs to be addressed with due seriousness. In other words, efforts to stop its transmission are important. The virus is commonly transmitted through ingestion, frequently by putting unwashed hands into the mouth after they’ve touched feces or fluids from an infected person. This contact doesn’t have to be direct, and shared toys or surfaces, which can host the virus for days, may pass the infection.

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Another means of infection with hand, foot and mouth disease is exposure to droplets, as from coughs or sneezes. This is harder to avoid because symptoms may emerge after a person is contagious. There can be no way to know, in some instances, whether a sneeze carries the illness.

Environments that seem most hospitable to hand, foot and mouth disease include daycares and preschools. Many kids are immune to this condition by the time they’re 10 years old. In daycare settings, though, there is more chance of contact with contagious fluids, due to diapering and toiletry needs and a high number of children who aren’t immune.

Young children are also likely to have very poor hygiene. Many kids do put their hands in their mouth often. Regular hand-washing and disinfecting of toys, plus making sure all workers follow protocol when changing diapers or helping kids with toilet use, may aid in preventing the spread of HFMD. It may stll be impossible to always keep the infection from passing.

Given the difficulty of controlling disease spread in places like daycare facilities, it’s important to keep kids with this illness at home until a physician approves their return to school. Doctors don’t always test for the specific viral cause of hand, foot, and mouth disease, but they should caution parents about signs that could signal severe complications. At home, parents may want to follow good hand-washing policies during an outbreak. They may also wish to encourage babies and toddlers to keep hands out of their mouths.

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