In the Know: TriStar Medical Group Doctor Breaks Down Hand, Foot & Mouth Disease

An outbreak of hand, foot and mouth (HFM) disease recently caused more than a dozen students at Florida State University to fall ill. This viral infection, not to be confused with foot-and-mouth disease, which occurs in animals only, typically affects small children and is found in daycare centers, not college campuses. So, why has hand, foot and mouth, also struck our college-aged population?

“That is a little bit of a harder question, but the answer is likely multifactorial,” Dr. Matt Ducey, an HCA-affiliated TriStar Medical Group family physician, said. “First, the virus causing this particular outbreak is more contagious, making it easier for others to get sick. Second, the environment of a college campus, where large social gatherings such as parties and campus events can help spread the disease more efficiently.”

“Hand, foot and mouth can affect all ages,” the Brentwood (Tenn.) East Family Medicine doctor added, “but it does tend to favor younger children.”

Dr. Ducey took some of our questions to help break down the disease, its symptoms and how you can help prevent it below. Take a look!

What is hand, foot and mouth disease?
Hand, foot and mouth (HFM) disease is an infection that is named after the classic findings of small ulcers found in the mouth, as well as red bumps with a clear center found on the hands and feet.

What are the causes of HFM?
There are a few different viruses we know of that causes HFM, and probably many more that we have yet to identify. But the most common viruses that cause it are enterovirus and coxsackievirus.

What are the symptoms?
The classic symptoms are a non-itchy rash found inside the mouth – primarily the tongue and the side of the mouth – as well as the hands and feet.  However, sometimes we see symptoms that happen before the rash, specifically, low grade fever, abdominal pain, diarrhea and vomiting.  We also can see refusal to eat in very young children.  And in very rare cases, severe symptoms such as paralysis, meningitis, fluid in the lungs, and failure of the heart can happen, but for most patients, it is a very mild infection.

Who’s most at risk for HFM?
Typically, this is a disease of infants and children below the age of five, but it is quite contagious and sometimes large outbreaks can happen in close quarters: daycares, college campuses, summer camps, etc.  The most recent Florida State outbreak is a good example of this. Also, it is most common in the summer and fall months.

How does it spread?
The virus is spread from person to person through contact of bodily fluids (mainly stool, but also oral and respiratory secretions, as well as liquid from the rash).  People are considered most infectious during the first seven days of illness.

How is it treated?
Treatment is mainly supportive with over-the-counter pain and fever reducing medicine (i.e. Tylenol), in addition to maintaining good hydration.  HFM is most dangerous for very young children who refuse to eat due to the mouth ulcers. They sometimes require hospitalization for hydration purposes.

How do you prevent hand, foot and mouth disease?
Like any other viral illness, hand washing is the single most important thing you can do to prevent transmission.  Close contact with any infected person should also be avoided for seven days, if at all possible.

Dr. Matt Ducey is a member of HCA’s Physician Services Group. He is board-certified in family medicine and provides patient-centered care to the entire family, including infants and seniors, with a focus on preventative care and chronic diseases, specifically, diabetes.