In the United States, coxsackievirus A16 is most commonly detected, but other enteroviruses (such as coxsackievirus A10) can cause hand, foot, and mouth disease. Recently, coxsackievirus A6 has been detected in outbreaks. Internationally, enterovirus 71 is a common etiologic agent.
Person-to-person, through contact with saliva, sputum, fluid in blisters, or stool of an infected person.
Distributed worldwide; recent large outbreaks have been reported in Cambodia, China, Japan, Korea, Malaysia, Singapore, Thailand, Taiwan, and Vietnam.
Incubation period is 4–6 days. Patients usually present with fever and malaise, followed by sore throat and the development of vesicles in the mouth and a rash, often vesicular, on the hands (palms) and feet (soles). In some cases, the rash may be more widespread. Lesions usually resolve in 1 week, but rare complications can include aseptic meningitis and encephalitis.
Diagnosis is most often made clinically. Laboratory testing (such as PCR) is available and is usually performed on atypical or severe cases.
Avoiding close contact with infected people, maintaining good hand hygiene, and disinfecting potentially contaminated surfaces, including toys.