Why do you get hfmd

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Last updated: April 8, 2026

Quick Answer: Hand, foot, and mouth disease (HFMD) is primarily caused by enteroviruses, most commonly coxsackievirus A16 and enterovirus 71. It spreads through direct contact with infected individuals, respiratory droplets, or contaminated surfaces, with outbreaks often occurring in childcare settings. According to the CDC, HFMD typically affects children under 5 years old, with most cases in the U.S. occurring in summer and fall. While usually mild, severe complications like viral meningitis or encephalitis can occur, particularly with enterovirus 71 infections.

Key Facts

HFMD is most commonly caused by coxsackievirus A16 (accounting for about 80% of cases) and enterovirus 71
The disease primarily affects children under 5 years old, with peak incidence between 1-2 years of age
Outbreaks typically occur in summer and fall months in temperate climates
The incubation period is 3-6 days after exposure before symptoms appear
HFMD is highly contagious, with transmission possible for weeks after symptoms resolve

Overview

Hand, foot, and mouth disease (HFMD) is a common viral illness that primarily affects infants and young children, though adults can also contract it. First described in 1957 during an outbreak in Toronto, Canada, HFMD has since been recognized worldwide as a significant childhood illness. The disease gets its name from the characteristic rash that typically appears on the hands, feet, and inside the mouth. While generally mild and self-limiting, HFMD can cause significant discomfort and occasionally leads to serious complications. The World Health Organization reports that large outbreaks occur regularly in the Asia-Pacific region, with some countries like China and Vietnam experiencing annual epidemics. In the United States, the CDC estimates that tens of thousands of cases occur each year, though many go unreported. The disease has seasonal patterns, with most cases in temperate climates occurring between spring and fall, while tropical regions see year-round transmission.

How It Works

HFMD spreads through multiple transmission routes, making it highly contagious in close-contact settings. The primary mechanism involves direct person-to-person contact with infected saliva, nasal secretions, fluid from blisters, or feces. Respiratory droplets from coughs or sneezes can also transmit the virus. Additionally, contaminated surfaces and objects can harbor the virus for days, facilitating indirect transmission. After exposure, the virus enters the body through the mouth or respiratory tract, then replicates in the lymphoid tissues of the throat and intestines. During the 3-6 day incubation period, the virus multiplies before symptoms appear. The characteristic rash develops as the virus spreads through the bloodstream to the skin and mucous membranes. Individuals remain contagious for days to weeks after symptoms appear, with the virus continuing to shed in stool for several weeks. Proper hygiene practices, including handwashing and surface disinfection, are crucial for controlling spread.

Why It Matters

HFMD matters because it represents a significant public health concern, particularly for young children and childcare facilities. The disease causes substantial economic impact through missed workdays for parents and healthcare costs. In severe cases, particularly those caused by enterovirus 71, HFMD can lead to neurological complications like aseptic meningitis, encephalitis, or acute flaccid paralysis. According to WHO data, severe outbreaks in the Asia-Pacific region have resulted in hundreds of deaths, primarily among young children. The disease also highlights the importance of infection control measures in schools and daycare centers, where outbreaks can quickly spread. Research into HFMD vaccines continues, with China approving the first EV71 vaccine in 2015, demonstrating progress in prevention efforts. Understanding HFMD transmission patterns helps public health officials implement effective containment strategies during outbreaks.