Health officials in several American states are reporting significant outbreaks of hand, foot and mouth disease this autumn, a highly contagious virus that is infecting populations at unusually high rates.
The states of Maryland, Virginia, Tennessee, and Wisconsin have all noted increased cases of the virus, which typically affects young children but can also cause symptoms in older children and adults.
Unprecedented Case Numbers
Dr. Allison Agwu, a professor of infectious diseases at Johns Hopkins University School of Medicine in Baltimore, describes the current situation as "out of control." In her home state of Maryland, case numbers have reached alarming levels.
"We're seeing four to five times what they saw this time last year," Dr. Agwu reported, highlighting the dramatic increase compared to previous seasons.
While concerning, this spike follows a cyclical pattern according to Dr. Matthew Thomas, a pediatric infectious diseases specialist at WVU Medicine Golisano Children's Hospital in West Virginia.
"Some years you'll see a lot of cases, like we're seeing this year, and then it kind of fades away, where you don't hear about it for a while," Thomas explained, noting that such fluctuations are characteristic of the virus.
Recognizing the Symptoms
As the name clearly indicates, hand, foot and mouth disease presents with distinctive blisters on the hands, feet, and inside the mouth. The illness belongs to the enterovirus family, as explained by Dr. Jennifer Duchon, an associate professor in newborn medicine at Mount Sinai Hospital in New York.
Initial symptoms often resemble those of a common cold, including fever and respiratory issues like a runny nose. The defining features emerge later with a rash typically appearing on the hands and feet, accompanied by painful ulcers or blisters in the mouth, usually at the back of the throat.
Dr. Agwu noted that these skin manifestations typically appear a couple of days after the fever begins. In some cases, as the rash subsides, patients may experience peeling skin on their hands and feet.
"In really dramatic cases, sometimes your fingernails can fall off," Dr. Duchon added, though she emphasized this represents a less common outcome.
Transmission and Prevention Strategies
Hand, foot and mouth disease spreads easily through multiple pathways, earning its description as "super contagious" from Dr. Agwu.
The virus transmits through respiratory droplets from coughs and sneezes, contact with fluid from blisters, and contaminated surfaces. It also spreads via fecal matter, making diaper-changing a particular risk activity for parents and caregivers.
Prevention focuses on consistent hygiene practices:
- Frequent handwashing with soap and water
- Using alcohol-based hand sanitizer when soap isn't available
- Avoiding touching your face
- Staying away from sick individuals
- Wearing masks in high-risk situations
Dr. Thomas emphasized that good hand hygiene is particularly crucial for anyone changing diapers or handling items that might be contaminated.
Treatment and Recovery
Most children and adults recover from hand, foot and mouth disease at home within about a week through symptomatic care. Since it's a viral illness, antibiotics are ineffective.
Treatment focuses on managing symptoms with fever-reducing medications, staying hydrated, and maintaining nutrition. The painful mouth ulcers can make drinking and eating difficult, requiring extra attention to fluid intake.
Dr. Thomas advised that medical care should be sought if patients cannot stay hydrated or eat enough. In more severe cases, complete recovery may take up to 10-14 days.
While rare, serious complications can occur. Dr. Duchon warned to watch for extreme fatigue or breathing difficulties after the initial symptoms subside, as these could indicate heart involvement.
Anyone sick with the virus should isolate to prevent spreading it to others, practicing the same caution recommended for other contagious illnesses like COVID-19 and the common cold.
