Overview: HFMD on the Rise in the United States
Hand, foot, and mouth disease (HFMD) is drawing renewed attention as outbreaks surge in several U.S. states this fall. Health officials report that cases in some areas, including Maryland, are notably higher than in previous years. While HFMD is usually a mild illness, its contagious nature means families, schools, and childcare centers must stay vigilant and practice good hygiene to slow transmission.
What is HFMD and who is most at risk?
HFMD is caused by enteroviruses, most commonly coxsackievirus A16 and enterovirus 71. It predominantly affects children under age 5, but older children and adults can contract the virus, especially if they have exposure in crowded settings or through shared objects. Symptoms typically begin with fever, reduced appetite, and a sore throat, followed by a distinctive rash with small blisters on the hands, feet, and inside the mouth. In some cases, adults may experience milder symptoms or simply a sore throat and fatigue.
Recognizing the signs: symptoms to watch for
Key symptoms to monitor include:
- Fever and general malaise
- Painful sores or ulcers in the mouth, sometimes making swallowing uncomfortable
- Rash or blisters on the palms, soles of the feet, or buttocks
- Loss of appetite and irritability in children
Most cases resolve within 7 to 10 days without complications. However, dehydration can occur if painful mouth sores make drinking difficult. Seek medical care if a child shows signs of dehydration, has a very high fever, is unusually sleepy, or has a stiff neck, which could indicate a more serious issue.
Why the surge now? Understanding transmission and seasonality
HFMD spreads easily through respiratory droplets, contact with contaminated surfaces, and close personal contact. The fall season often brings more indoor gatherings, school openings, and shared play spaces, creating opportunities for viruses to spread. While there is no specific vaccine for HFMD in the United States, public health guidance emphasizes early recognition, isolation of infected individuals, and rigorous hygiene practices to curb outbreaks.
Prevention: practical steps families can take
Protecting children and households from HFMD involves a combination of hygiene, environmental cleaning, and mindful social behavior:
- Hand hygiene: Wash hands with soap and water for 20 seconds after diaper changes, after using the bathroom, before meals, and after playdates. Alcohol-based hand sanitizers are less effective against enteroviruses and should not replace handwashing.
- Disinfect frequently touched surfaces: Regularly clean toys, doorknobs, faucet handles, and tablet devices with a household disinfectant.
- Avoid sharing items: Do not share cups, utensils, towels, or water bottles among children during outbreaks.
- Keep children home when ill: If a child has fever, mouth ulcers, or a widespread rash, keep them home from school or daycare until fever-free for at least 24 hours and symptoms have improved.
- Hydration and comfort: Offer soothing foods and fluids. Avoid acidic or spicy items if mouth sores cause pain, and consider cold or soft textures to ease swallowing.
- Clothing and diapering: Use breathable clothing and change diapers promptly to reduce skin contact and moisture in affected areas.
Parents should talk to a pediatrician if there are concerns about persistent fever, dehydration, or symptoms lasting longer than a week. While most HFMD cases are mild, severe symptoms warrant professional evaluation to rule out other illnesses.
When to seek medical care
Contact a healthcare provider if the patient experiences:
- Signs of dehydration (dry mouth, crying without tears, reduced urination)
- A fever lasting more than a few days or higher than 102°F (39°C)
- Severe sore throat or inability to swallow fluids
- Symptoms that worsen or do not improve after several days
In some cases, a clinician may confirm HFMD with a physical examination. Laboratory testing is not typically needed unless there are unusual symptoms or a concern for another illness.
Looking ahead: stopping the spread requires coordinated effort
Public health authorities emphasize that awareness and simple hygiene measures can reduce transmission in schools and communities. Parents, caregivers, and educators should reinforce handwashing, regular surface cleaning, and clear guidance about staying home when sick. While HFMD can cause uncomfortable symptoms, most children recover fully with supportive care and time.
Key takeaways
HFMD is on the rise in parts of the U.S. this fall. The most reliable defenses are proper hand hygiene, environmental cleaning, and careful adherence to staying home when sick. Early recognition and supportive care help most children return to normal quickly, while vigilance protects the broader community from further spread.
