Nikhil Thatte
Medical Science Department, Pediatric Oncall, Mumbai

Hand, Foot and Mouth Disease (HFMD) is a viral illness occurring mainly in infants and children. Occasionally, young adults and adults may develop the disease. The causative virus is usually Coxsackie virus A16 from the genus Enterovirus, family Picornaviridae. Enterovirus 71 along with other coxsackie virus types A4-A7, A9, A10, B1-B3, and B5 are responsible for some sporadic cases. (1)


Mode of transmission - The disease is contagious, transmission occurs by the following routes:

Direct contact with nasal and/or oral secretions,
Fecal-oral
Aerosolized droplets in a fecal-oral or oral-oral route

During epidemics, transmission from mother to fetus also occurs.

Incubation period - 3-7 days

Age - It is common in children, especially infants and children under 5 years of age. The severity of disease as well as complications are more in this age group.

Sex - Males and females are equally affected

Geographical distribution - It occurs worldwide. HFMD shows a seasonal variance only in temperate countries, with cases spiking in summer. However, in tropical countries like India, there is no seasonal pattern.

The disease occurs both sporadically as well as in the form of epidemics.

Recent outbreaks: Southeast Asia has seen the maximum number of cases in the recent past. Taiwan (1998) and Singapore (2000) recorded epidemics of HFMD. Recently, an increase in the number of HFMD cases has been reported from Indian cities like Mumbai (2) and Vadodara (3).

Risk factors: Contact with HFMD, large family number, and rural residence are risk factors in the setting of an epidemic.