Hand, foot and mouth disease (Enterovirus 71, EV 71)

What is hand, foot and mouth disease?

Hand, foot and mouth disease is a common viral illness that mainly affects infants and children but can sometimes occur in adults. It is caused by a group of viruses called enteroviruses, including certain coxsackie viruses (most commonly A16) and enterovirus 71.

There is no vaccine or medication that protects against hand, foot and mouth disease.

What is my risk?

The enteroviruses that cause hand, foot and mouth disease are found worldwide.

• Young children are most at risk of being infected with hand, foot and mouth disease.
• Travellers are at increased risk if visiting or living in overcrowded living conditions.
• The risk of infection depends on destination and time of year:
  • In temperate climates (regions with four seasons), travellers are most at risk during the summer and autumn months.
  • In tropical climates, the risk of infection is year-round.

How is it transmitted?

• Hand, foot and mouth disease is spread by coming into contact with secretions (fluids) from the nose and throat, saliva, fluid from blisters or stool (feces) of an infected person.
• It is spread through close personal contact (kissing or hugging), coughing and sneezing or from touching objects and surfaces that have been contaminated with the virus.

What are the symptoms?

• The symptoms can take 3 to 7 days to appear.
• Symptoms usually include fever, loss of appetite, sore throat, generally feeling unwell, painful blister-like sores in the mouth, and a rash with or without small blisters, usually on the palms of the hands or on fingers, soles of the feet or on toes and may also appear on the knees, elbows, buttocks or genital area. 
• The disease is usually mild and most people recover in 7 to 10 days.
• Rare complications can include encephalitis (swelling of the brain) and meningitis (swelling of the membrane around the brain and spinal cord), which may lead to death.

Can hand, foot and mouth disease be treated?

There is no specific treatment for hand, foot and mouth disease. Symptoms can be treated with medications that provide relief for the pain of mouth sores, fever and aches.  It is important to stay well hydrated.

Recommendations

Consult a health care provider or visit a travel health clinic preferably six weeks before you travel.

1. Protect yourself and others from the spread of germs:
   1. Wash your hands frequently
      • Wash your hands with soap under warm running water for at least 20 seconds, as often as possible, especially before eating or preparing food and after using the bathroom or changing diapers.
      • Alcohol-based hand sanitizer can also be used if soap and water are not readily available. It's a good idea to keep some with you in your pocket or purse when you travel.
   2. Practice proper cough and sneeze etiquette
      • Cover your mouth and nose with your arm to reduce the spread of germs. If you use a tissue, dispose of it as soon as possible and wash your hands afterwards.
   3. Keep shared items and surface areas clean
      • Clean doorknobs, toys, and other surfaces that many people, especially children, touch on a regular basis.
   4. Try to avoid close contact with people that are sick.
      • Avoid close contact, such as kissing or hugging, and sharing cups or eating utensils with people who are sick.
2. Monitor your health
   • If you or your child develops symptoms similar to hand, foot and mouth disease while travelling or after you return to Canada, you should see a health care provider. Seek medical attention immediately if your child is showing signs of dehydration, stiff neck, back pain, convulsions or persistent headache.
   • Tell your health care provider that you have been travelling or living in an area where there is an outbreak of hand, foot and mouth disease.