Hand, foot and mouth disease - Causes 

Causes of hand, foot and mouth disease 

Hand, foot and mouth disease is caused by different types of enterovirus all belonging to a group called enterovirus A. The most common types are coxsackievirus A16, A6, A10 and enterovirus 71.

It is believed the virus first spreads to tissue inside the mouth, near the tonsils, and down to the digestive system.

The virus can then spread into nearby lymph nodes (glands) and then throughout the body, via the blood. The immune system (the body’s defence against infection) controls the virus before it can spread to vital organs, such as the brain.

How it spreads

The viruses that cause hand, foot and mouth disease can be spread in two different ways:

  • respiratory droplets  in almost the same way as a common cold
  • surface or contact contamination with fecal matter (stool)

People usually become infected by picking up the virus on their hands from contaminated objects, then placing their hands near their mouth or nose. It is also possible to breathe in the virus if it is suspended in the air.

The viruses are unable to spread in this way once a person’s symptoms have passed.

However, the viruses also occur in large amounts in the stools of an infected person, and can stay for up to four weeks after the symptoms have gone.

You can also become infected with hand, foot and mouth disease if you make contact with fluid from the blisters or saliva of someone who is infected.

Page last reviewed: 10/03/2014

Next review due: 10/03/2016


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The 7 comments posted are personal views. Any information they give has not been checked and may not be accurate.

chi_tac said on 24 August 2014

I have been affected by hfmd for 6 days now. day1 -high fever, severe headaches. day2-sore throat, beginning to see sores on my body. day3-5-many canker sores in my mouth, unable to eat or drink. Its now day 6. im finally able to drink and eat a little(mostly soft foods). i have developed rashes, especially on feet and hands, but it is definitely all over my body. hard to walk, due to pain in feet.some bumps are itchy, but not as bad as others.
I believe I was infected by my daughter, who also infected my other two children. This disease is one of the most painful that I have experienced. To mitigate the pain, I am using ibuprofen. For my canker sores, I am using something similar to the magic mouthwash and peroxyl.
My doctor said there is nothing that can be done.Also, that there seems to be many cases in my area .

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Bec86 said on 28 February 2014

I have been told I have this disease and I can confirm that adults do not get a mild dose of it!!
I must have 20 ulcers in my mouth, about 50 small blisters spread over my hands, same on my feet. However I also have massive blisters all over my legs mainly around my ankle/shin area! These are bright red, hot to touch and very very sore!! I also have a good few random blisters all over my body. I havnt seen any pictures of this disease looking anywhere near as bad as what I have and I don't know anyone to have or have had this disease themselves.
In all I feel rotten!!!

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thryth said on 04 October 2013

I've caught it from my son and realise why he was so upset and off his food. I feel sick, my throat is very sore especially around my tonsils, my mouth is full of ulcers and my gums are swollen and sore. My sense of taste is off and I have blisters on my hands and feet which while it's true that they don't itch, they failed to mention that they hurt, making it painful to walk and grip. I Feel generally unwell and tired. All in all it isn't nice and if your little one has it, make sure they get extra cuddles and give them their favourite easy to swallow food they don't need to chew much, plenty to drink and some paracetamol.

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Bimbee said on 09 September 2013

I have had this for at least 8 weeks, mostly affecting my mouth, but also my digestive system. It is miserable and debilitating, and as the others have said, not mild in adults.. and not unusual either, by the sound of things.

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BURN18 said on 24 November 2012

This is not mild in adults - please review your notes. I have this horrid disease as I type and I am finding it very difficult to press the buttons with my finger tips. My rash, blisters are more server than I have seen on any website. Luckily my daughter had a mild type and it got me almost overnight, out of the blue. I can't eat, drink, swallow, i'm finding it hard to even walk on my feet, open doors and type this out. I have allergies to pain killers so I can't take anything to ease the pain - bath is all that helps with the itching but nothing is easing the mouth / throat pain.

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Mummy_bear1 said on 21 September 2012

Trying to recover from this disease, which my daughter caught while on holiday in Spain. Luckily for her she had a mild dosage of it. I thought i had a sore throat to start with until the red spots appeared on my hands, when i was then diagnosed with hand, foot and mouth disease. I can agree as an adult it is not a mild disease and finding it quite painful just to drink let alone eat anything. At the moment not even paracetamols are working and after 4 days not feeling any better. Just having lots of warm drinks and hoping the paracetamols start to work soon.

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Abroody said on 24 August 2011

Just recovering from this disease. I have had a very miserable 10 days. Thought I had tonsillitis at first, but when the spots appeared I realised I had picked it up from my grandson attends a nursery. It is certainly not a mild illness in adults and I agree with all the other posts. Nothing really alleviates the symptoms but paracetamol, lots to drink and tea tree cream helped a bit.

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The Asian epidemics

All of the most recent mass outbreaks of hand, foot and mouth disease cases have:

  • been caused by the enterovirus 71
  • occurred in East and South Asian countries, such as China, Taiwan, Malaysia and Vietnam

How to prevent germs from spreading

Cleaning and good hygiene tips to help reduce the number of germs in your home

Symptom checker

If you have a health problem, our symptom checker can help you manage it or find out where to go for help