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.

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

Page last reviewed: 10/03/2014

Next review due: 10/03/2016