New Jersey Department of Health
Hand Foot and Mouth Disease Talking Points for Schools/Childcare
September 30, 2016
What is Hand Foot and Mouth Disease (HFMD)?
Hand, foot, and mouth disease is a common viral illness that is most frequently seen in the summer and early fall. This illness generally is mild and is most commonly caused by coxsackievirus A16 and enterovirus 71.
What are symptoms of HFMD?
Symptoms of HFMD often include fever, reduced appetite, sore throat, a feeling of being unwell, painful sores in the mouth that usually begin as flat red spots. A rash of flat red spots that may blister on the palms of the hands, soles of the feet, and sometimes the knees, elbows, buttocks, and/or genital area. These symptoms usually appear in stages, not all at once. Not everyone will get all of these symptoms. Some people may show no symptoms at all, but they can still pass the virus to others.
How is HFMD spread?
The viruses that cause HFMD can be found in an infected person’s nose and throat secretions (such as saliva, sputum, or nasal mucus), blister fluid, and feces (stool).
An infected person may spread the viruses that cause HFMD to another person through close personal contact, the air (through coughing or sneezing), contact with feces, contact with contaminated objects and surfaces. For example, you might become infected by kissing someone who has HFMD, or by touching a doorknob that has viruses on it then touching your eyes, mouth or nose.
Who is at risk for HFMD?
Infants and children younger than five years old are most likely to get HFMD, because they do not yet have immunity (protection) to the viruses that cause HFMD. However, older children and adults can also get HFMD. In the United States it is more common for people to get HFMD during summer and early fall.
How is HFMD treated?
There is no specific treatment for HFMD. Fever and pain can be managed with over-the-counter fever reducers and pain relievers. It is important for people with HFMD to drink enough fluids to prevent dehydration (loss of body fluids).
How can I protect myself from becoming infected with HFMD?
There is no vaccine to protect against HFMD. However, you can reduce the risk of getting infected with the viruses that cause HFMD by following a few simple steps:
- Wash your hands often with soap and water for 20 seconds, especially after using the toilet and changing diapers.
o Teachers and parents should assist young children with handwashing.
o If soap and water are not available, hand sanitizer containing at least 60% alcohol may be used.
- Avoid touching your eyes, nose and mouth with unwashed hands.
- Avoid close contact such as kissing, hugging, and sharing cups, water bottles and eating utensils with people who have HFMD.
- Clean and disinfect frequently touched surfaces, such as toys, sports equipment, doorknobs, especially if someone is sick.
o Routine disinfection procedures are effective for HFMD. For more information on cleaning and disinfecting see the NJDOH “General Guidelines for the Control of Outbreaks in Schools and Daycare Settings” (control measure section) at http://www.nj.gov/health/cd/outbreaks.shtml.
If a child is diagnosed with HFMD, should they be excluded from school/daycare or team sports?
Exclusion from school or sports is recommended for ill individuals until they are fever free for 24 hours without fever reducing medicine. The decision about whether an individual is healthy enough to return to sports should be made by their health care provider.
For school exclusion guidance, go to link above.
Should team sports be cancelled or schools closed during outbreaks of HFMD?
NJDOH does not recommend cancelling team sports or closing school for outbreaks of HFMD or most infectious diseases. Schools should work with local health departments (LHD) to ensure that recommended control measures (e.g., exclusions, increased cleaning) are being followed. LHDs should be advised if team sports are cancelled or schools closed for outbreaks of communicable disease.
Single cases of HFMD are not reportable in New Jersey. However, confirmed or suspect outbreaks of any communicable disease are immediately reportable to the local health department of the jurisdiction in which the school is located. An outbreak is defined as an occurrence of disease greater than would otherwise be expected at a particular time and place. If you suspect an outbreak may be occurring, call your LHD and refer to the guidance document referenced above. A directory of local health departments can be found at http://localhealth.nj.gov. Notification MUST be made by phone.