Hand Foot and Mouth Disease (HFMD)
Overview
Hand, Foot, and Mouth Disease (HFMD) is caused by viruses belonging to the Enterovirus genus. Coxsackievirus A16 is the most common cause of HFMD in the United States, but more than 20 types of enteroviruses have been associated with the illness. HFMD is a common illness that usually affects infants and children younger than 5 years old, but cases in older children and adults can occur. While typically mild and self-limiting, HFMD can spread quickly in childcare and school environments through close contact, shared items, and contaminated surfaces. Outbreaks of HFMD typically occur during summer and autumn months.
Clusters and outbreaks in early education settings often require a coordinated response between schools, childcare centers, and local health departments.
HFMD Information
Surveillance and Reporting
HFMD is not a reportable condition for individual cases; however, outbreaks or clusters should be reported promptly. Several Texas Laws and Texas Administrative Code, Health & Safety Code, Chapters 81, 84, and 87 require specific information regarding outbreaks of communicable diseases to be provided to public health. Outbreaks of HFMD are usually benign and self-limited; however, please contact your local health department if more serious illness occurs, complications are reported, or in the event of an outbreak.
Definition of an outbreak: Any number of HFMD cases above baseline of usual case activity at the same facility would constitute an outbreak.
Prevention in Childcare Center and School Settings
- Hand hygiene: Wash hands often with soap and water for at least 20 seconds, especially after changing diapers, using the toilet, using a tissue to cover coughs and sneezes, and before and after caring for someone who is sick.
- Surface Cleaning: Increase frequency of cleaning and disinfecting frequently touched surfaces and soiled items, including toys and playmats. Make sure the disinfectant being used by the facility is registered with the U.S. Environmental Protection Agency (EPA) as a detergent-disinfectant or a hospital grade disinfectant effective against enteroviruses.
- Change Contaminated Fabrics: Contaminated clothing, sheets, or mats should be changed as soon as possible. While handling contaminated fabrics, disposable gloves should be worn and followed with proper hand hygiene.
- Respiratory Etiquette: Facilities should teach children and caregivers to cover mouths and noses when coughing or sneezing with disposable tissue followed by hand washing.
- Limit Contact: Discourage sharing eating utensils or cups and avoid contact with saliva and respiratory secretions.
- Stay Home When Sick: Exclude children and staff with fevers until 24-hours fever-free without the use of fever suppressing medication. Exclude children with open blisters or uncontrollable drooling.
- Communication: It is recommended that the school or childcare center notify parents and staff when there is a case in the facility. Facilities are required to notify their local health department when there are more cases than baseline in the same classroom.
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