Causes & Transmission


Hand, foot, and mouth disease is caused by viruses that belong to the Enterovirus genus (group), which includes polioviruses, coxsackieviruses, echoviruses, and other enteroviruses:

  • Coxsackievirus A16 is typically the most common cause of hand, foot, and mouth disease in the United States, but other coxsackieviruses can also cause the illness.
  • Enterovirus 71 has also been associated with cases and outbreaks of hand, foot, and mouth disease, mostly in children in East and Southeast Asia. Less often, enterovirus 71 has been associated with severe disease, such as encephalitis.
  • Several types of enteroviruses may be identified in outbreaks of hand, foot and mouth disease, but most of the time, only one or two enteroviruses are identified.


Toddler with hand , foot and mouth disease.

The viruses that cause hand, foot, and mouth disease can be found in an infected person’s

  • nose and throat secretions (such as saliva, sputum, or nasal mucus)
  • blister fluid
  • feces (poop)

You can get exposed to the viruses that cause hand, foot, and mouth disease through

  • close personal contact, such as hugging an infected person
  • the air when an infected person coughs or sneezes
  • contact with feces, such as changing diapers of an infected person, then touching your eyes, nose, or mouth before washing your hands
  • contact with contaminated objects and surfaces, like touching a doorknob that has viruses on it, then touching your eyes, mouth, or nose before washing your hands

It is also possible to get infected with the viruses that cause hand, foot, and mouth disease if you swallow recreational water, such as water in swimming pools. However, this is not very common. This can happen if the water is not properly treated with chlorine and becomes contaminated with feces from a person who has hand, foot, and mouth disease.

Generally, a person with hand, foot, and mouth disease is most contagious during the first week of illness. People can sometimes be contagious for days or weeks after symptoms go away. Some people, especially adults, may become infected and not develop any symptoms, but they can still spread the virus to others. This is why people should always try to maintain good hygiene, such as frequent handwashing, so they can minimize their chance of spreading or getting infections.

You should stay home while you are sick with hand, foot, and mouth disease. Talk with your healthcare provider if you are not sure when you should return to work or school. The same applies to children returning to daycare.

Hand, foot, and mouth disease is not transmitted to or from pets or other animals.

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