Hand-foot-and-mouth disease risk factors

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Risk Factors

The risk factors for development of hand foot mouth disease include:

• Close contact with infected patient
• Improper hand washing
• Sharing toys with other children
• Not washing hands before meal and after using the toilet

• Risk factors predisposing patients for the development of severe manifestations of hand foot mouth disease include:
  • Infection in children age of less than one year
  • Body temperature greater than 39.0°C
  • Duration of fever greater than three days
  • Absence of skin lesions, diarrhea, dyspnea, and hyperglycemia
  • Vomiting
  • Increased neutrophil count

Because enteroviruses, including those causing HFMD, are very common, pregnant women are frequently exposed to them, especially during summer and fall months. As for any other adults, the risk of infection is higher for pregnant women who do not have antibodies from earlier exposures to these viruses, and who are exposed to young children - the primary spreaders of enteroviruses.

Most enterovirus infections during pregnancy cause mild or no illness in the mother. Although the available information is limited, currently there is no clear evidence that maternal enteroviral infection causes adverse outcomes of pregnancy such as abortion, stillbirth, or congenital defects. However, mothers infected shortly before delivery may pass the virus to the newborn. Babies born to mothers who have symptoms of enteroviral illness around the time of delivery are more likely to be infected. Most newborns infected with an enterovirus have mild illness, but, in rare cases, they may develop an overwhelming infection of many organs, including liver and heart, and die from the infection. The risk of this severe illness in newborns is higher during the first two weeks of life.

Strict adherence to generally recommended good hygienic practices by the pregnant woman (see "Can HFMD be prevented?" below) may help to decrease the risk of infection during pregnancy and around the time of delivery.