In this article:
What Is Hand, Foot, and Mouth Disease (HFMD)?
HFMD is a contagious viral illness most often caused by enteroviruses. In children, it typically begins with fever and general malaise, followed within a day or two by mouth ulcers and a blistering rash on the hands, feet, sometimes buttocks, knees, or elbows.While many cases remain mild and self-limiting, some can evolve into more serious complications (e.g. meningitis, encephalitis, or dehydration). In India, HFMD has historically been under-reported, but in recent years, surveillance and studies have begun documenting outbreaks more regularly.
Why Cases Are Rising in India Right Now
If you’ve noticed more children around you falling sick with similar rashes and fevers, it isn’t a coincidence. Multiple cities are reporting clusters of hand-foot-mouth disease this season, pointing to a clear upward trend.Recent outbreaks in cities:
- In Delhi and NCR, paediatric clinics are seeing 5–6 new HFMD cases daily.
- Across Delhi and Haryana, reports warn of a “sudden spike” in HFMD cases, especially in schoolchildren.
- In Delhi, medical practitioners say almost every school currently has at least one or two children with symptoms of HFMD.
- The New Indian Express reported a significant rise in Delhi, particularly among children aged 3 to 7.
Historical and epidemiological background:
- Over the last decade, India has recorded HFMD outbreaks in 2004, 2007, 2012, 2014, and later.
- A 2022 study noted HFMD resurgence in Bhubaneswar (26 cases among children up to 9 years) that raised an alert.
- In Karnataka, between April and October 2022, molecular surveillance characterised circulating enterovirus strains causing HFMD.
- In the western state, a recent private school outbreak was documented: most cases were mild, average duration short.
- India’s surveillance is still limited, so many mild or unreported cases likely go uncounted.
Why the Rise Now?
- Humidity and monsoon conditions favour viral persistence on surfaces and ease transmission in crowded indoor settings.
- Schools and day-care resuming full in-person attendance increases close contact and shared toys, surfaces, and utensils.
- Immunity gap may have widened during COVID-19 lockdowns: children had fewer exposures to common viruses, possibly lowering cross-protection.
- Virus evolution and diversity: Recent surveillance shows increasing presence of non-EV-A71/CVA strains, co-infections, and recombinant viruses.
- Under-recognition historically: because HFMD was less commonly diagnosed, public caution and prevention measures may lag.
How to Recognise the Symptoms Early
Early detection is your best defence. The timeline and symptoms often go like this:| Day / Phase | What May Appear |
| Incubation (2–7 days) | The child may feel unwell, low fever, fatigue, loss of appetite, sore throat. |
| Day 1–2 after fever | Painful sores or ulcers appear inside the mouth (tongue, gums, palate). The child may refuse to eat or drink. |
| Day 2–3 onward | Blisters or red spots on palms, soles, sometimes knees/elbows/buttocks. Lesions may be fluid-filled, then crust. |
| Peak & resolution (over 7–10 days) | Symptoms usually improve. Fever resolves in 2–3 days; skin lesions may persist slightly longer. |
Watch for these red flags in toddlers:
- Poor feeding, drooling (due to pain)
- Irritability, lethargy
- Refusing fluids (risk of dehydration)
- Worsening rash turning into larger blisters
- High, persistent fever beyond 4–5 days
- Neurological signs (vomiting, neck stiffness, confusion)
- Signs of shock (rapid pulse, cold extremities)
How HFMD Spreads: Why It Is Contagious
Understanding modes of spread helps you break the chain:- Saliva, nasal secretions: from coughs, sneezes, or close contact
- Fluid from blisters / skin lesions: direct contact with the fluid or broken skin
- Faecal–oral route: enteroviruses shed in stool; if hygiene is lax, surfaces get contaminated
- Contaminated objects and surfaces: toys, door handles, utensils, tabletops
- Respiratory droplets: less important but possible in crowded settings
The viral shedding can begin even before symptoms and continue days beyond visible healing, so children might infect others before you know.
Treatment and Home Care
There is no specific antiviral treatment for HFMD. Management is supportive and symptomatic.What you can do at home (for your toddler):
- Hydration first: Encourage frequent sips of water, oral rehydration solution (ORS), milk, or non-acidic fluids
- Pain and fever control: Use age-appropriate paracetamol or ibuprofen (consult your paediatrician)
- Soft, cool foods: Mashed potatoes, yoghurt, cool soups, avoid spicy or acidic foods
- Mouth care: You can rinse with saline or use anaesthetic gel if prescribed by a doctor, to ease ulcer pain
- Skin care: Keep lesions clean, avoid scratching; use mild antiseptic or soothing lotions (if advised)
- Isolate temporarily: Keep your child at home until the lesions crust over and they feel better
- Maintain comfort: Rest, calm environment, avoid crowding
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FAQs on Hand, Foot, and Mouth Disease in Toddlers: Why Cases Are Rising and How You Can Protect Your Child
- Can HFMD be transmitted from adults to children?
Yes. Adults may carry and shed enteroviruses, sometimes with mild or no symptoms, and transmit via saliva, nasal secretions, or contact. - How long is a child contagious?
Contagiousness can begin prior to symptoms and last until blisters heal and virus shedding decreases, often 7 to 10 days, sometimes more. - Will my child get HFMD again?
Yes. Because multiple strains exist, immunity to one doesn’t always protect against another. - Is there any vaccine or preventive medicine?
Currently no widely available vaccine in India targeting all HFMD strains; prevention depends on hygiene, isolation, and surveillance.
