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Hand-Foot-Mouth Outbreak Causing Neurologic Disease in Kids

| September 14, 2018, 11:27 AM

feet with Hand Foot and Mouth Disease Evolve Direct Primary Care Annapolis Anne Arundel County Maryland

The CDC has reported today about a viral outbreak involving 34 children who have developed neurologic complications as a result of enterovirus (EV), a common cause of Hand-Foot-Mouth disease. The outbreak has currently been identified in Colorado only but healthcare providers have been alerted to watch for further spread. 

The children affected so far have been younger with the average age only 13 months old and the oldest 3 years of age. All of the children had fever and irritability followed by signs of some of the following encephalitis (brain infection), weakness, seizures or paralysis. 

EV-A71 is a specific kind of enterovirus causes hand, foot, and mouth disease and neurologic disease, primarily among children aged <5 years. Common symptoms include fever with a rash on the palms, soles, and mouth.

Severe CNS EV-A71 infection can cause an infection of the brainstem which leads to heart and lung failure and/or a polio-like illness. The CDC monitors for EV-A71 epidemics and since the 1980’s, they have detected seasonal endemic EV-A71 activity in the United States.

It is important to note that less than 1% of these infections are caused by EV-A71. Peak season for Hand, Foot and Mouth disease is usually June to October so we are almost near the end of the peak season now.  

Hand, Foot and Mouth Disease

The Basics

Hand, Foot and Mouth (HFM) is only mildly contagious and is fairly common in young kids. Children develop a rsh on their hands and feet and sores in the mouth. They usually have a sore throat, fever over 100.5F, and are irritable, not eating and in general look and act “sick”. 

Fever is usually the first sign that they are getting sick and often happens before the rash. In fact, the rash often doesn’t start until the 2nd or 3rd day of being sick. The mouth sores and sore throat usually start just before the rash on the hands and feet. 

The rash is usually not very itchy. Sometimes the rash can blister. 

When to See Your Doctor

HFM usually only lasts for a few days and often you do not need to see the doctor. But, if the mouth sores or sore throat are keeping your child from drinking fluids and staying hydrated, you should call your doctor right away. Likewise, if his or her fever spikes very high, fairly suddenly, that is another indication to call the doctor. Lastly, if he or she is not getting better after a few days or symptoms are getting worse after the first few days, then definitely go see a doctor then. 

With the new information in this report, the providers at Evolve are recommending special attention to any neurologic signs or symptoms such as stick neck, child appearing particularly flaccid or any of the muscles of the face and eyes not working properly. 

Where Do They Get It?

HFM is a fairly common illness that kids get at day care. Unfortunately, this is one of those viral illness that a child continues to spread sometimes weeks after the all the symptoms have gone away. 

Kids under 5 years of age are most likely to get it but it is still fairly common up until age 10. After age 10, most kids have been exposed to it and have developed immunity so they are at lower risk. 

Adults can get HFM and have no symptoms but then spread it to kids. 


feet with Hand Foot and Mouth Disease Evolve Direct Primary Care Annapolis Anne Arundel County MarylandHFM disease can be prevented with the typical cold and flu virus prevention.

  1. Frequent hand washing,
  2. Disinfect commonly touched areas including toys
  3. Teach your kids to keep their hands away from their mouth and face.
  4. Keep kids out of school and day care until fever resolves. 

Although keeping kids home when they have a fever is important to limit how much of the virus that they spread is helpful, keep in mind that the virus can still be spread for weeks after the fever and rash are gone, the peak period of contagiousness is while they have the fever. 

If you have any questions or have been experiencing one of the above symptoms, see your doctor immediately. Evolve Medical is also happy to see you. Same day scheduling on-line here or call 844-322-4222. Or email them at [email protected].

If you find these health and wellness updates helpful, follow Evolve Medical on Facebook, Twitter, Instagram or Google+.

Hand foot and mouth from Evolve Direct Primary Care, provides the highest rated primary care and urgent care to Annapolis, Edgewater, Davidsonville, Crownsville, Severna Park, Arnold, Gambrills, Crofton, Pasadena and Glen Burnie.

Evolve Direct Primary Care, provides the highest rated primary care and urgent care to Annapolis, Edgewater, Davidsonville, Crownsville, Severna Park, Arnold, Gambrills, Crofton, Pasadena and Glen Burnie.


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About the Author - Evolve Direct Primary Care

Evolve Direct Primary Care and Virtual Urgent Care is Annapolis’ highest rated urgent care and primary care. Designed for busy people tired of long waits and rushed providers. The peaceful, healing atmosphere is designed to reflect their emphasis on patient respect, convenience as well as excellence in care. Evolve offers virtual urgent care visits for only $95 or monthly membership in Direct Primary Care for as little as   $49/mo.  Members receive their primary and urgent care either free or at heavily discounted prices. Members enjoy more time with their provider, unprecedented access, caring staff and providers — and save money with or without insurance.  Evolve also helps patients save money by finding less expensive medications, avoiding unnecessary procedures and tests and improves help by cutting down on the medical errors which are so common elsewhere. Find out why everyone loves Evolve: or call 844-322-4222.

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