Significant Increase of Hand, Foot and Mouth Disease Reported

The West Virginia Bureau for Public Health has identified a significant increase in reported outbreaks of hand, foot, and mouth disease statewide.
In 2025, a total of 38 cases of the illness have been reported, including 17 outbreaks since Sept. 1, 2.
The disease is a common viral illness that primarily affects infants and children, with typical seasonal increases during the summer and fall months.
While individual cases are not reportable in West Virginia, emergency department, urgent care and outbreak data indicate a higher number of cases this year compared to prior years. Older adolescents and adults may also be affected.
Symptoms include sudden onset of fever, painful oral sores and vesicular rash on the hands and feet.
A rash develops within 1–2 days of fever onset.
The infectious period begins two days before onset of the rash, continues during acute illness and may persist for weeks after symptoms resolve.
The disease is most commonly cause by Coxsackievirus A16 and Enterovirus 71.
Spread occurs primarily through contact with respiratory secretions or stool of infected persons. Prolonged asymptomatic viral shedding is common.
Children and staff do not need to be excluded from school or childcare if they are: fever-free for at least 24 hours without fever-reducing medication, well enough to participate in routine activities and not experiencing uncontrolled drooling from mouth sores.
This message was directly distributed by the West Virginia Bureau for Public Health to local health departments and professional associations. Receiving entities are responsible for further disseminating the information as appropriate to the target audience.
A health advisory provides important information for a specific incident or situation. It may not require immediate action.
Exclusion does not prevent further spread because asymptomatic individuals may shed virus for weeks.
Requiring a physician’s note is not needed to return to daycare, school, or work is not recommended.
HFMD is a clinical diagnosis; laboratory testing is unnecessary in most cases.
Testing may be considered if the diagnosis is uncertain or in severe or unusual presentations like meningitis, sepsis.
Routine testing is not recommended.
Prevention and control measures include frequent handwashing, especially after diapering and bathroom use and before food handling, respiratory hygiene and cough etiquette and regular cleaning and disinfecting of frequently touched surfaces and toys.