Can you Catch Hand-Foot-and-Mouth Disease Twice?

My fourteen-month-old son recently had hand-foot-and-mouth virus. Is this something he can catch again, or will he be immune from future recurrences? It’s nice to have a place to ask non-urgent questions about the little ones, and as I know you — you have seen my son in the office — I trust your answers and advice.
Nancy Stone – Post-Doctoral Fellow – Stanford Medical School – Palo Alto, California

Image of boy holding his feet. Can you catch Hand-Foot-and-Mouth Syndrome twice?

Dr. Greene’s Answer:

The incredible human body is equipped with an immune system that staggers the imagination. In ages past, explorers charted thrilling new lands. Today, one of the most exciting frontiers of discovery is the wondrous, intricate, complex immune system silently protecting us day and night.

Two types of defense against viruses predominate in the bloodstream: humoral immunity and cellular immunity. The humoral (or one might say ‘liquid’) immune system attacks viruses when they are loose in the body, either in the bloodstream or in bodily secretions. The cellular immune system attempts to destroy viruses once they have taken up residence inside the body’s cells.

The humoral response consists of antibodies made to specific viruses. These antibodies remain present in the circulation and secretions, hopefully eliminating the virus and protecting against future infections. The more water soluble a particular virus is, the more effective the humoral response. A good example of this is the poliovirus. Polio vaccines (and other vaccines) work precisely because they so effectively stimulate specific antibody formation. When a person is re-exposed to polio, the virus is destroyed by antibodies before infection sets in.

The cellular response consists of certain white blood cells, such as cytotoxic lymphocytes or natural killer cells, which attack and destroy our own cells that have been invaded and altered by viruses. Some viruses, such as herpes, are ‘sneaky’ enough to hide in our cells without changing the way they look to the cellular immune system. These viruses can remain dormant within cells for years, only to re-emerge periodically when our humoral defenses are weak and allow the viruses to get loose in the circulation once again.

Hand-Foot-and-Mouth Syndrome is a Distinct Viral Illness

It produces blisters in the mouth in 90% of infected children and a characteristic rash primarily on the hands, feet, or buttocks in 64% of these children. Most children are cranky, with a sore throat, decreased appetite, and/or fever. The illness typically clears within a week.

Hand-foot-and-mouth syndrome was first reported in 1956, in Australia. As far as we know, it never occurred before that time. For the next 7 years it was reported, only occasionally, in pockets dotting the globe. By 1963, however, it became a common feature of childhood worldwide.

Several Different Viruses Can Cause Hand-Foot-and-Mouth Syndrome

Hand-foot-and-mouth syndrome is caused by several different viruses, including coxsackieviruses A5, A9, A10, A16, B1, B3, enterovirus 71, foot-and-mouth disease virus, and herpes simplex. The vast majority of cases, however, are caused by coxsackievirus A16.

A child with a healthy immune system will form antibodies to whichever virus caused the infection. If your son is re-exposed to the same virus, he will probably not be re-infected. He is still susceptible, in varying degrees, to the other viruses. Since 1963, most children have had one case of hand-foot-and-mouth syndrome, caused by coxsackievirus A16.

There is one other snag. While most children clear their bodies of the virus within one week, coxsackievirus A16 occasionally succeeds in hiding inside children’s own cells, like herpes. By eluding the cellular immune system, coxsackievirus A16 can cause chronic or recurring skin lesions. Healthy humoral immunity is able to keep these recurrences from being as severe as the initial episode.

Will your son catch hand-foot-and-mouth syndrome again? Probably not, but there are no guarantees. Who knows? In the next century, enterovirus 71 might become the major cause of hand-foot-and-mouth syndrome. Even so, the human immune system has a remarkable history of adapting to the ever-changing microscopic world around us.

Dr. Alan Greene

Dr. Greene is the founder of DrGreene.com (cited by the AMA as “the pioneer physician Web site”), a practicing pediatrician, father of four, & author of Raising Baby Green & Feeding Baby Green. He appears frequently in the media including such venues as the The New York Times, the TODAY Show, Good Morning America, & the Dr. Oz Show.

  1. Teresa

    My grandson has hand foot and mouth disease. Symptoms started with low grade nighttime fever x 2 days. Then, the evening before the last fever, he returned home from daycare with a rash on his face around his mouth. On further inspection, my daughter noted lesions in his mouth, on his tongue, blisters on palms of his hands, lesions on his buttock; all typical of HFMD. Furthermore, what is atypical from what I have read in multiple articles, his rash did not appear on the feet, but is on and around his knees, in umbilical button, on lower abdomen, on thighs, on elbows, middle inner aspects of arms, and perineal area. Lesions were so diffusely scattered that I first thought it may be mild cause if Chickenpox, even though he has had one dose of Chickenpox vaccine. I am posting this comment just as a FYI for those who may have an atypical child with HFMD.

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  2. Jane

    I had Hfmd in August of 2014. Every few months since I get outbreaks of blisters on my hands and mouth. It doesn’t seem to be contagious anymore but will the blistering ever go away?

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  3. Anne S

    I am 20 and have just caught it for the second time and it’s worse than last year. It’s been 10 months since the first one and that time the blisters/lesions had stayed confined to my hand and feet and I had multiple painful ulcers in my mouth making me unable to speak/eat. Since then I had recurrent lesions a few times on my hands but they were faint and I didn’t give it much thought. This time it came back full force and i also got painful blisters on my knees, elbow and anus as well as the usual ulcers in mouth and blisters on hand/feet. I really hope it’s the last time- I have never experienced so much pain in my mouth and I’ve lost a lot of weight in one week of barely eating.

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  4. Gregg

    Dr. Greene,

    I see by the numerous comments here that many individuals have been affected by the coxsackie virus a number of times. Most research points to once you have the virus you build an immunity to it. Can you provide some insight as to why the coxsackie virus re-occurs in some individuals.

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  5. Dr.pradeep

    My 15 months old son got infected by hfmd twice within a span of 45 days. Please share your opinion.

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    • Gregg

      I am 47 years old and got infected with the coxsackie virus. The mouth sores were terrible and lasted 9-10 days. I continued to have periodic night sweats and three weeks later I came down with a bad chest cold and the coxsackie virus came back. The mouth sores were not as bad the second time around but still very uncomfortable. Doctor ran blood and urine tests and everything was ok. I still have the remnants of the chest cold. It’s been a rough 5 weeks. If it comes back again I will be sent to an infectious disease doctor.

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  6. Nicholas Nii

    I’ve had HFMD ever since Thanksgiving, and it’s been gone now. However, I have a Dog at home. Since I had it I had been feeding him. I basically touched his food with the part that was diseased, then he eats his food. I understand that this virus is only transmitted by humans. However what would this virus actually do to dogs?

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    • Sarah

      It wouldn’t do anything AT ALL. It can NOT be transmitted to him in anyway which also means you couldn’t somehow “catch” it from your pup.

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  7. Madi C.

    Hello, If my boyfriend infected me with HFMD, can i re-infect him?

    Thanks!

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  8. donna hughes

    Hi, My son is 5. He has hfmd. What creams are best to use and how long should he be off school?

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  9. Craig cambridge

    I have had hand foot and mouth desease 6 times in the last 2 years. It makes me very ill along with the blisters on the mouth, hands,feet and anus. Could you please tell me why it keeps reaccuring. Thanks

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  10. Amanda

    Our five year old has HFMD severally twice, and mildly another time. He presented and was diagnosed with strep last week, second time in a month. However, when I looked at his throat, I had a hunch it was HFMD. The striations in the throat have two different patterns from strep and HFMD. So I was surprised and happy with the strep diagnoses. After he was released for activity, he played soccer in the sun. After an hour, he walked off the field with HFMD blisters infecting mouth, face, hands, buts, knees (normal for him), and feet. I am positive the antibiotics he is taking breaks his body down and pushes what is dormant in his body up. I am also positive most doctors are have limited education and will not expand their mind. I would like to take him to an intelligent doctor to be evaluated. Who do I take him to? Why can’t doctors understand the body mutates and does not follow this checked off exact list.
    I would like to understand why he keeps getting this and it is obvious it is not the normal version. He continuously looses nails, as well. There has to be some type of preventive technic, something to kill this virus. This exhausting, painful, and time consuming. I am also, this makes him more contagious for other herpes virus and other related diseases. Thank you!

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  11. Kristine

    Hello,

    My young daughters have both had HFMD….one of them twice. Since they’ve had it I get recurrent lesions on my hands and feet whenever I am run down or stressed out….probably about every 3 or 4 months. I have never had a full blown case of it myself…just the lesions on my hands and feet along with headaches and fatigue. Afterwards, my hands and feet peel. Also, I go to many children’s birthday parties where I find out after that children end up getting HFMD. I guess they get it from me when I don’t notice that I even have the lesions yet! I feel guilty that kids keep getting sick because of me. Do I need to see my doctor about this? I assume since it’s a virus that there’s nothing I can do.

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    • jessica V

      My daughter came home with HFMD from her half brother that is in preschool … she end up giving to her other brother and me . It has been over a week. Could my son get it right back after a week has past?

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  12. marelleann

    Hi. My daughter (6 yrs old) and my son (3 yrs old) are having hfmd. Their cousin is being infected too because they played. I just want to ask if my son and daughter will be able to catch it again?

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  13. Rebecca

    I am a nanny and I am 29. I caught it from the kids two summers in a row now! I don’t have a very reliable immune system when it comes to throat related illnesses, but you can definitely catch it as an adult. It feels like strep with worse chills, sweats, body aches, and flu like symptoms including nausea and stomach issues. The hand blisters are faint and don’t really hurt. I suppose this strain is still in me somehow or I caught one of the other ones? The bright side is you are cured naturally within a week or just a few days!

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  14. Riley

    Hello! I am hoping someone can offer me some advice or opinions of developing HFM multiple times. My daughter has just started her 3rd round of HFM. She is just two. She is a healthy baby (with the exception of only having one kidney) and rarely gets ill. I am worried that her immune system may be compromised or something else may be going as to why she’s getting this virus. Has any other parent had their child catch HFM 3+ times? Thank you for any advice offered!!

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    • Deepak

      Yes my son caught it for thr third time in past 2 years. Although no fever on 2nd and 3rd time and it went away faster. I am clueless too about the recurrence.

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      • Roxana

        My daughter had it when she was 2 years old a very severe case, I thought she will never get it again but she just got it. This is her second time and she is 10. This time also was server easy the first one . I’am very surprised about her getting it again.

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  15. Bes

    Hello,

    I have a 15 month old with hf&md. He is the only baby at daycare. How did my son get it? I have older children at home but no one has been sick in the few weeks.

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  16. Jesse James

    Hi sir, I just had an outbreak of HFMD. I caught it from my boyfriend. What is the likelihood that he’ll catch it again once I wait about ten days? I have a rather strong immune system and would like to think I will get better soon. This is my first encounter with this disease. I am going to try and stay hydrated. Also, I have not yet broke out in a rash and it has been two days, what is the likelihood that I will?
    Thank you.

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  17. Rikki

    Hey!! My daughter had hand, foot and mouth at the end of 2013! She had it 7 times in 11 months!! First time she was in hospital her temp was 39 to 40 for 3 days!! How many times can you catch hand, foot n mouth??

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  18. WorriedMama

    My daughter was just diagnosed with HFM or herpangina but I was also told it’s possible it could be HSV. No one in my family has HSV & she was not near any kids that have acted sick at all or have been known to have cold sores. So I know that some kids don’t end up showing s/s of having HFM or HSV but I am curious as to what you think my daughter has? She spiked a fever of 104, 24hrs later I noticed 2 blisters on her lips & then some inflammation to one area of her gums (probably a blister forming), & on her tongue as well. She continued to have a fever of 101-102 for another 24 hrs & also developed more blisters, this time outside of her lip line as well & several inside her mouth. We are on day 5 now & she has not gotten any rash to her body or extremities (which made the dr doubt a HFM dx). Her gums are also very red & inflamed & bleed if I try to brush them. Needless to say we are using Ibp/APAP & magic mouthwash but I want to know what this is. Especially now that you are saying that the HFM can cause recurrent lesions (that I would have assumed to be HSV if she got anything in the future). To be able to determine if the virus is coxsackievirus vs herpangina vs HSV would I need a blood test? And what do you think she is afflicted with?

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    • B janes

      My 17 month old got HFMD and only had blisters inside of his mouth. He then passed it onto his almost 5 month old brother who has blisters on the outside of his mouth, hands, feet, and traveling down his arms and legs. Each child is different I suppose.

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  19. Wendy

    my son aged 3 caught HFMD just this week for the third time since he was born. First time when he was 18 months, fever and bad mouth sores, no spots on hands/feet/buttocks. Second time when he was two years old, no fever but had painful mouth sores and a few spots on this feet and buttocks, no itch. Third time fever and mouth sores but not painful at all, so far still no spots on hands/feet/buttocks. He caught it this last time from his cousin who is two and she had fever and very painful mouth sores. Not sure if his sores were not painful this time as he has some kind of immunity or different viruses have different effects on different people.

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    • Hi Wendy,

      Different strains of viruses can indeed produce different symptoms in different kids. And there are a couple of different conditions that are closely related. When kids have mouth sores without spots on the hand/feet/buttocks it can still be HFMD – but it could also be herpangina. I hope this is the end of these infections for your 3-year-old. He’s certainly had his share!

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  20. Lelia

    My kids are ages 2 and 1, they go to daycare 3-5 days a week. They both have had hand, foot, and mouth multiple times now. It’s very frustrating with them always being sick with this virus. Is there something I’m doing wrong or is it just all the different viruses? Please help me understand what’s going on with my kids.

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  21. Meg

    Thanks for explaining the working of the immune system as it pertains to HFMD. Ever since i got it along with my son in 2011, I get very tiny blisters on my hands and feet when I get sick. For the longest time i thought they were warts but they always went away. Then i realized they felt exactly like the HFMD blisters and thought maybe I was crazy since i don’t know anyone else with long-term symptomology. Now i understand!

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  22. charmaine.rebello

    Sir, what are the best preventive measures for swine flu?

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  23. A.Ramesh

    My grand daughter, aged two and half years, is suffering with hand foot and mouth disease. Doctor has given oral aid drops ( 2 drops at time x 4 times ) and zoral cream and advised to apply on blisters if there is any itchy.
    Is there any other medicine for that disease? How can we improve her immune system as she is suffering with cold twice in a month?

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  24. Amber

    Hello, My 19 month old son had hand foot mouth disease about 4 months ago and he just got it again a week and half ago. He is now getting over it and it was going away. He had it very bad in his genital area and i did not understand that. Now i am experiencing the very sore blisters on my feet, legs, hands, and head, my son is also getting it again on his genital area. I am not sure what to do about it because we have been to 4 doctors and 2 hospitals. We have heard it is flea bites, HFMD, and even some say they dont know what it is. I just want to know whats going on with my son and why I am getting now also.

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  25. carlie

    Hello, my 18 month old son caught HFMD a month ago. We thought it had ran its course and was cleared up after a couple weeks. Now the blisters have returned on feet. Waking at night and very irritable. Not sure on fever because has been getting motrin for molars cutting through. My questions are; how can we find out what strand he has and is he contagious when the blisters reappear? Also both times has had a molar cutting, any correlation between the two?

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  26. Patricia Columbo

    My neighbor’s child has had HF&M 3 times within the past 4 1/2 months. He is 2 yrs old. It has been said the parents both have an STD called Herpes Simplex. He gets very high fevers & needs to be hospitalized when he gets these bouts. Am I correct in understanding what you’ve written – states HF&M can be caused by the Herpes Simplex virus? If so, what needs to be done where he can be free of this disease and not have anymore relapses.

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  27. John Annis

    My son had hand, foot and mouth syndrome in 1982 when he was less than a year old. He’s 33 now and apparently caught it again from his kids. It must be a different virus causing it, I guess. The blisters look the same, and are on his hands, feet and mouth just like they were 31 years ago.

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  28. Linda Wolski Gonzales

    My grandson has HFMD on the soles of his feet. Yesterday, I noticed about a dozen “pimple-like” blisters near my left elbow. I can’t wear long sleeves because it is too darn hot here, but if it is HFMD, I am terrified of getting it on my face because I would lose income as my work would require me to stay home.;

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    • Jjp

      I hope you stayed home if it was HFM regardless of it was on your face. People like you are the reason it’s spread in society because you dont stay home (or keep your kids home) & infect everyone else.

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      • Michigab

        And that’s why everyone should get paid sick leave and help paying for childcare and emergency childcare services.

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  29. Kate

    I have the same question as Dari. I got HFMD from my 6-month old daughter nine months ago and every once in a while I get a lesion or two on my hands. I’m assuming that means that for me the virus has made it into my cells (you said it was like Herpes?!). Am I condemned to have this for the rest of my life now? Does this mean there’s something wrong with my immune system?

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  30. Saoirsephoto

    I’ve noticed from time to time spots and bumps on my toddler’s feet very similar (but not as bad) to when she had HFMD and occasionally on my hands as well (the entire family got it). Does this mean that the virus has embedded like herpes simplex does? Will it pop like this for the rest of her life and like with the herpes virus, is she contagious every time the spots reappear?

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  31. Dari

    Hi, I caught HFMD from my toddler back at the end of the summer. I had a mild case, red marks on the palms of my hands and some sores/blisters in the mouth. My daughter had it worse. Ever since this episode, anytime I have a cold or am not feeling well, I notice that I get a few on my hands and in my mouth again. Am I going to keep having outbreaks of this from now on whenever I catch a cold, etc.? Also, am I contagious when I have these recurrences? I’ve been teaching preschool for over 12 years so I think I have a pretty strong immune system. I’m all set with blisters in my mouth! Thanks for any feedback:-)

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  32. Melissa

    Hello, im 30 and have it for the second time. I had it when I was 22 the first time. My mom doesnt remember me having it when I was a child. Does this mean I have a weak immune system?? Or just a run of bad luck with this virus!? I work in health care and am wondering how long I should be off before going back. Thank-you, Melissa D

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  33. -AJ

    What about a teenager age 18 with a HFMD can he be caught again??

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  34. Rita Robelin Huron

    My granddaughter is 3 months old and she was diagnosed with HF&MD in early July. Well it is now August and she still has it or has got it again. She has lesions all over her hands which she puts in her mouth all the time. She has been to the doctors twice and they just say it will go away. She also has the blisters all over her body. I know it is rare to get it twice, should we take her to the doctors again and ask for blood work to see if there is anything else going on? Do these lesions hurt or itch? She is only 3 months old and can’t tell us how she feels. Please advise.

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    • Alan Greene

      Rita, when a rash isn’t getting better when expected, going back to re-evaluate is a great idea. Putting the hands in the mouth all the time might be a normal behavior at her age, might be a sign her gums feel strange with teething — or might because her hands itch or hurt.

      There are other things that could cause her symptoms as well, including scabies – which cause a rash that can be a great mimicker (http://www.drgreene.com/articles/scabies/)

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      • Rita Robelin Huron

        If it was scabies we would all have it since we hold her all the time and it is highly contagious. No one we know has HF&MD. Should we have blood work done? Could a low immune system prevent her from fighting off this disease? Please advise.

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        • Alan Greene

          Rita, when it’s not clear what’s going on, taking a baby back to the doctor to ask for a re-evaluation and whether blood work would be appropriate seems wise.

          Most people with the virus that causes HFM disease don’t have symptoms, so it’s impossible to know if she’s been exposed. And many people with scabies don’t react to them, and don’t get the itching or the rash – so comfortable family members don’t rule it out.

          A careful re-examination and perhaps blood work, depending on the findings, seems prudent. Blood work could also evaluate the immune system, though there are plenty of other possible reasons for the prolonged rash.

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        • Dr. Greene, my granddaughter(age 2 and a half years) has also has this virus at least 3-4 times in the past year alone. She nor her brother have been vaccinated(he’s 5 years old). Is it possible that their immune systems are compromised because of this?

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    • Heather White Parker

      Use baby wipes and wash them down with it pretty regular it will help make the rash go away my aunt told me this and it really works been using them on my 5 year old for two days and the rash is almost gone.

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      • Hi Heather and Rita,

        Not all wipes are created equal. Some have chemicals that may irritate. Three brands I like a lot are Episencial, Honest, and 7th Generation. All are very gentle.

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