Doctors see surge in hand, foot and mouth cases this summer
There are usually some 200,000 reported cases of the viral illness each year, according to the American Medical Association, with spikes typical during summer and fall. But this summer, doctors say they're seeing even more than usual — although why remains unclear.
'I've been practicing pediatrics for about a decade. I don't think I've ever seen this many cases over a period of a few weeks,' Dr. Edith Bracho-Sanchez, a pediatrician at Columbia University Irving Medical Center in New York City, told The New York Times this week.
In Philadelphia, doctors told CBS News that the virus was spreading at summer camps, and a pool in the suburb of Chester was closed for a day after a reported infection.
"Each of our centers across the Philadelphia and surrounding county area are seeing multiple cases," Dr. Bob Czincila, medical director of Vybe urgent care, said.
Health officials in Maryland, New Jersey and Virginia, also told The Times that there have been more outbreaks in their states in 2025 compared to recent years. However, there is little concrete data because the Centers for Disease Control and Prevention does not require that doctors report cases.
The doctors have not hypothesized on the reason for the uptick in cases.
Hand, foot, and mouth disease commonly spreads at daycares, schools, and through water sources. The illness, which is common in children under the age of five, can cause a painful red rash of blister-like lesions, fever, and mouth sores.
Doctors say infection is usually not serious and people recover after a week or 10 days. Still, it is very contagious. Children can spread hand, foot and mouth disease from the day before the rash shows up and for several days after the rash appears, according to the Children's Hospital of Philadelphia.
People are often infected by contact with viruses in fecal matter, fluid from blisters, objects and surfaces with virus particles, and virus particles in the air after a person sneezes, coughs, or even just talks.
'Sometimes those small water-filled blisters can rupture and become shallow ulcers as well, especially in the mouth, which can be painful,' Dr. Terry Yen, a pediatrician and chief medical officer at Texas Children's Urgent Care, said.
To prevent infection, people should frequently wash their hands, disinfect surfaces, and avoid close contact with others.
If you are infected, most cases resolve on their own, but kids with a temperature above 103 degree Fahrenheit or who have rash that spreads to other parts of the body should see a doctor, Dr. Emily Boss, director of pediatric otolaryngology at Johns Hopkins Medicine, told The Times.
Treatment can help to alleviate uncomfortable symptoms. People can take pain relievers, although parents should never give aspirin to children.
Instead, kids can take Tylenol and Advil in the first three days of illness, when getting ahead of symptoms can make a major difference, Dr. Natasha Burgert, a pediatrician and national spokeswoman for the American Academy of Pediatrics, told The Times.
The mouth sores should be left to heal on their own. Try to eat soft foods and make sure to drink enough water to stay hydrated. The sores may make children not want to drink water.
With hand, foot and mouth disease, 'you get worried about children, especially younger children, who are not eating or drinking well becoming dehydrated. That would be a concern,' Yen warned.
That is why it is important to 'get children to drink more and help make them comfortable by treating the fevers and the pain.'
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I'll give you three insights: one is that when the NFL stopped denying the game caused CTE, it took some of the energy out. It stopped there being a clear bad guy in the story. Two is the sports industry has benefited from the fracturing of media. There just aren't that many full-time investigative journalists in sports anymore. Then point three is you can't get this issue on television anymore, and that's primarily because the NFL has now given a game to every media platform. It's not even a well-kept secret that anybody who carries game broadcasts is very concerned about [not calling attention to] CTE in the NFL. [Days after this interview, the NFL announced it had bought a 10% stake in ESPN.] I can remember there being some urgency to establish a link between CTE and violence – but all the research at the time was inconclusive. Has anything changed? I still wouldn't say there's been a definitive study. 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Can we point to a reduction in potential brain injuries? Firstly, the NFL had to take the brain injury risk seriously because there's a [players] union. But that doesn't exist in college. We did an editorial recently to accompany a study that showed basically that 80% of the NFL's concussions are in games; in college, it's 30% [meaning the overwhelming majority happen during practice]. The editorial laid out how the NFL set the tone 10 years ago by virtually eliminating hits in practice. The reality is I'm glad the NFL has started making some stronger changes – most recently, to kickoff procedures. No one was dying for that, but now we're all fine with it. But the sad part is the other levels aren't copying the NFL. Like, how is the NFL proving that it's safer, but college and high school football aren't even talking about it? In high school, apart from two states that have severe limits, everybody else has pretty loose limits, no monitoring and no penalties. I'm having that battle on a daily basis to warn athletes, especially the ones who are old enough to understand, that they're not being warned and their coaches are not properly educated on CTE. So for all the good things that have happened, slowly progressing the discussion, we should not expect CTE to go down. We're still creating the same problem; we just feel better about it. Personally, it always rankles me to hear announcers complain about roughness penalties that strike them as overzealous. Then you realize safety is an afterthought to the business – that if the changes are too radical and fans turn off the TV, the hitting comes back. And I don't have a problem with that at the NFL level. Players get half the revenue, so they can have that discussion about how safe they want it to be. But we also have to educate the fans to allow it to be safer. The one place where that's actually happened is professional wrestling. Now that fans understand the risks, they want matches to be stopped when people have concussions. Even now you see wrestling fans struggle to play back old matches because it's so obvious how dazed some of those guys were in the ring. I had that discussion with a 25-year-old who works for a sports organization in the brain health space who was like, 'I watched some matches from your era. What the hell were you guys doing?' So, we could educate NFL fans too to enjoy a slightly safer game. But who wants to be reminded that many of the guys they're watching already have CTE? Given that the NYC shooting happened during NFL training camps, I was surprised that players didn't have more to say about it. Current NFL players don't talk about CTE because many of them don't understand it and others know they'll be punished if they do. I mean, let's be honest: Jerry Jones [owner of the Dallas Cowboys] is still on the record saying he doesn't believe that football causes CTE even though he's lost a teammate from Arkansas to it. So if you play for the Cowboys and start talking about CTE, I wouldn't be surprised if he cut you the next day. Ten years ago there was a lot of talk about the need for a test to detect CTE in the living. Are we any closer to that? Yes. We've learned tau Pet scans for Alzheimer's disease don't work. But we have identified targets we think might make it diagnosable from blood, and we are trying two more new tau Pet tracers that people are hopeful might work for CTE. Interview has been edited and condensed for clarity.
