The West Virginia Bureau for Public Health (BPH), has identified a significant increase in reported outbreaks of hand, foot, and mouth disease (HFMD) statewide. In 2025, a total of 38 HFMD outbreaks have been reported, including 17 outbreaks since September 1, 2025.
HFMD 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 higher HFMD activity this year compared to prior years. Older adolescents and adults may also be affected.
Clinical Features
•Symptoms: Sudden onset of fever, painful oral sores, and vesicular rash on the hands and feet.
•Illness course: Rash develops within 1–2 days of fever onset; vesicles are typically non-pruritic.
•Infectious period: Begins two days before rash onset, continues during acute illness, and may persist for weeks after symptoms resolve.
•Causative agents: Most commonly Coxsackievirus A16 and Enterovirus 71.
Transmission
Spread occurs primarily through contact with respiratory secretions or stool of infected persons. Prolonged asymptomatic viral shedding is common.
Exclusion Guidance
•Children and staff do not need to be excluded from school or childcare if they are:
oFever-free for at least 24 hours without fever-reducing medication
oWell enough to participate in routine activities
oNot experiencing uncontrolled drooling from mouth sores
•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.
Testing
•HFMD is a clinical diagnosis; laboratory testing is unnecessary in most cases.
•Testing may be considered if the diagnosis is uncertain or in severe/unusual presentations (e.g., meningitis, sepsis).
•Routine testing is not recommended.
Prevention and Control
•Frequent handwashing (especially after diapering, bathroom use, and before food handling).
•Respiratory hygiene and cough etiquette.
•Regular cleaning and disinfecting frequently touched surfaces and toys.
Recommendations
1. HFMD activity is increasing statewide. Similar trends are being reported nationally. No increase in illness severity has been observed.
2. Clinicians should consider HFMD in the differential diagnosis for rash illnesses, particularly in children. Because measles continues to circulate nationally and internationally, clinicians should also remain vigilant for febrile rash illnesses that could represent measles.
3. Children with HFMD rarely require exclusion from childcare or school. Refer to outbreak guidance for exclusion criteria.
4. For further information, contact OEPS at (304) 558-5358, ext. 1, or visit the CDC HFMD resource page: CDC: About HFMD.
Wheeling-Ohio County Health Department
1500 Chapline Street, Room 106
Wheeling, WV 26003
(Get Directions)
Howard Gamble, MPH, LHA
Administration
(304) 234-3682
(304) 830-0420
[email protected]
Elizabeth Fowler, MSN, RN, BSN
Nursing Director
(304) 234-3682
[email protected]
Lock Johnson, RS
Chief Inspector-Environmental
(304) 234-3682
[email protected]
Savannah Lowe, MS, RD, LD
Nutrition Director
(304) 234-3888
[email protected]
Wayland Harris, EMT-P
Threat Preparedness Director
(304) 234-3682
[email protected]
William C Mercer, MD
Project HOPE Program
(304) 234-3682
[email protected]
Posted 09/29/25
Ohio Valley residents who are in need of a flu shot can visit the Wheeling-Ohio County Health Department to get their yearly seasonal flu vaccination. The WOCHD Seasonal Flu Vaccination Clinics are Mondays and Fridays from 9:00-11:00am and 1:00-3:00pm. Insurance and Medicaid are accepted, vaccines for individuals with no insurance and for patients covered by the VFC program. At this time, seasonal flu shots will be offered to individuals 6 months of age and older. Anyone interested in ge...
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