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The basics of hand-foot-and-mouth disease

A brief look at the ailment that put Noah Syndergaard on the DL.

MLB: Washington Nationals at New York Mets Andy Marlin-USA TODAY Sports

Hand-foot-and-mouth disease (HFMD) is a highly-contagious viral infection that affects mostly children in their first decade of life. It is characterized by rashes on the hands and feet and painful sores in the mouth. About 10-15 million symptomatic cases of HFMD are reported each year, and they are most commonly prevalent in the summer and the fall. Generally, the disease is self-resolving, lasting for only seven to ten days and requires little more than supportive treatment. The major concern is that since the mouth sores can be painful, a patient could resist fluid intake due to the pain upon swallowing, and dehydration can occur.

HFMD is most often seen in toddlers in daycare or in preschool and spread in areas where lack of hand washing or poor diaper changing habits—such as not wearing gloves—are rampant. The symptoms of the disease include:

  • Fever
  • Sore Throat
  • Malaise
  • Irritiability
  • Loss of appetitie

The signs commonly are:

  • a red rash on the palms and soles of the feet and occasionally the buttocks
  • Painful lesions on the inner part of the cheek, gums and on the tongue.

Though HFMD is a disease most commonly found in young children, adults are at a risk especially if they are immunocompromised or frequently around large groups of young children in a closed environment again typically in the summer or fall. A professional athlete who develops this disease will have at least a three-to-six day incubation period where he’ll be very contagious. That player would be not be allowed in the clubhouse area for that time. Since the disease typically runs its course in less than ten days, it would not be uncommon for an athlete to miss very little time. In the case of a baseball pitcher, he should only miss one start on average.

If the disease is not diagnosed immediately in an adult, the most common early symptoms are fatigue and malaise. That could perhaps explain why after just 84 pitches, Noah Syndergaard lost some velocity on his fastball and complained of a dead arm in Friday’s game against the Yankees. It is a likely hypothesis that the early stages of HFMD were already present.