Coxsackievirus A16 is the most common cause of HFMD while enterovirus 71 (EV-71) is the second most common.[4] Many other strains of coxsackievirus and enterovirus can also be responsible.[4][5] The viruses that cause HFMD are spread through direct contact with the mucus, saliva, or feces of an infected person. HFMD often occurs in small epidemics in nursery schools or kindergartens, usually during summer or autumn.[3] Signs and symptoms normally appear 3–6 days after exposure to the virus.[6] The rash generally goes away on its own in about a week, and most cases require no treatment other than symptomatic relief.[7] No antiviral treatment or vaccine is currently available for HFMD, but development efforts are underway.[8]