Current status of hand-foot-and-mouth disease

Abstract

Hand-foot-and-mouth disease (HFMD) is a viral illness commonly seen in young children under 5 years of age, characterized by typical manifestations such as oral herpes and rashes on the hands and feet. These symptoms typically resolve spontaneously within a few days without complications. Over the past two decades, our understanding of HFMD has greatly improved and it has received significant attention. A variety of research studies, including epidemiological, animal, and in vitro studies, suggest that the disease may be associated with potentially fatal neurological complications. These findings reveal clinical, epidemiological, pathological, and etiological characteristics that are quite different from initial understandings of the illness. It is important to note that HFMD has been linked to severe cardiopulmonary complications, as well as severe neurological sequelae that can be observed during follow-up. At present, there is no specific pharmaceutical intervention for HFMD. An inactivated Enterovirus A71 (EV-A71) vaccine that has been approved by the China Food and Drug Administration (CFDA) has been shown to provide a high level of protection against EV-A71-related HFMD. However, the simultaneous circulation of multiple pathogens and the evolution of the molecular epidemiology of infectious agents make interventions based solely on a single agent comparatively inadequate. Enteroviruses are highly contagious and have a predilection for the nervous system, particularly in child populations, which contributes to the ongoing outbreak. Given the substantial impact of HFMD around the world, this Review synthesizes the current knowledge of the virology, epidemiology, pathogenesis, therapy, sequelae, and vaccine development of HFMD to improve clinical practices and public health efforts.

Addressing vaccine-preventable encephalitis in vulnerable populations

“…Although no vaccine against EV-A71 has been granted approval by the US Food and Drug Administration, three inactivated vaccines have been licensed in China [75]. Following their introduction in Chinese urban centers, a significant drop in EV-A71-associated HFMD cases was observed [76].…”

Study on the epidemiological characteristics of enterovirus among pediatric patients in Hangzhou, China: A comparison between the pre‐COVID‐19, COVID‐19 pandemic, and post‐COVID‐19 periods

“…Treatment for HFMD and HA primarily consists of supportive care aimed at providing pain relief and managing fever 43 . Over‐the‐counter pain medications and throat lozenges can be used to alleviate discomfort.…”

Papulovesikulöses Exanthem und ausgeprägter einseitiger Hörverlust bei einem 20‐jährigen Mann

“…2,3 Durch Coxsackie-A6-Virus hervorgerufene HFMD zeichnet sich durch höhere Inzidenz bei Erwachse-nen und häufigeres Auftreten in den Wintermonaten aus als HFMD-Formen, welche durch andere Viren hervorgerufen werden. 4 Häufig sind die Rückseiten der Hände und Füße befallen, 2 was jedoch bei unserem Patienten nicht der Fall war. Während bei der "klassischen" HFMD in der Regel keine Blasen und Krusten auftreten, findet man diese Hautveränderungen häufig bei atypischer HFMD.…”

“…14 Auch wenn HFMD in der Regel milde Krankheitsverläufe aufweist, können kardiopulmonale und neurologische Komplikationen wie SSHL auftreten. 4…”