According to the World Health Organization (WHO), Hand, foot and mouth disease (HFMD) is a common infectious disease that occurs most often in children, but can occur in adolescents and occasionally in adults. In most cases, the disease is mild and self limiting, but more severe clinical presentation with neurological symptoms such as meningitis, encephalitis and polio-like paralysis may occur.


In the first six months of 2016, China and Japan are reporting different occurrences of the viral disease compared to last year.

In China through June 30, a total of 1,305,593 cases of HFMD including 122 deaths were reported in 2016. This includes 452,668 cases reported in June alone. This compares to the same period in 2015 when China reported  984,699 cases of HFMD and 28 deaths.

The reverse is true in Japan this year to date. Japan saw a big HFMD year in 2015; however, so far this year the numbers are way down.

Through the first seven months of the year, Japan has reported  17,387 HFMD cases. This compares to the same period in 2015 when the country reported 216,971 cases of HFMD.

Hand, foot, and mouth disease is caused by viruses that belong to the Enterovirus genus (group). This group of viruses includes polioviruses, coxsackieviruses, echoviruses, andenteroviruses.

  • Coxsackievirus A16 is the most common cause of hand, foot, and mouth disease in the United States, but other coxsackieviruses have been associated with the illness.
  • Enterovirus 71 has also been associated with hand, foot, and mouth disease and outbreaks of this disease.

EV-71 has been implicated in HFMD outbreaks in Southeast Asia over the several years. EV 71 is a non-polio enterovirus.

Complications associated with HFMD caused by the more pathogenic EV-71 strain include encephalitis, aseptic meningitis, acute flaccid paralysis, pulmonary edema or hemorrhage and myocarditis. Most deaths in HFMD occur as a result of pulmonary edema or hemorrhage.