The number of hand, foot and mouth disease (HFMD) cases in Asia so far this year sees one country reporting tens of thousands, and others reporting thousands of cases of the viral, typically childhood infection.

Image/CIA
Image/CIA

In China, the number of cases of HFMD in 2015 has exceeded 90,000 during the first two months of the year, a similar case count as seen in previous recent years, according to the World Health Organization (WHO) Western Pacific Region. China has also seen 10 HFMD fatalities to date.

Japan has reported in excess of 13,000 cases to date, a number higher than what has been seen in recent years. For example, for the period 12 March to 1 April 2015, there were 4,252 cases reported compared with 776 over the same reporting period in 2014.

As of 28 March, there were 6,510 HFMD cases reported in Singapore for 2015. The situation in Singapore has prompted the US Centers for Disease Control and Prevention (CDC) to issue a travel notice for travelers to the city-state today.

Vietnam has also reported a significant number of HFMD cases in 2015 to date. For the period 1 January to 22 March 2015, there were 9,334 cases of HFMD reported in Vietnam, including two deaths.

HFMD is typically a benign and self-limiting disease. Most common in young children, it presents as fever, oral lesions and rash on the hands, feet and buttocks. The oral lesions consist of rapidly-ulcerating vesicles on the buccal mucosa, tongue, palate and gums. The rash consists of papulovesicular lesions on the palms, fingers and soles, which generally persist for seven to 10 days, and maculopapular lesions on the buttocks.

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

  • 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.

According to the US Centers for Disease Control and Prevention (CDC), there is no vaccine toprotect against the viruses that cause hand, foot, and mouth disease.

A person can lower their risk of being infected by

  • Washing hands often with soap and water, especially after changing diapers and using the toilet.
  • Cleaning and disinfecting frequently touched surfaces and soiled items, including toys.
  • Avoiding close contact such as kissing, hugging, or sharing eating utensils or cups with people with hand, foot, and mouth disease.