As of May 2012, Vietnam continues to see sustained high incidence of hand, foot and mouth disease (HFMD) since the beginning of the year. China, Hong Kong (China), Macao (China) and Singapore have been reporting an increase in number of cases. The peak of this current epidemic wave has not passed yet as the overall incidence is still increasing in Vietnam, China Hong Kong (China), Macao (China) and Singapore. In Republic of Korea and Japan, the two countries specially affected during 2011, HFMD overall levels remain low. Surveillance for HFMD is currently conducted through sentinel reporting units in Japan and Republic of Korea while the rest of reporting systems vary by country.
Outbreaks of HFMD are frequently reported in Asia and 2-3 year cyclical patterns have been described, usually starting in May. The last large outbreaks in South-East Asia were reported in 2008 and 2010. The low activity in Republic of Korea and Japan compared to 2011 and the increasing activity in the other reported countries seem to be consistent with the 2 to 3 year cyclical patterns frequently observed.
While the current situation is not unexpected, particularly noteworthy is the situation in Vietnam, where overall 46 277 cases including 27 deaths have been reported from across 63 provinces since the beginning of the year up to 18 May 2012. The WHO Vietnam country office is currently working with its partners at the Vietnamese MoH to ensure availability of technical resources for the implementation of prevention and control measures.
HFMD is a common and mild viral illness mainly affecting young children due to different non-polio enterovirus infections (enterovirus 71, Coxsackie virus A). Symptoms of HFMD include fever, blister-like sores in the mouth (often painful), and a rash. More severe clinical presentation with neurological symptoms such as meningitis, encephalitis and polio-like paralysis may occur, but deaths are rare. The risk for developing complications depends on the age (higher for infants) and the pathogen (usually higher for enterovirus 71 infections compared to Coxsackie virus A infections). HFMD is also a common infant disease in Europe where is usually self limiting.
There is currently no vaccine or medicine to prevent HFMD. For European citizens travelling to epidemic areas, the risk for infection is limited when applying strict personal hygiene, as reflected in a recent travel notice issued by CDC for prevention of HFMD for travellers to Vietnam.
World Health Organization, Western Pacific Region, HFMD updates
ECDC threat assessment of hand, foot and mouth disease in Asia, May 2010
ECDC previous epidemiological update on HFMD, September 2011