We have recently been tracking reports of an increase in the number and severity of cases of Hand Foot and Mouth disease in Asia. It is not possible to get exact numbers but we have seen reports from China, Vietnam and Indonesia, with thousands of illnesses and tens of fatalities per outbreak.
The earliest reports that we have tracked are from Vietnam in August 2011 when the Ministry of Health declared a pandemic. At that point there had been 32,000 cases and 81 deaths in Vietnam so far in 2011. However, further research has shown that there has been a large and rapid spread of Hand Foot and Mouth disease in China since 2004.
In the UK and US Hand Foot and Mouth disease is most commonly caused by coxsackie virus A16. It causes mild symptoms and mostly affects children. The outbreaks we are seeing in Asia are caused by a range of enteroviruses but one that is commonly reported is human enterovirus 71 (HEV-71). The numbers of people affected, the severity of the symptoms and the incidence of fatality from this form of the disease are a cause for concern.
We have recently seen a report into the development of a vaccine against HEV-71. This work has been prompted by the rapid rise in cases of this more virulent form of the disease. it is interesting to note that human enteroviruses evolve in much the same way as influenza viruses do, which raises the spectre of more virulent and dangerous strains arising and makes combating the disease through vaccine development more difficult..