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ECDC: Hand, foot and mouth disease in Asia, September 2011

tetano

Editor, Senior Moderator
This epidemiological updates complements the ECDC risk assessment of hand, foot and mouth disease in Asia, produced by ECDC in May 2010.

In 2011, compared to 2010, the number of cases of hand, foot and mouth disease (HFMD) doubled in Japan and the Republic of Korea and more cases were reported from Macao (China). Vietnam reported more than 40 000 cases in 2011 but no data are available for comparison with the previous year. The peak of these outbreaks in 2011 has passed and the incidence is decreasing, except for Vietnam where disease activity is still ongoing at high levels. In Vietnam, more than half of the cases are due to enterovirus 71, while in Japan Coxsackie virus A6 has been confirmed in more than half of the cases. In other countries in the region like mainland China, Hong Kong SAR and Singapore, HFMD incidence was significantly lower in 2011 compared to 2010.

Outbreaks of HFMD are frequently reported in Asia and 2-3 year cyclical patterns are described, usually starting in May. The last large outbreaks in South-East Asia were reported in 2008 and 2010, affecting China, Hong Kong SAR, Taiwan, Japan, and Singapore. While the current situation is not unexpected, the ongoing outbreak is noteworthy considering that the recent HFMD incidence in Japan is the highest reported during the last 10 years, which might partly be explained by the tsunami that occurred in the country earlier this year. The increase of cases in 2011 in the Republic of Korea compared to previous two years is consistent with the 2 to 3 year cyclical patterns frequently observed. In addition, lack of surveillance systems in several South-East Asian countries and unpredictable temporal and geographic changes of the viruses increase the level of uncertainty.

HFMD is usually a mild disease mainly affecting young children due to different non-polio enterovirus infections (enterovirus 71, Coxsackie virus A).. 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 which is usually self limiting. For European citizens travelling to epidemic areas, the risk for infection is limited when applying strict personal hygiene.

http://www.ecdc.europa.eu/en/activi...=512ff74f-77d4-4ad8-b6d6-bf0f23083f30&ID=1196
 
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