Medical Microbiology and Immunology

, Volume 205, Issue 5, pp 397–407 | Cite as

Hand, foot and mouth disease (HFMD): emerging epidemiology and the need for a vaccine strategy

  • S. Aswathyraj
  • G. Arunkumar
  • E. K. Alidjinou
  • D. HoberEmail author


Hand, foot, and mouth disease (HFMD) is a contagious viral disease and mainly affects infants and young children. The main manifestations are fever, vesicular rashes on hand, feet and buttocks and ulcers in the oral mucosa. Usually, HFMD is self-limiting, but a small proportion of children may experience severe complications such as meningitis, encephalitis, acute flaccid paralysis and neurorespiratory syndrome. Historically, outbreaks of HFMD were mainly caused by two enteroviruses: the coxsackievirus A16 (CV-A16) and the enterovirus 71 (EV-A71). In the recent years, coxsackievirus A6 and coxsackievirus A10 have been widely associated with both sporadic cases and outbreaks of HFMD worldwide, particularly in India, South East Asia and Europe with an increased frequency of neurological complications as well as mortality. Currently, there is no pharmacological intervention or vaccine available for HFMD. A formalin-inactivated EV-A71 vaccine has completed clinical trial in several Asian countries. However, this vaccine cannot protect against other major emerging etiologies of HFMD such as CV-A16, CV-A6 and CV-A10. Therefore, the development of a globally representative multivalent HFMD vaccine could be the best strategy.


HFMD Enteroviruses Vaccine Epidemiology 



This work has been supported by the Ministère de l’Éducation Nationale de la Recherche et de la Technologie, Université de Lille 2 (Équipe d’accueil 3610) and Centre Hospitalier Régional et Universitaire de Lille, France. Aswathyraj SUSHAMA is a Ph.D. student under International Mobility Grant-2014 for Doctoral Students, the Partnership for Excellence between Lille 2 University, France, and Manipal University, India. Authors thank Dr. Babak Afrough (Senior Virologist, Virology and pathogenesis group, Public Health England, United Kingdom) and Dr. Piya Paul Mudgal (Assistant Professor, Manipal Center for Virus Research, Manipal University, Manipal, India) for reading and editing the language of the manuscript.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • S. Aswathyraj
    • 1
    • 2
  • G. Arunkumar
    • 2
  • E. K. Alidjinou
    • 1
  • D. Hober
    • 1
    Email author
  1. 1.Université de Lille Faculté de Médecine CHU Lille Laboratoire de virologie EA3610LilleFrance
  2. 2.Manipal Center for Virus Research (Regional Reference Laboratory for Influenza Virus & ICMR Virology Network Laboratory-Grade-I)ManipalIndia

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