Study finds new culprit in hand, foot and mouth disease cases

A new study by Chinese scientists reveals a concerning shift in the pathogens causing hand, foot and mouth disease. The research, published in China CDC Weekly, indicates that coxsackievirus A6 is emerging as a dominant culprit, particularly for severe cases in young children.

The study, based on data from 2012 to 2023, highlights the evolving nature of CVA6. The scientists observed a significant increase in the strain's population diversity, potentially contributing to its growing role in outbreaks.

Previously, enterovirus A71 was the primary concern for severe hand, foot and mouth disease. However, the widespread use of an EV-A71 vaccine has led to a decline in those cases. Unfortunately, this success has created an environment for other enterovirus strains like CVA6 to take hold.

The study emphasized the importance of enhanced surveillance for severe hand, foot and mouth disease, particularly among children under 5 years old who are most susceptible due to their developing immune systems. The data showed a concerning skew toward males in severe cases, with 64.9 percent affecting boys.

Researchers called for the development and distribution of vaccines targeting CVA6. However, the strain's diverse population presents a challenge in vaccine development.

"There is no need for excessive public panic," assured Ji Hong, a researcher involved in the study from Jiangsu provincial CDC, acknowledging the natural evolution of pathogens. She emphasized that enteroviruses have a relatively low transmission capability.

The peak season for hand, foot and mouth disease is May to July and September to November, coinciding with warmer weather and increased human interaction. Ji stressed that the probability of severe cases remains low.

Preventive measures like frequent hand washing, disinfection and avoiding crowded spaces are crucial during high-incidence periods. Parents, especially those with young children, are urged to be vigilant for symptoms such as persistent fever, neurological issues and abnormal breathing or heart rate. Seeking prompt medical attention is essential in such cases, she said.