Etiology, epidemiology and clinical assessment of hand, mouth and foot disease

Hand-foot-and-mouth disease (HFMD), first identified in 1957, has evolved into a significant global health concern. It is caused primarily by enteroviruses, particularly Coxsackievirus (CV) and Enterovirus A71 (EVA71), HFMD predominantly affects children under five. The disease's etiology has shifted over the years, with newer strains like CV-A6 and CV-A10 emerging as notable culprits in recent outbreaks across Asia, America, and Europe. Epidemiologically, HFMD poses a major challenge in regions like the Western Pacific, with countries like China reporting over 10 million cases between 2008 and 2014. Clinical manifestations range from asymptomatic to severe, including potentially fatal neurological or cardiopulmonary complications. Treatment is primarily supportive, lacking specific antiviral therapies, and involves antiviral and immunoglobulin therapies, respiratory and cardiovascular support, and traditional Chinese medicine. Prevention focuses on hygiene practices, with no vaccines currently available. This review synthesizes current knowledge on HFMD's etiology, epidemiology, and clinical assessment, aiming to enhance understanding and inform effective public health strategies.