Hand foot and mouth disease
Version: November 2025
Introduction
Hand, foot, and mouth disease (HFMD) is a common viral infection primarily affecting children under 5 years old, though older individuals can also be infected. It is typically caused by non-polio enteroviruses, with coxsackievirus A16 being among the most common culprits. Symptoms include fever, sore throat, and a rash characterized by painful red blisters on the tongue, gums, inside of cheeks or skin on palms, soles, or buttocks. HFMD is highly contagious and spreads through contact with an infected person’s saliva, respiratory droplets, fluid from blisters, or feces. While uncomfortable, HFMD usually resolves without serious complications in 7-10 days.
Highlights
- Seasonal Pattern: HFMD cases consistently peak in summer months, with noticeable increases from May to October.
- Reduced Mortality: Deaths from HFMD have significantly declined, with many recent months showing zero fatalities, although one death occurred in November 2025.
- Impact of COVID-19: A marked drop in cases during 2020 corresponds with COVID-19 restrictions, suggesting public health measures affected HFMD transmission.
- Current Trends: In 2025, cases have resurged, particularly mid-to-late in the year, pointing to an upward trend compared to earlier years, though still within historical peak ranges.
Analysis
Cases Analysis
The Hand, Foot, and Mouth Disease (HFMD) data from mainland China covering November 2015 to November 2025 highlights distinct seasonal trends and low mortality rates. Typically, HFMD cases rise in spring, peak from May to July, and subsequently decline, aligning with the disease’s epidemiological behavior, which sees increased transmission during warmer months primarily affecting children.
From 2016 to 2019, the data reveals high case numbers with modest mortality, indicating prevalent outbreaks yet effective control over fatal outcomes. In 2020, as the COVID-19 pandemic started, a significant drop in HFMD cases is observed, likely due to heightened public health measures such as social distancing and improved hygiene practices. This reduction suggests the influence of broader pandemic measures on other infectious diseases. However, following the easing of restrictions, cases increased again, particularly in 2023, yet deaths remained rare, underscoring advancements in healthcare responses and interventions.
Overall, HFMD presents an ongoing public health challenge in China, with seasonal trends and fluctuations in case numbers over the years. The low mortality rate throughout the period reflects successful management of severe cases. The striking decrease in cases during 2020, followed by recovery in numbers, emphasizes the impact of external health interventions, offering valuable insights into controlling infectious diseases.
Deaths Analysis
The analysis of Hand, Foot, and Mouth Disease (HFMD) from 2015 to 2025 in mainland China shows variable deaths over the years. In 2016, HFMD reached a peak, with June recording 45 deaths out of 452,668 cases, reflecting a seasonal pattern from spring to summer. This spike could be due to increased human contact and environmental factors conducive to viral transmission. However, from 2020 onwards, both cases and deaths significantly declined, impacted perhaps by COVID-19 measures that restricted interactions and emphasized hygiene practices.
Post-2021, the mortality rate dropped sharply, with zero deaths from mid-2023 to 2025 despite fluctuating case numbers. This decline signifies possible improvements in medical treatment, early detection, and better public understanding of HFMD. Factors likely contributing to consistently low death rates include increased population immunity, effective public health strategies, or changes in virus virulence. High case numbers in recent years mirror pre-2020 levels, yet deaths remain negligible, highlighting the effectiveness of sustained public health interventions and advances in HFMD management. Overall, HFMD’s threat has diminished, marking a triumph in controlling this illness and reducing its fatality, though monitoring seasonal fluctuations remains crucial.