HFM Disease surging in 8 American states
In this DML Report…
Hand, foot, and mouth disease (HFMD) cases are surging across the United States in 2025, with health experts estimating up to 1 million infections nationwide, compared to the typical annual figure of over 200,000. In Maryland, cases are four to five times higher than the same period last year, while significant increases have also been reported in Pennsylvania, New Jersey, Virginia, Ohio, Kansas, West Virginia, Wisconsin, and Tennessee. In New York City's Staten Island, several cases were identified this summer, with expectations of further growth. Dr. Allison Agwu of Johns Hopkins University described the situation as appearing out of control this year, Dr. Edith Bracho-Sanchez of Columbia University noted seeing more cases this summer than in the previous decade, Dr. Natasha Burgert in Kansas observed her practice reflecting the nationwide trend, and Dr. Matthew Thomas of WVU Medicine Golisano Children's in West Virginia stated that some years experience high volumes that then subside. The CDC does not track HFMD directly, making exact national figures unavailable.
HFMD is caused by viruses in the enterovirus family, most commonly coxsackievirus A16, and spreads through respiratory droplets, saliva, stool, blister fluid, contaminated surfaces, shared objects like toys, and potentially swallowed virus particles in untreated water. It primarily affects children under five, especially in group settings such as daycares, nurseries, and schools, but can also impact older children and adults, particularly those with weakened immune systems. Initial symptoms include fever, sore throat, and runny nose, resembling a common cold, followed by painful mouth sores typically at the back of the throat and red bumps or blisters on the hands and feet that may peel during healing. Some cases involve vomiting, and very young children may rarely develop neurological complications like brain inflammation, requiring urgent medical attention. The illness generally lasts about a week, though severe mouth ulcers can extend recovery to 10-14 days.
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No vaccine or antiviral treatment exists for HFMD, so management focuses on symptom relief with over-the-counter pain relievers and ensuring hydration, especially for children struggling to swallow due to mouth sores. Medical care is advised if hydration cannot be maintained, fever persists, eating becomes difficult, or signs of complications like extreme fatigue or breathing issues appear, though these are uncommon. Prevention measures include frequent hand-washing with soap and water, using alcohol-based sanitizers when washing is unavailable, avoiding face touching, cleaning shared surfaces, and staying away from sick individuals. Diagnosed children should stay home for at least seven days. Transmission is heightened by seasonal factors such as mixing at summer camps, swimming pools, and theme parks; back-to-school environments; and warm, humid weather that helps the virus survive on surfaces. Water parks have been identified as potential hotspots, with one in Philadelphia temporarily closing in July after a child visitor tested positive. Doctors emphasize vigilance and precautions amid this intense cyclical surge.