Epidemiology and Infection

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Epidemiology and Infection (2010), 138:1071-1089 Cambridge University Press
Copyright © Cambridge University Press 2010

Review Article

Human enterovirus 71 and hand, foot and mouth disease

S. S. Y. WONGa1, C. C. Y. YIPa1, S. K. P. LAUa1 and K. Y. YUENa1 c1

a1 Carol Yu Centre for Infection, Department of Microbiology, The University of Hong Kong, Queen Mary Hospital, Hong Kong
Article author query
wong ssy [PubMed]  [Google Scholar]
yip ccy [PubMed]  [Google Scholar]
lau skp [PubMed]  [Google Scholar]
yuen ky [PubMed]  [Google Scholar]


Hand, foot and mouth disease (HFMD) is generally a benign febrile exanthematous childhood disease caused by human enteroviruses. The route of transmission is postulated to be faeco-oral in developing areas but attributed more to respiratory droplet in developed areas. Transmission is facilitated by the prolonged environmental survival of these viruses and their greater resistance to biocides. Serious outbreaks with neurological and cardiopulmonary complications caused by human enterovirus 71 (HEV-71) seem to be commoner in the Asian Pacific region than elsewhere in the world. This geographical predilection is unexplained but could be related to the frequency of intra- and inter-typic genetic recombinations of the virus, the host populations' genetic predisposition, environmental hygiene, and standard of healthcare. Vaccine development could be hampered by the general mildness of the illness and rapid genetic evolution of the virus. Antivirals are not readily available; the role of intravenous immunoglobulin in the treatment of serious complications should be investigated. Monitoring of this disease and its epidemiology in the densely populated Asia Pacific epicentre is important for the detection of emerging epidemics due to enteroviruses.

(Accepted December 02 2009)

(Online publication January 08 2010)

Key Words:Hand; foot and mouth disease; enterovirus; enterovirus 71


c1 Author for correspondence: Professor K. Y. Yuen, Department of Microbiology, The University of Hong Kong, 4/F University Pathology Building, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong. (Email: kyyuen@hkucc.hku.hk)