User:Racosta0511/Hand, foot, and mouth disease

In China, HFMD is a notifiable disease and has been so for 12 years, whereas data in countries like the USA and Europe is not monitored as closely and relies on self report for mild cases. Only when there has been an outbreak is HFMD monitored more closely in these countries. Approximately ⅓ of those infected with HFMD remain clinically asymptomatic.

Potential factors that put a child at risk of developing HFMD include drinking unboiled water, eating somewhere other than home, and not washing hands before eating. A child living in a rural area is more likely to develop HFMD, although it has been mentioned that this factor may be confounded by variables such as socioeconomic status or differing hygiene habits. Males are more likely to become symptomatic and need medical intervention compared to females. Most cases of HFMD occur in children 1-2 years old in Asian countries, and 82.6% of cases occurred before a child turned 6 years old. The incubation period between infection and onset of symptoms ranges on average from 3-7 days. Environmental conditions such as humidity and temperature have been correlated with outbreaks of HFMD. It has been seen that exposure to sunshine/UV could protect an individual from infection of HFMD, however this needs to be investigated further because the seasonal trend of the disease (more cases in the summer months) seems to contradict these laboratory findings.

When making a vaccine, it should ideally cover all major genotypes and subgenotypes. According to epidemiological studies, genotypes C/D and B/C will be the best candidates while data for CV-A6 and CV-A10 are still needed. However, consistent epidemiologic surveillance needs to be performed in order to formulate an appropriate vaccine to be most efficient for major genotypes.

The public health concern was focused on the Asian-Pacific region of the world as it has been found this is where HFMD is most prevalent. However, it gained focus on preventative strategies because it began to appear most recently in the western region of the world. It should be known that HFMD appears unexpectedly in different parts of the world and is not solely in the Asian-Pacific region although that is where it began.

As far as cost is concerned, this vaccine will be low cost and because of the emergence of the disease, once developed, it will go on the WHO’s list of national immunization resources.

A study conducted by the World Health Organization (WHO) aimed to evaluate the effectiveness of HFMD emergency preparedness reporting in preventing disease spread in the global Western Pacific region. WHO noted that this region experiences approximately 302 HFMD outbreaks each year. The cases per month vary greatly, ranging from 7,512 cases in January 2009 to 104 cases in May 2010 (WHO). The mean duration of HFMD is approximately 15.7 days. However, in outbreaks of 20 or more cases, this timeframe is extended to 26.0 days. The results of the study indicated that mandated emergency preparedness reporting of HFMD incidences decreased the incidence of the disease. The incorporation of emergency preparedness reporting in other countries can lead to a reduction in the size and number of future outbreaks by reducing the reporting time and creating a faster response.

This response system is also proven to incorporate a C3 algorithm into predicting HFMD outbreaks. The sensitivity of this system has proven to be successful; 99.3% accuracy for predicting outbreaks of 20 cases or more, and 84.6% accuracy for outbreaks of no more than 10 cases.

According to a study regarding the occurrence of HFMD in Hong Kong, they saw an increase of the disease during certain time periods. They found that during the warmer months (May-July), there was an increase in cases compared to the winter peak (October-December), there was a decrease. This is because HFMD is associated with various meteorological factors, which includes temperature, vapor pressure, and duration of sunshine. Hong Kong is one of the areas in Asia that sees increases in cases of HFMD every year. For years, it has been considered an epidemic because of the fast increase of cases and the complications that are associated with it. Over the last decade, they recorded about 1,200 outbreaks with about 8,000 people being infected. As a response to the outbreaks over the years, they suggest socially distancing, maintaining good hygiene, and disinfection of the environment. These should be followed during the warmer seasons.