Unusual Surge in Hand, Foot, and Mouth Disease Raises Public Health Concerns

Physicians and public health officials across the mid-Atlantic region are reporting a noticeable rise in hand, foot, and mouth disease (HFMD), a typically mild but highly contagious viral illness that primarily affects young children, according to reporting by MedPage Today. New national data mirror these local concerns. According to Epic Research, medically attended HFMD has risen 3-fold across the US compared with last year and nearly double the rate observed in 2023. Current rates are “221.8 cases per 100,000 patients vs 76.3 and 120.3, respectively.”

HFMD is caused by enteroviruses such as coxsackievirus and presents with flu-like symptoms, painful mouth sores, and a rash on the hands, feet, and sometimes the buttocks or legs. While most infections resolve within a week, severe complications can occur, including dehydration and, rarely, meningitis or encephalitis.

In Virginia, the increase has been striking. “During a typical year, we might see 45 to 65 outbreaks reported per year, and then this year, in 2025, we have had so far 198 outbreaks of hand, foot, and mouth disease reported,” said Dawn Saady, deputy director of the Division of Surveillance and Investigation at the Virginia Department of Health. She called it “a significant uptick,” noting that 99% of the state’s outbreaks occurred in K(indergarten) through 12 schools and child care centers.

Environmental factors may be contributing. Saady explained that enteroviruses “spread more easily in warm temperatures and high humidity,” adding that settings with close contact, such as camps and classrooms, increase transmission. She also pointed to “changes in circulating strains” and a potential immunity gap after a mild 2024 season.

Other experts reported similar trends. Matthew Thomas, MD, West Virginia University Medicine, said this is “the largest peak that we have probably seen since 2019 or 2020,” although periodic spikes are expected. Dean Blumberg, MD, University of California Davis, emphasized that “the vast majority of cases are mild” but acknowledged that a small number can become severe.

It is not only in the US. Hong Kong is also reporting an increase in HFMD. Germany, the Philippines, Canada, and the Near East are also reporting higher-than-normal case numbers this year.

Public health officials are urging awareness as families head into the holidays. Hand hygiene remains the most effective prevention tool. “Kids are going to come into contact with one another; it is very spreadable,” Thomas said. “We need to be vigilant and take care of our kids as it comes.”