Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, 450001, China.
Academy of Medical Science, Zhengzhou University, Zhengzhou, 450001, Henan, China.
J Biomed Sci. 2023 Feb 24;30(1):15. doi: 10.1186/s12929-023-00908-4.
Hand-foot-and-mouth disease (HFMD) is a viral illness commonly seen in young children under 5 years of age, characterized by typical manifestations such as oral herpes and rashes on the hands and feet. These symptoms typically resolve spontaneously within a few days without complications. Over the past two decades, our understanding of HFMD has greatly improved and it has received significant attention. A variety of research studies, including epidemiological, animal, and in vitro studies, suggest that the disease may be associated with potentially fatal neurological complications. These findings reveal clinical, epidemiological, pathological, and etiological characteristics that are quite different from initial understandings of the illness. It is important to note that HFMD has been linked to severe cardiopulmonary complications, as well as severe neurological sequelae that can be observed during follow-up. At present, there is no specific pharmaceutical intervention for HFMD. An inactivated Enterovirus A71 (EV-A71) vaccine that has been approved by the China Food and Drug Administration (CFDA) has been shown to provide a high level of protection against EV-A71-related HFMD. However, the simultaneous circulation of multiple pathogens and the evolution of the molecular epidemiology of infectious agents make interventions based solely on a single agent comparatively inadequate. Enteroviruses are highly contagious and have a predilection for the nervous system, particularly in child populations, which contributes to the ongoing outbreak. Given the substantial impact of HFMD around the world, this Review synthesizes the current knowledge of the virology, epidemiology, pathogenesis, therapy, sequelae, and vaccine development of HFMD to improve clinical practices and public health efforts.
手足口病（HFMD）是一种常见于 5 岁以下儿童的病毒性疾病，其特征为口腔疱疹和手、脚皮疹等典型表现。这些症状通常在数天内自行缓解，无并发症。在过去的二十年中，我们对手足口病的认识有了很大的提高，并引起了广泛关注。各种研究，包括流行病学、动物和体外研究，表明该疾病可能与潜在致命的神经并发症有关。这些发现揭示了与最初认识的疾病不同的临床、流行病学、病理学和病因学特征。需要注意的是，手足口病与严重心肺并发症以及在随访中观察到的严重神经后遗症有关。目前，尚无针对手足口病的特定药物干预措施。中国食品药品监督管理局（CFDA）已批准使用的灭活肠道病毒 A71（EV-A71）疫苗已被证明能有效预防 EV-A71 相关手足口病。然而，多种病原体的同时传播和传染病原体分子流行病学的演变使得仅基于单一制剂的干预措施相对不足。肠道病毒具有高度传染性，偏爱神经系统，特别是在儿童人群中，这导致了持续爆发。鉴于手足口病在全球的巨大影响，本综述综合了目前对手足口病的病毒学、流行病学、发病机制、治疗、后遗症和疫苗开发的认识，以改善临床实践和公共卫生工作。
