Notifiable Communicable Diseases Research Articles

Epidemic situation of malaria in Lishui City from 2013 to 2018

To analyze the epidemic situation and epidemiological characteristics of malaria in Lishui City from 2013 to 2018, so as to provide the evidence for formulating the malaria control strategy. The data pertaining malaria cases in Lishui City from 2013 to 2018 were captured from National Notifiable Communicable Disease Reporting System and the Information System for Parasitic Diseases Control and Prevention, and the epidemiological features of malaria cases were analyzed. A total of 119 malaria cases were reported in Lishui City from 2013 to 2018, including 101 cases with falciparum malaria (84.87%), 6 cases with vivax malaria (5.04%), 8 cases with ovale malaria (6.72%), and 4 cases with mixed infection (3.36%). Among the 119 cases, there were one local case with blood transfusion-induced malaria and 118 cases with over- seas imported malaria. There were 98.32% of the imported malaria cases acquiring infection in African countries, and most cases were reported in Qingtian County (60.50%) and Liandu District (22.69%). In addition, 86.55% of the malaria cases were detected in individuals at ages of 20 to 50 years, and most cases were found in oversea workers (52.94%) and businessmen (38.65%). Most of the malaria cases in Lishui City are imported from Africa, and the monitoring and health education pertaining to malaria control knowledge requires to be intensified among high-risk populations.

An Update on the Epidemiological Situation of Alveolar Echinococcosis: Recording and Reporting Structures in Austria, Switzerland and Germany

Alveolar echinococcosis (AE) is a rare disease in Austria, Switzerland and Germany (DACh) caused by an infection with the parasite Echinococcus multilocularis. The aim of the study was to describe differences in the detection and reporting systems of alveolar echinococcosis in Austria, Switzerland and Germany and to describe epidemiological trends. As part of an epidemiological update on 6th September 2019 in Ulm, Germany, experts and representatives discussed differences in the reporting and recording systems as well as the current epidemiological situation. Since 2004, Austria has had an obligation to report suspected cases, diseases and deaths of alveolar echinococcosis by name in accordance with §1 Para. 1 of the Epidemiegesetz 1950 (EpidemieG) and the Ordinance on Notifiable Communicable Diseases. According to §7 Para. 3 of the German Infection Protection Act (IfSG), Germany has also been subject to a reporting obligation since 2001, but not by name. In addition, national registers are available in both countries, which can be used to answer scientific questions. In Switzerland, there is no obligation to report human alveolar echinococcosis since 1997. Efforts are currently being made to implement a national register for alveolar echinococcosis in Switzerland. Despite different reporting and recording systems, a similar epidemiological trend can be observed for DACh. In Austria, Switzerland and Germany there is a slightly increasing trend of human cases with alveolar echinococcosis. The direct comparability is limited due to different reporting obligations. The structures often do not allow a joint answering of scientific questions concerning diagnostics, treatment and care.

Spatial distribution characteristics of reported echinococcosis patients in Inner Mongolia Autonomous Region from 2013 to 2018

To investigate the spatial distribution patterns and changing tendency of reported echinococcosis patients in Inner Mongolia Autonomous Region from 2013 to 2018, so as to provide the evidence for the management of echinococcosis in high-risk areas. All data pertaining to echinococcosis patients in Inner Mongolia Autonomous Region were captured from the National Notifiable Communicable Disease Reporting System from 2013 to 2018 and analyzed using a spatial epidemiological method. The incidence of reported echinococcosis was 0.22 to 0.41 per 100 000 in Inner Mongolia Autonomous Region from 2013 to 2018, and the number of banner reporting echinococcosis patients increased from 24 in 2013 to 39 in 2018. The highly prevalent areas of echinococcosis were mainly concentrated in West Ujimqin Banner (the highest incidence, 19.23 per 100 000), East Ujimqin Banner (the highest incidence, 12.93 per 100 000) and New Barag Right Banner (the highest incidence, 11.66 per 100 000). Three-dimensional trend analysis showed that the areas with high incidence of reported echinococcosis were mainly located in central by eastern parts of Inner Mongolia Autonomous Region. There was a positive spatial autocorrelation in the number of echinococcosis patients, and the cases appeared a clustering distribution (Moran's I > 0, P < 0.05), with "high-high" and "low-high" regions. The reported echinococcosis patients show a spatial aggregation in Inner Mongolia Autonomous Region, and the hotspot areas are mainly concentrated in Xilingol League and Chifeng City, in which targeted control interventions for Inner Mongolia Autonomous Region are recommended to be intensified.

The outbreak of COVID-19: An overview.

In late December 2019, a previous unidentified coronavirus, currently named as the 2019 novel coronavirus#, emerged from Wuhan, China, and resulted in a formidable outbreak in many cities in China and expanded globally, including Thailand, Republic of Korea, Japan, United States, Philippines, Viet Nam, and our country (as of 2/6/2020 at least 25 countries). The disease is officially named as Coronavirus Disease-2019 (COVID-19, by WHO on February 11, 2020). It is also named as Severe Pneumonia with Novel Pathogens on January 15, 2019 by the Taiwan CDC, the Ministry of Health and is a notifiable communicable disease of the fifth category. COVID-19 is a potential zoonotic disease with low to moderate (estimated 2%–5%) mortality rate. Person-to-person transmission may occur through droplet or contact transmission and if there is a lack of stringent infection control or if no proper personal protective equipment available, it may jeopardize the first-line healthcare workers. Currently, there is no definite treatment for COVID-19 although some drugs are under investigation. To promptly identify patients and prevent further spreading, physicians should be aware of the travel or contact history of the patient with compatible symptoms.

A Preliminary Study of Real-time Capturing and Sharing of Routine Health Data among the Public Health Professionals.

Context:Electronic health record (EHR) has the potential to make available the real-time data of the patient to the healthcare professionals by connecting all levels of the public health system, irrespective of their geographical boundaries.Aim:This study aims to test the capturing and sharing of real-time patient data at primary, secondary, and the tertiary level.Settings and Design:The cloud-based EHR system developed earlier was used to capture real-time data of the patient visiting a primay health center (PHC) in Udupi District of Karnataka.Subjects and Methods:About 100 patient records including laboratory and pharmacy data have been captured into the EHR system. The confidentiality of patient data is assured.Results:The result of the study indicated no errors while capturing and sharing the patient data in real time. The system also evidenced the availability of vital statistics about the patient visiting PHCs. The system also allowed the professionals at referral level to view patient data for providing quality healthcare.Conclusion:EHR plays a vital role in capturing, storing, and sharing patient data for providing quality healthcare and it should be made mandatory by the central health agencies in the provision of patient care and reporting of notifiable communicable diseases at all levels.

Analysis of imported malaria cases in Leshan City from 2012 to 2018

To analyze the epidemiological characteristics of reported malaria cases in Leshan City, so as to provide insights into malaria control. The data pertaining to malaria cases and epidemiological individual information in Leshan City from 2012 to 2018 were captured from the National Notifiable Communicable Disease Reporting System and the Information System for Parasitic Diseases Control and Prevention, and a descriptive epidemiological analysis was performed. A total of 34 malaria cases were reported in Leshan City from 2012 to 2018, and all cases were confirmed as imported malaria cases by Sichuan provincial malaria diagnosis reference laboratory. Of all 34 cases, there were 14 vivax malaria cases, 18 falciparum malaria cases, a malariae malaria case and an ovale malaria case. The sites where malaria parasite infections occurred mainly included African areas (accounting for 58.82%) and Southeastern Asian areas (accounting for 29.41%), and the malaria cases were mainly reported in January, February, June and July, which accounted for 65.63% of all cases. The cases included 33 men and a woman, and had ages of 21 to 59 years. The cases'occupations mainly involved overseas peasants, technical workers and businessmen. The duration from onset of malaria to diagnosis ranged from 0 to 31 days, and the percentage of definitive diagnosis was 85.29% at initial diagnosis. There are no local malaria cases in Leshan City; however, imported malaria cases are reported. The monitoring, management and health education of overseas returners should be further strengthened and malaria training should be improved to enhance the diagnostic and treatment capability in professionals, so as to consolidate malaria control achievements.

Epidemiological and space-time analysis of Beijing Intestinal Infectious Diseases

Epidemiological and space-time analysis of Beijing Intestinal Infectious Diseases

Antakya Örneğinde Türkiye’de Bildirimi Zorunlu Bulaşıcı Hastalıklar ve Bildirim Durumu

Antakya Örneğinde Türkiye’de Bildirimi Zorunlu Bulaşıcı Hastalıklar ve Bildirim Durumu

Knowledge, Awareness, and Compliance of Disease Surveillance and Notification Among Jordanian Physicians in Residency Programs.

Health professionals’ knowledge and awareness of the disease surveillance is essential for reporting diseases to health departments. This study aimed to assess the knowledge and attitudes of Jordanian physicians toward public health surveillance of communicable disease. A cross-sectional study was conducted among resident doctors who were working in 4 main Ministry of Health hospitals and 2 teaching hospitals in Jordan in September 2017. A self-administered paper-based questionnaire was used to collect the data. The questionnaire collected information about sociodemographic and practice-related characteristics of physicians and included items to assess their knowledge of surveillance and reporting practices. This study included 223 physicians (152 males and 71 females). About 60.1% of the residents were graduates from medical schools in Jordan and the remaining (39.9%) were graduates from medical schools in other countries. Approximately two thirds of residents (62.3%) were doing their residency in Ministry of Health hospitals and the rest (37.7%) in 2 teaching hospitals. Only 44.8% of physicians had defined surveillance correctly. Only 27.4% of physicians had been educated or trained on surveillance. About 39.5% of physicians had filled at least one report form during their practice. The main reasons for not reporting mandatory diseases were high workload (49.8%) and being not trained on reporting diseases (46.6%). A relatively high percentage of physicians have insufficient knowledge of surveillance and reporting of notifiable communicable diseases. Training of physicians on surveillance and diseases notification is highly needed. The practice of disease notification should be enforced in Jordanian hospitals.

Progress toward eliminating TB and HIV deaths in Brazil, 2001\u20132015: a spatial assessment

BackgroundBrazil has high burdens of tuberculosis (TB) and HIV, as previously estimated for the 26 states and the Federal District, as well as high levels of inequality in social and health indicators. We improved the geographic detail of burden estimation by modelling deaths due to TB and HIV and TB case fatality ratios for the more than 5400 municipalities in Brazil.MethodsThis ecological study used vital registration data from the national mortality information system and TB case notifications from the national communicable disease notification system from 2001 to 2015. Mortality due to TB and HIV was modelled separately by cause and sex using a Bayesian spatially explicit mixed effects regression model. TB incidence was modelled using the same approach. Results were calibrated to the Global Burden of Disease Study 2016. Case fatality ratios were calculated for TB.ResultsThere was substantial inequality in TB and HIV mortality rates within the nation and within states. National-level TB mortality in people without HIV infection declined by nearly 50% during 2001 to 2015, but HIV mortality declined by just over 20% for males and 10% for females. TB and HIV mortality rates for municipalities in the 90th percentile nationally were more than three times rates in the 10th percentile, with nearly 70% of the worst-performing municipalities for male TB mortality and more than 75% for female mortality in 2001 also in the worst decile in 2015. The same municipality ranking metric for HIV was observed to be between 55% and 61%. Within states, the TB mortality rate ratios by sex for municipalities in the worst decile versus the best decile varied from 1.4 to 2.9, and HIV varied from 1.4 to 4.2. The World Health Organization target case fatality rate for TB of less than 10% was achieved in 9.6% of municipalities for males versus 38.4% for females in 2001 and improved to 38.4% and 56.6% of municipalities for males versus females, respectively, by 2014.ConclusionsMortality rates in municipalities within the same state exhibited nearly as much relative variation as within the nation as a whole. Monitoring the mortality burden at this level of geographic detail is critical for guiding precision public health responses.

Communicable diseases. The case of sexually transmitted infections: A retrospective 3-year study

Introduction Health surveillance is essential for the effective impact assessment, monitoring and control of diseases and risks to health, including communicable diseases, and is necessary for an efficient public health practice capable of effectively protecting and promoting the health of populations. In Portugal, mandatory notification of communicable diseases established since 1949, in Law 2036, August 9. The current mandatory list of notifiable diseases encompasses 65 diseases, six of which are sexually transmitted infections (STIs), which are a public health problem.2 Methods A retrospective and descriptive study conducted through the collection of information from the database of the National Epidemiological Surveillance System. The notified cases of STIs between 2015 and 2017 disaggregated by demographic variables: sex, age and geographical location and clinical variables: disease and case definition. Results The total number of reported cases of STIs throughout these 3 years was 134, with the following distribution: 33.0% syphilis (n = 44), 25.4% gonorrhea (n = 34), 13.4% hepatitis C (n = 18), 13.4% HIV/AIDS (n = 18), 9.7% chlamydiase (n = 13) and 5.2% (n = 7) hepatitis B. Of the reported cases, 54.6% (n = 83) were males and 21.7% (n =33) were female, with ages ranging from 13 to 75 years and mean age of 39.5 years. Most of reported cases of STIs observed in Alto Seixalinho and Baixa da Banheira. Overall, there was an increase in the frequency of reported cases of STI, with a particular focus on gonorrhea. Conclusion Notification should be early because it can protect the health of the population by ensuring identification and follow-up of cases, identification of contacts, investigation and containment of disease outbreaks.

Health care providers' compliance with the notifiable diseases surveillance system in South Africa.

BackgroundThe optimal performance of a notifiable disease surveillance system (NDSS) is dependent on health care provider (HCP) compliance with communicable disease notification. HCP compliance ensures appropriate investigation and control measures by relevant health care authorities. This study examines the compliance of HCPs with the NDSS in South Africa and factors associated with their compliance.MethodsA cross-sectional survey was carried out in three randomly selected provinces. We stratified by type of facility, and recruited clusters of HCPs on survey day to participate. All consenting HCPs in the randomly selected health care facilities on the day of the survey, completed a questionnaire that elicited information on socio-demographic characteristics and notification practices. The data were analysed using STATA® 14, using the identifiers for stratum and cluster as well as the calculated sampling weights.ResultsThe study found that 58% of 919 HCPs diagnosed a notifiable disease in the year preceding the survey. The majority of these professionals (92%) indicated that they had reported the disease, but only 51% of those notified the disease/s correctly to the Department of Health. Paediatricians were less likely to notify correctly (OR 0.01, 95% CI 0.00–0.12, p = 0.001). The factors that influenced notification were HCPs perceptions of workload (OR 0.84, 95% CI 0.70–0.99, p = 0.043) and that notification data are not useful (OR 0.84, 95% CI 0.71–0.99, p = 0.040). The study found no association between correct notification and HCPs’ willingness to notify, experience or training on the NDSS, understanding of the purpose of the NDSS, knowledge of what to notify, or perception of feedback given.ConclusionsThe compliance of HCPs in South Africa with the NDSS is suboptimal. In light of the important role of HCPs in the effective functioning of the NDSS, information on NDSS usefulness and guidelines on correct notification procedures are needed to increase their compliance.

Application of autoregressive integrated moving average model in predicting the reported notifiable communicable diseases in China

Objective: To develop the models for predicting the reported legally notifiable diseases in China. Autoregressive integrated moving average (ARIMA) model was applied to forecast the trend of diseases. Methods: Cases used for building the model were from of the records of Notifiable Infectious Diseases in China from May 2009 to July 2016 with R software and the model's predictive ability was tested by the data from August 2016 to January 2017. Results: A strong seasonal nature was seen in the reported cases of notifiable communicable diseases, with the lowest point in February and highest peak in June. ARIMA (4, 1, 0) (1, 1, 1)(12) model was established by the team to forecast the notifiable communicable diseases. Data showed that the biggest and lowest relative errors appeared as 9.78% and 2.21%, respectively, with the mean of the relative error as 5.39%. Conclusion: Based on the results of this study, the ARIMA (4, 1, 0) (1, 1, 1)(12) model seemed to have had the sound prediction of notifiable communicable diseases in China.

Surveillance of communicable diseases for decisionmaking in Egypt: 2006-2013.

The Egyptian Ministry of Health and Population surveillance system provides data about notifiable communicable diseases. This study aimed to provide information for decision-making to reduce the burden of communicable diseases in Egypt by analysis of the surveillance data for 2006-2013 to identify trends in the incidence of the diseases by governorate, season, age and sex. Composite risk-index scores were estimated to rank the 27 Egyptian governorates into 3 groups: high, medium and low risk. The 15 diseases with the highest incidence were food and waterborne diseases (5 diseases), vaccine-preventable diseases (7 diseases) and others, e.g. hepatitis C infection. Bloody diarrhoea and typhoid had the high incidence for 2006-2013. There were 11 high-risk governorates; Ismailia had the highest risk-index score. The findings suggest the need for specific interventions related to environmental sanitation and improving the childhood immunization programme, particularly in the high-risk governorates.

Evaluating the timeliness of reporting in a First Nations communicable diseases program.

Timely reporting of communicable diseases is necessary to enable a prompt response to mitigate and control outbreaks. This is especially true among First Nations communities due to a number of factors, including unique social determinants of health, which can contribute to rapid disease transmission. To assess the timeliness of reporting for 12 notifiable communicable diseases in the Northern Inter-Tribal Health Authority, which includes 33 First Nations on-reserve communities in Northern Saskatchewan, Canada, and to assess whether there were differences in reporting times depending on degree of remoteness of community, season or year. Data for four sexually transmitted infections (STIs) and eight other communicable diseases were abstracted from the integrated Public Health Information System (iPHIS) between 2008 and 2013 and compared against the targets set for reporting in the Saskatchewan Communicable Disease Control Manual. The reporting time was defined as the duration from client exposure or presentation at clinic to the case notification day at Saskatchewan's Ministry of Health. Communicable diseases were evaluated for proportion of cases reported within recommended time, and mean reporting time. Geographical and reporting data were also recorded to assess variations in reporting time among different northern communities and according to season or year. A total of 9,767 records were identified for the 12 diseases; all had a 14-day recommended reporting time, with the exception of shigellosis, which had a three-day reporting time. Overall, 93.6% of the diseases were reported in the recommended reporting time, although there was variability among the diseases. All four of the STIs (chlamydia, gonococcal infections, HIV and syphilis) had over 90% of cases reported within the 14-day recommended time period. Other communicable diseases reporting times varied from a high of 93.4% for methicillin-resistant Staphylococcus aureus (MRSA), 91.7% for lab-confirmed influenza and 89.1% for streptococcal A-invasive disease to a low of 16.2% for shigellosis and 12.2% for pertussis. Salmonellosis and pneumococcal-invasive disease were intermediary with 77.4% and 72.2%, respectively. Mean reporting times indicated that eight of the 12 diseases (66.7%) had reporting times similar to or better than recommended times. There appeared to be a correlation between longer reporting periods and the more northern communities. There were no seasonal variations found but yearly-trend analysis demonstrated an anomalous year in 2011, in which all communicable diseases with the exception of STIs experienced a peak in reporting delays. Overall, communicable disease reporting in this northern health authority program met recommended reporting times, although there were variations according to the disease, the area reporting and the year. Further research is needed to understand these variations in order to inform efforts to strengthen communicable disease surveillance among First Nations communities.

The professional status of infectious disease physicians in China: a nationwide cross-sectional survey

ObjectivesThe evolution of infectious diseases (IDs) poses a challenge to many ID physicians, who must either adapt or transition to another career track. This national cross-sectional study assessed the current working conditions and problems faced by ID professionals in China. MethodsA national questionnaire survey of ID physicians and their facilities throughout China was performed in May–June 2016 using stratified random sampling. ResultsA total of 156/300 (52.0%) ID departments and 1071/2250 (47.6%) physicians from 21 provinces participated in the survey. Overall, 151 (96.2%) of 156 hospitals had ID wards and 141 (90.4%) provided outpatient consultations. The average number of ID physicians per department was 10.32 ± 6.57. The ratio of patient beds to doctors was 5: 1, and the ratio of patient beds to nurses was 5: 1.85. Training in IDs was available in 126 (80.8%), and ID research was performed in 108 (69.2%), of the 156 departments. The main service provided by ID physicians was the management of legally notifiable communicable diseases. The annual income of 942 (88.0%) of the 1071 physicians was below $15 000. Of these physicians, 870 (81.2%) felt high or very high pressure in their work, whereas only 514 (48.0%) were satisfied or very satisfied with their jobs. ConclusionsThe limited medical service provided by ID physicians is poorly aligned with current healthcare demands. Moreover, the heavy workloads, high stress, poor compensation and limited career prospects for ID physicians in China impede the continued development of specialists and places them in a career dilemma. ID physicians should work to develop and diversify the field and to enhance their capacities by learning new technologies and collaborating with other medical disciplines.

Reporting quality of notifiable communicable diseases in hospitals in China, 2015

Objective To evaluate the reporting quality of notifiable communicable diseases in hospitals at all levels in China, and provide evidence for the further improvement of the reporting quality. Methods A total of 116 hospitals in 9 provinces were investigated, which were selected through multi-stage stratified cluster sampling in 31 provinces, autonomous regions, municipalities and Xinjiang Production and Construction Corps. Results A total of 1952 outpatient and inpatient records were analyzed, in which 1867 were reported through direct network reporting system. The overall reporting rate was 95.65%. The differences in reporting rates among hospitals at different levels were significant (2=34.251, P0.0001). The reporting timeliness rate was 97.75%, the completeness and accuracy of reporting cards were 89.45% and 69.76%, the concordance rate of electronic reporting was 81.52%. The differences in reporting timeliness rates and accuracy of reporting were significant. Conclusion Except underreporting and delay in reporting, the overall reporting rate was high in 2015. It is suggested to further standardize the data reporting and use information technique in infectious diseases reporting in hospitals to improve the quality of reporting effectively.

Analysis on duplicate reporting of hepatitis B in national notifiable communicable disease report system in China, 2011-2013

Objective: To analyze the duplicated reporting of hepatitis B in the national notifiable communicable disease report system (NNDRS) in China during 2011-2013. Methods: The data of hepatitis B reported from January 1, 2011 to December 31, 2013 were collected from NNDRS, the duplicated reporting were searched with software SAS 9.1.3 according to the cases'ID number, name, gender, birth data and current address code. Results: During 2011-2013, a total of 3 389 374 hepatitis B cases were reported through NNDRS, but the duplicated reporting rate was 7.35% (249 047). According to 6 protocols, the duplicated reporting rate ranged from 0.88% to 6.38%. If using the data in 2011 as the baseline, the duplicated reporting rate in the three years was 2.91%, 8.11% and 11.72%, respectively. In the duplicated repeating, 33.04% (71 709) occurred in the same year, and 66.96% (145 329) occurred in other year. Without the duplicated repeating, the hepatitis B incidence in Xinjiang and Qinghai provinces in 2013 could decreased by 30.80/100 000 and 26.26/100 000, respectively. Conclusions: The analysis indicated that the duplicated repeating rate of hepatitis B was 7.36% in NNDRS during 2011-2013, and the duplicated reporting mainly occurred in other years. The duplicated reporting of hepatitis B in NNDRS had greatly affected the accuracy of surveillance data in some provinces, such as Xinjiang and Qinghai.

Epidemic trend on notifiable communicable diseases from 2010 to 2015 in Beijing

To analyze the trends and epidemiological characteristics of notifiable communicable diseases from 2010 to 2015 in Beijing so as to provide reliable reference data. Data on the epidemiological characteristics was gathered and analyzed through the monitoring programs on notifiable diseases, reported by the China Information System for Disease Control and Prevention, from 2010 to 2015. A total of 764 290 cases of notifiable communicable diseases were reported from 2010 to 2015 in Beijing. The annual reported incidence on notifiable communicable diseases showed an annual downward (χ(2)=1.25×10(4), P<0.01), with rates between 498.95/100 000 and 828.45/100 000. The annual reported incidence rates of intestinal infectious diseases and respiratory infectious diseases also showed an annual downward (χ(2)=1.25×10(4), P<0.01; χ(2)=4.97×10(2), P<0.01), which accounted for 39.72% and 33.01% among the total classes A and B reported cases, respectively. The average annual reported incidence rates in males were higher than that in females. The average annual incidence of children under 7 years old appeared higher than that of the other age groups that accounted for 47.79% of the total reported cases. High incidence mainly appeared in children that living scattering around which accounted for 31.64% of the total reported cases. The first three leading incidence rates seen in other infectious diseases were infectious diarrhea, hand-foot-and-mouth disease and dysentery for the last consecutive 6 years. The laboratory diagnosed rate on notifiable disease was 16.67%, but with a trend of annual increase. Intestinal infective diseases kept the highest incidence among all the notifiable communicable diseases, suggesting the necessity of improving the prevention and control programs on notifiable communicable diseases in preschool, especially in those children with their houses scattered around. Programs on laboratory diagnosis also need to be strengthened.

Etiology, pathogenesis, antivirals and vaccines of hand, foot, and mouth disease

Abstract Hand, foot, and mouth disease (HFMD), caused by enteroviruses, is a syndrome characterized by fever with vesicular eruptions mainly on the skin of the hands, feet, and oral cavity. HFMD primarily affects infants and young children. Although infection is usually self-limited, severe neurological complications in the central nervous system can present in some cases, which can lead to death. Widespread infection of HFMD across the Asia-Pacific region over the past two decades has made HFMD a major public health challenge, ranking first among the category C notifiable communicable diseases in China every year since 2008. This review summarizes our understanding of HFMD, focusing on the etiology and pathogenesis of the disease, as well as on progress toward antivirals and vaccines. The review also discusses the implications of these studies as they relate to the control and prevention of the disease.