In Japan, the incidence of Hand-Foot-Mouth Disease (HFMD) among children is rising sharply, particularly in Osaka Prefecture, where reported cases have exceeded warning thresholds. This worrying trend has prompted local health authorities to urge parents, kindergartens, and childcare facilities to enforce thorough handwashing practices and the use of separate towels. The symptoms can particularly complicate fluid intake for small children, leading to potential dehydration.
Between June 29 and July 5, pediatric clinics and medical facilities in Osaka reported an average of 5.96 patients per establishment, surpassing the alert threshold of five patients. Across Japan, the average number of cases reported last week was 4.61 per reporting clinic.
Hand-Foot-Mouth Disease Affects Children Under Two Years
The majority of reported cases in Osaka involve children aged one year. Following them are two-year-olds and infants under one. Nationally, around half of the reported cases affect children under two years. However, outbreaks can also occur among elementary school children.
Japan monitors HFMD through approximately 3,000 selected pediatric clinics and medical facilities. The weekly data does not reflect the total number of affected children but rather the average number of patients per participating establishment.
Hand-Foot-Mouth Disease typically occurs in Japan each year among infants and toddlers up to around four years of age. Most cases are registered during the summer months when the virus spreads more easily in kindergartens and childcare facilities.
Symptoms Appear Within Days
Symptoms usually manifest three to five days after infection. Blisters measuring two to three millimeters may appear in the mouth, as well as on the palms, soles, and backs of the feet. Fever can also accompany these symptoms; about one-third of those infected will experience fever, generally remaining below 38 degrees Celsius. Most patients recover within three to seven days.
Severe mouth pain can cause young children to eat and drink insufficiently, risking dehydration. Therefore, parents and caregivers should monitor whether an infected child is consuming enough fluids.
In rare cases, Hand-Foot-Mouth Disease can lead to severe complications, including inflammation of the meninges, brain, or heart. For this reason, the Japanese Ministry of Health recommends closely observing the condition of sick children, even if their symptoms initially appear mild.
Viruses Persist Even After Recovery
The disease spreads through droplets, direct contact, and fecal-oral transmission. Droplets are particularly produced during coughing and sneezing, while contact infections occur via hands or shared surfaces. Even after visible symptoms subside, the virus can still be excreted in feces for two to four weeks, meaning an infected child can transmit the virus even after the rash and fever have resolved.
Osaka’s health authorities advocate for rigorous handwashing with soap and water following toilet use, diaper changes, and contact with bodily fluids. Families, kindergartens, and childcare facilities are advised against sharing towels and must properly dispose of diapers and other waste.
Currently, there is no vaccine or medication available to prevent Hand-Foot-Mouth Disease. Therefore, physicians focus on treating the symptoms. Because the viruses can also be shed by individuals showing no visible symptoms, merely isolating infected children is not sufficient to prevent outbreaks.
