Photo/Illutration A strain of enterovirus that causes hand, foot and mouth disease (Provided by the National Institute of Infectious Diseases)

Hand, foot and mouth disease cases, a viral infection that causes rashes on the hands, feet and mouth, are on the rise across Japan well into October, despite being typically considered a summer illness.

Designated medical institutions nationwide reported 10.78 hand, foot and mouth disease patients per facility on average during the week ending Oct. 13, according to the National Institute of Infectious Diseases.

This marks a rise in cases for three consecutive weeks and the largest number of cases during this period of the year in the past decade.

By prefecture, Ehime has the highest average, with 28.25 patients per medical institution surveyed.

Yamagata followed with 26.61 patients, Toyama reported 25.25, Miyagi tallied 22.58, Kagawa recorded 18.14 and Fukushima reported 17.92.

In 41 of Japan’s 47 prefectures, the number of hand, foot and mouth disease patients has exceeded the warning level of five per institution.

In the Tokyo metropolitan area, Saitama had 16.4 patients per facility, followed by Chiba with 15.46, Kanagawa with 13.17 and Tokyo with 12.33.

Hand, foot and mouth disease spreads through droplets released into the air by sneezing and coughing, or by touching the eyes, nose or mouth with hands contaminated by the virus.

It causes fever and rashes in the mouth, on the palms and on the soles of the feet. In rare cases, complications such as encephalitis—inflammation of the brain—can occur.

Even after symptoms subside, the virus can continue to be released in patients’ stool for several weeks.

There are several types of enteroviruses that cause the disease. The strain affecting the most patients this year leads to rashes not only on the hands and feet but also on the face and abdomen.

The disease typically spreads in the summer. This year, cases increased in June and July and declined in mid-August. But infections have begun to rise again since then.  

While the disease is most common among children aged 2 and younger, this year has seen a relatively high number of cases among children aged 3 and older, including elementary school students.

“Hand, foot and mouth disease cases have been low in the past few years during the spread of COVID-19. As a result, many older children lack immunity, which is likely contributing to the continued spread of the disease,” said Hiroyuki Moriuchi, a professor of pediatrics at Nagasaki University who is well-versed in infectious diseases. 

There is no specific treatment for the disease, with most cases subsiding within three to seven days.

However, pain from mouth rashes can make it difficult to maintain proper hydration and nutrition, which may lead to dehydration.

Moriuchi advises parents to seek medical attention if their children show symptoms such as the inability to stay hydrated, vomiting, reduced urination or extreme fatigue.

Alcohol-based sanitizers are thought to be less effective against enteroviruses. Proper handwashing with soap and water is essential for prevention.

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