Research and Development of HFMD Vaccines

HFMD is a viral contagious disease that occurs most often in children under 5 years old (Zhang et al. Emerg Microbes Infect 4(2):e12, 2015). It is a self-limiting disease with common clinical manifestations, including sores in the mouth, rash with blisters on the hands and/or feet, herpangina, and fever. It has a good prognosis, and some patients with severe cases may further develop neurological diseases (He et al., Epidemiol Infect 145(9):1865–1874, 2017). Substantial molecular etiological and epidemiological studies have demonstrated that the common pathogens that cause HFMD are enterovirus A 71 (EV-A71), coxsackie virus A 16 (CV-A16), A10 (CV-A10), and A6 (CV-A6), and coxsackie virus B 3 (CV-B3) and B5 (CV-B5). EV-A71 and CV-A16 infections are the most common, with the identified cases accounting for over 60% of all HFMD cases (Koh et al., Pediatr Infect Dis J 35(10):285–300, 2016; Chang et al., Pediatrics 109(6):e88, 2002). Furthermore, EV-A71 is recognized as the major pathogen for fatal cases (Wong et al., Epidemiol Infect 138(8):1071–1089, 2010).