Hand-foot-and-mouth disease caused by coxsackievirus A6 on the rise.

Hand-foot-and-mouth disease (HFMD) is a viral illness caused most commonly by coxsackievirus A16 (CVA16) and enterovirus 71 (EV71). The disease mainly affects pediatric populations younger than 5 years and is characterized by lesions of the oral mucosa, palms, and soles, lasting for 7 to 10 days. In recent years, CVA6 has become a major cause of HFMD outbreaks in the United States and worldwide. This strain also has been associated with adult HFMD. It affects broader demographics and causes more severe disease with unique findings compared to typical viral strands. Patients often have higher fever and longer duration of disease than typical HFMD and often present with more severe skin manifestations, spreading to a wider distribution than typical HFMD. We review the increasing prevalence of this viral illness to better characterize its clinical presentation.