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Toppage > Hand, foot and mouth disease and herpangina, epidemiological week 1–26, 2026 (as at July 1, 2026)

Hand, foot and mouth disease and herpangina, epidemiological week 1–26, 2026 (as at July 1, 2026)

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◆Hand, foot and mouth disease and herpangina, epidemiological week 1–26, 2026 (as at July 1, 2026)

Hand, foot and mouth disease (HFMD) and herpangina are enterovirus infections that occur mainly among children every summer. HFMD is characterized by vesicular eruptions on the hands, feet and oral mucosa, whereas herpangina is characterized by vesicular eruptions on the oral mucosa. Although both diseases generally have a favorable prognosis, they may rarely become severe and be complicated by central nervous system complications neurogenic pulmonary edema, or cardiopulmonary failure. The main routes of transmission are droplet, oral (fecal–oral), and contact transmission.

Under Japan’s Infectious Diseases Control Law, both infectious diseases are classified as Category V pediatric sentinel surveillance diseases. The number of clinically diagnosed patients has been reported on a weekly basis from approximately 3,000 pediatric sentinel sites nationwide until April 6, 2025, and from approximately 2,000 sentinel sites since April 7, 2025. 

In epidemic years over the past decade, excluding those during the coronavirus 2019 (COVID-19) pandemic, nationwide trends of HFMD showed an increase around week 20, reaching a peak of about 10.0 cases per sentinel site around week 30. It then declined to around 1.0 by week 40, and mostly subsided by weeks 48-50.

In 2024, a characteristic bimodal pattern was observed, with peaks in week 28 (13.34 cases per sentinel site; 41,885 cases) and week 41 (10.78 cases per sentinel site; 33,760 cases). In contrast, activity in 2025 was lower than usual, with the highest number of cases per sentinel site being 0.63 (1,474 cases) in week 31. Because the number of reporting sentinel sites differed between the two years, caution is required when comparing weekly case counts.

In 2026, as in previous years, reports began to increase in week 20, reaching 0.65 cases per sentinel site (1,477 cases), and continued to rise to 4.61 (10,396 cases) by week 26. (Graph of epidemic trends over the past 10 years: https://id-info.jihs.go.jp/surveillance/idwr/jp/graph/weekly/06hfmd.html)

Regarding trends in herpangina activity over the past 10 years, excluding the years of the COVID-19 pandemic, an increase was confirmed around week 20, reaching a peak of approximately 3.00–4.00 cases per sentinel site around week 30, followed by a relatively rapid decline and subsiding by around weeks 48–50.

In 2026, as in previous years, reports of herpangina began to increase in week 20, reaching 0.15 cases per sentinel site (331 cases), and rose to 1.15 (2,592 cases) in week 26. The highest peak in the past 10 years was in week 27 of 2023 with 7.32 cases per sentinel site (22,980 cases), and the current level of herpangina activity in 2026 is comparable to or lower than that in previous years (graph of epidemic trends over the past 10 years: https://id-info.jihs.go.jp/surveillance/idwr/jp/graph/weekly/10herp.html).

The serotypes of the virus detected in patients with HFMD vary from year to year. Among viruses isolated or detected from patients with HFMD during the most recent five years, the main viruses, in descending order, were coxsackievirus A6 (CA6) and A16 (CA16) in 2022, and enterovirus 71 (EV71) and CA6 in 2023. In 2024, when a bimodal pattern was observed, CA6 was most frequently isolated or detected during the first peak and CA16 during the second peak. In 2025, the main viruses were enterovirus18(E18) and EV71, and in 2026, as at July 1, they were CA6 and EV71 (viruses isolated/detected from HFMD cases by year, 2022–2026: https://kansen-levelmap.mhlw.go.jp/Byogentai/Pdf/data37j.pdf). The main viruses isolated or detected from patients with herpangina were CA6 in 2022; coxsackievirus A2 (CA2), A4 (CA4), and A10 (CA10) in 2023; CA6 in 2024; CA4 in 2025; and CA6 in 2026 (viruses isolated/detected from herpangina cases by year, 2022–2026: https://kansen-levelmap.mhlw.go.jp/Byogentai/Pdf/data38j.pdf). In 2026, HFMD activity generally followed the usual seasonal pattern, and no large epidemic has been observed. Nevertheless, continued monitoring of disease trends is required beyond the summer season, when HFMD typically increases. Likewise, although herpangina activity is currently similar to that observed in previous years, continued monitoring of future trends remains important.

For detailed information and the latest situation regarding the National Epidemiological Surveillance of Infectious Diseases for HFMD and herpangina, please refer to the following (as at July 1, 2026):


Department of Infectious Disease Surveillance
National Institute of Infectious Diseases, Japan Institute for Health Security

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