Environmental conditions, shifting immunity, and viral strain could help explain 2025 spike

See Virginia's spike in HFMD cases in 2025

The state's own tracking showed a significant jump in HFMD cases in July 2025 as compared to the prior few years, and that more people were visiting the emergency room and urgent care centers for the disease, but epidemiologists could not explain why the numbers were so high.

Adults usually have some immunity to HFM Disease—but can still spread it

In 2025, certain eastern states including Virginia and West Virginia reported a sizable uptick in their HFMD cases, particularly in their schools and daycare centers, though the reason for the larger outbreaks remains unknown. When adults or teens get the disease, their symptoms are usually mild or even asymptomatic. Still, they may pass the disease between people, too. (Some users may encounter a paywall.)

CDC does not require docs to report hand, foot, and mouth cases which makes tracking difficult

Mid-Atlantic states saw a surge of hand, foot, and mouth disease in 2025 for as-yet unknown reasons. Virginia, Maryland, and New Jersey, reported elevated outbreak numbers in 2025 as compared to other recent years, but since the US Centers for Disease Control and Prevention does not require mandatory reporting of positive HFMD cases—unlike strictly notifiable diseases like measles—it's hard to truly know the extent of the outbreaks and how significant the caseload is as compared to prior years across the region or country.

In 2012, a virus that causes HFMD may have killed dozens of kids in Asia

More than 50 young children in Cambodia died in spring 2012 for unknown reasons, but laboratory testing of samples available from a limited number of those children came back positive for Enterovirus 71. That virus, which can cause HFMD, is known to cause severe complications among some people who contract the disease. But health officials concluded that poor baseline health and then incorrect treatment using steroids helped exacerbate their condition, helping lead to the deaths.

At least 7 eastern college campuses experienced surprisingly large HFMD outbreaks in 2018

The outbreaks at the college level caused a particularly nasty set of symptoms, including the usual blisters in the mouth and on the hands and feet—but also affected the genitals. They surprised health officials who weren't sure why so many young adults were being sickened, including more than 120 kids at Johns Hopkins University. The disease also caused outbreaks at campuses including Princeton, Dartmouth, West Virginia University, Lehigh University, Wesleyan University in Connecticut, and Mars Hill University in North Carolina.

There are more than 200,000 cases of HFMD annually, and there's no cure

The highly contagious disease is caused by several viruses and it primarily affects little kids. It causes red spots in and around the mouth, hands, feet, and even the buttocks. They often become painful water-filled blisters that can burst and cause small ulcers. Eating and drinking is uncomfortable for about a week so patients need to be careful not to become dehydrated.

A look at the 2025 measles outbreak in West Texas and surrounding areas

A measles outbreak in the summer of 2025 ultimately led to more than 900 cases and the deaths of two young children. The highly contagious virus requires vaccination rates near 95% to achieve herd immunity—the Texas outbreak spread through areas of significant mistrust of vaccines, including the area’s Mennonite community.

Hand, foot, and mouth is usually seasonal—peaking in summer—but not always

This painful, contagious disease most commonly has outbreaks in summer and early fall in the US because the enteroviruses that cause disease can most readily survive and be transmitted in warmer, humid conditions. It can still show up throughout the year, however.

HFMD was first reported in 1957 in New Zealand

The first clinical report involved eight kids with the characteristic sores in New Zealand, and then in the years that followed there were dozens more cases there and also reports of outbreaks in England and Scotland, among other settings, including the US.

Small genetic changes that accumulate over time force flu vaccines to be updated regularly.

HFMD can survive on surfaces for days at a time

That's why the virus can be transmitted via fomites—surfaces that have virus on them like doorknobs, kids toys, etc. These viruses are resilient—they are often even resistant to freezing (and are frequently stored at freezing temperatures in lab settings).

Measles cases in the US reached a 35-year high in 2026 as vaccination rates dropped.

Although rare, HFMD can spreads in pools due to poor bathroom hygiene

In pools with inadequate levels of chlorine, this disease can spread via the poop-to-mouth route, though this isn't one of the most common ways the disease is transmitted. People can become infected by swallowing contaminated pool water after little kids (or their parents) don't do an adequate job removing virus-laden feces from the child before the child enters the water.

Major genetic shifts in flu viruses can spark global pandemics

Antigenic shift happens when two different influenza viruses infect the same host and swap genetic material. The result is a brand-new subtype of influenza which, if easily spread among people, can trigger a worldwide pandemic.

Discover the latest information on US measles cases from official outbreak tracking figures.

'Tomato flu' outbreak in India turned out to be HFMD

An illness initially dubbed "tomato flu" in 2022 that sickened children in Kerala, India, with symptoms typical of hand, foot, and mouth disease turned out to be that—not a new ailment. A letter published in the prestigious journal The Lancet had initially described the illness as "a new virus" but at least some of the children ultimately tested positive for one of the viruses that causes HFMD, so it wasn't a new condition after all. (Some users may encounter a paywall.)

US West Nile case numbers were up 40% in 2025 across the United States though theories vary to explain this surge.

HFMD symptoms typically begin to show up 3-6 days after exposure

Fever is often the first symptom and then painful sores may develop a day or two later. Coxsackie A16 is currently the most common enterovirus that leads to the disease, though there are several other enteroviruses that can cause it as well.

Autoimmune disease prevalence and incidence are on the rise—but no one knows why

Researchers theorize that environmental factors, including shifts to less healthy diets, air pollution, infections, stress, climate change, and exposures to xenobiotics—substances like pesticides, plastics, and toxins that incite immune responses—may all be fueling epigenetic changes to our bodies that make people's immune responses go awry.

Seasonal allergies don't always show up in childhood

The human immune system may become sensitized to pollen and develop an allergic reaction to it after prolonged exposure. Other triggers for new seasonal allergies may include exposure to new environments and changing climate conditions that affect allergy season length and conditions for various pollens.

Why we don't have an answer for the common cold

Since a landmark study of the common cold in 1925, researchers have learned much more about the seasonal ailment. Despite continuous study, people still contract colds for similar periods of time at the same rate with the same symptoms, and there's no vaccine. This article explains how the many viral strains make it hard to control.

Measles is one of the most contagious preventable diseases—it was eliminated in the US in 2000, but it is now making a resurgence due to declining vaccination rates.

Improved 19th-century sanitation meant kids encountered polio later, with worse results

Almost all children likely used to contract poliovirus, but scientists suggest that when infants encountered it very early in life—due to poorer conditions and hygiene—they still had some maternal protection from pregnancy or through breastmilk, so the symptoms were more flu-like.

10 locally acquired malaria cases were reported in the US in 2023—a surprise

The cases, reported in Florida, Texas, Maryland, and Arkansas, broke a 20-year streak since there had been no reported locally acquired mosquito-transmitted malaria in the country since 2003, when there was a case in Florida.

Climate change is influencing the spread of disease

Rising temperatures and water levels are forcing animals and pathogens beyond their typical boundaries. This article and its data visualizations explore the proliferation of climate-driven diseases.

Climate shifts are projected to cause more cases of food poisoning

Research published in 2024 suggests that with more severe heatwaves and natural disasters, scientists expect there to be a rise in foodborne disease, especially in Africa and Asia. Already, there are an estimated 600 million food poisoning cases and 420,000 deaths annually. Diarrhea is the most common cause of those deaths.

NASA worries about the reactivation of dormant viruses during missions—particularly the virus that causes shingles—because spaceflight suppresses the human immune system and elevates stress hormones, making it more challenging to stay healthy.

There may be 500,000 additional malaria deaths by 2050 according to peer-reviewed research published in 2026.

The 1957 and 1968 influenza pandemics caused millions of deaths worldwide

The 1957 H2N2 pandemic spread from East Asia, killing more than 1M globally, while the 1968 H3N2 pandemic began in Hong Kong and caused a similar toll, with both strains rapidly moving across continents.

Modern conveniences may be contributing to allergy increases

A combination of genetics and how the environment changes our genes are likely contributing to the rise in allergies. But daily conveniences, such as dishwashers and packaged baby food, also change the level of bacterial exposures in early life, with potential implications for allergy development, experts from Mount Sinai Health System state in this video discussion.

The flu vaccine has evolved alongside discoveries of new virus strains

After influenza B was identified in 1940, researchers created a two-strain vaccine by 1942. The WHO later built a global surveillance system to track mutations, enabling vaccines to be updated annually to target the strains most likely to circulate.

Measles infection can cause long-term immune system “amnesia”

The measles virus attacks the body's immune system, including preying on T and B cells in the lymphatic system. These cells hold memories of past infections, which can be degraded as the virus destroys them. This leaves patients susceptible to other infections for a year or longer.

Epstein-Barr virus—the cause of 'kissing disease' mononucleosis—may be the leading cause of MS

A Harvard study with data from more than 10 million US military personnel found that people that contracted Epstein-Barr virus had a roughly 32-fold increased risk of developing multiple sclerosis. The work, published in 2022, found that Infection of the virus preceded MS onset by a median of five years, raising questions about better Epstein-Barr virus management and potential disease prevention.

Two Lyme disease vaccines were in development in 2026

As of early 2026, there was no vaccine for Lyme disease available. One candidate vaccine, VLA15, was in later-stage clinical trials. Another designed to provide seasonal protection was licensed to a pharmaceutical company in 2025, and was planned for human clinical trials.

Human records of influenza stretch back more than two millennia

Accounts of flu-like illness appear as early as 412 BCE, when Hippocrates described a sudden wave of cough and fever. Centuries of recurring outbreaks culminated in the first clearly documented pandemic in 1580, spreading from Asia into Europe and Africa.

Human records of influenza stretch back more than two millennia

Accounts of flu-like illness appear as early as 412 BCE, when Hippocrates described a sudden wave of cough and fever. Centuries of recurring outbreaks culminated in the first clearly documented pandemic in 1580, spreading from Asia into Europe and Africa.

West Nile was reported in 47 states in 2025, with more than 1,400 people severely affected

Tracking numbers from the CDC indicate that the virus spread widely that year, with more than 2,000 reported human cases and many states seeing more than 25 sickened people. More than 1,400 people had neuroinvasive cases of the disease—meaning the virus had entered the nervous system, which can cause severe, potentially life-threatening illness.

More than 20 mosquito-borne and tick-borne diseases are found in the US

Children, older adults, and people with compromised immune systems are at particular risk of poorer health outcomes from these diseases. But dog owners and outdoor enthusiasts are among those at particular risk of contracting these illnesses, which include Lyme disease, Zika, and the condition Alpha-gal Syndrome.

A heatmap showing the drop in infectious diseases post-vaccine deployment

The number of infected people, measured over 70-some years and across all 50 states and the District of Columbia, declined significantly after vaccines were introduced.

Measles infection, which was nearly universal during childhood in prevaccine era, was described by the Persian physician Rhazes in the 10th century as "more to be dreaded than smallpox."

A 1954 outbreak at a Boston boarding school allowed scientists to isolate the measles virus and formed the basis for the first measles vaccine.

Wastewater testing has detected genetic evidence of polio, triggering vaccine boosters

Sampling of wastewater in London in 2022 detected fragments of polio virus, suggesting a vaccine-derived version of polio may be circulating. No one became ill, but the finding did trigger calls for a renewed booster inoculation campaign.

Lack of Vitamin D seems to be one major factor fueling MS risk

Researchers believe that a combination of factors can elevate MS risk, including a lack of vitamin D exposure in different locales, genetic history, cigarette smoke exposure, and Epstein-Barr virus infection.

Vector-borne diseases kill more than 700,000 people globally each year—and are growing

The diseases with the greatest potential to spread widely aren't the ones that quickly kill human hosts. Instead, the best hosts or reservoirs for vector-borne diseases would be chronically ill over the long term, increasing the likelihood that the pathogen could be transmitted to others.

Certain vaccinations may be more effective when given around the middle of the day.

Extreme weather conditions heighten cholera risks in settings like refugee camps

Runoff from sewage—exacerbated by situations like flooding or extreme rains—heightens this threat. Increasing temperatures also create the ideal conditions for the bacteria to reproduce, increasing transmission risks.

The COVID-19 pandemic led to a decrease in immunizations in the US and worldwide

Public health funds and resources that were diverted to COVID-19 response reduced efforts to combat polio and vaccinations for polio and other diseases declined during the pandemic, putting more people at risk for polio.

A timeline of major pandemics from 1899–2025

Modern pandemics have been defined by the race between globalization (which increases risk) and the development of new medicines. The Great Influenza epidemic claimed some 50 million lives, and the COVID-19 pandemic killed more than 7 million. In between, diseases like Ebola, cholera, AIDS, and more have devastated communities.

COVID-19 vaccine breakthroughs are driving efforts toward a universal flu shot

mRNA and other technologies used for COVID-19 vaccines are being applied to influenza research. Scientists hope these advances will lead to a universal flu vaccine that protects against multiple strains and reduces the need for yearly shots.

A rare measles complication is that the virus can linger in the body for years after apparent recovery and continue to replicate—leading to a progressive and fatal breakdown of the central nervous system that can occur decades after the initial infection.