HFMD is a global infectious disease with epidemics reported in most parts of the world, first reported in New Zealand in 1957, coxsackievirus was isolated in 1958, and the name HFMD was proposed in 1959. The early detection of HFMD was mainly due to Cox A16, while the association of HFMD with EV 71 infection was first reported in the early 1970s, and EV 71 was first identified in the United States in 1972. Since then, EV 71 infection has alternated with Cox A16 infection as the major pathogen of HFMD. Australia was one of the first countries, along with the United States and Sweden, to have EV 71 infection. 1972-1973, 1986, and 1999 saw epidemics of EV 71 in Australia, with most of the severely ill patients having central nervous system symptoms (CNS) and some patients having severe respiratory symptoms. mid-1970s, Bulgaria and Hungary had successive outbreaks of EV 71 with In the mid-1970s, Bulgaria and Hungary had outbreaks of EV 71 with CNS as the main clinical feature, with more than 750 cases in Bulgaria alone, 149 paralyzed and 44 deaths. In the United Kingdom, an epidemic of hand, foot, and mouth disease caused by Cox A16 occurred throughout Wales, England, in the fourth quarter of 1994. 952 cases were observed at surveillance sentinels, the largest epidemic ever recorded in the country, and most of the patients were 1 to 4 years old, with most of them having mild symptoms. Data on epidemiological information in the country since 1963 show that the interval between HFMD epidemics is 2 to 3 years. Other countries such as Italy, France, the Netherlands, Spain, Romania, Brazil, Canada, and Germany also have frequent HFMD caused by various types of coxsackie, echovirus, and EV 71. Japan is a country with a high incidence of HFMD and has had several large epidemics in its history, with Cox A16 infection being the main cause of the epidemic from 1969 to 1970 and EV 71 causing the two epidemics in 1973 and 1978. In 1997, an epidemic of HFMD caused mainly by EV 71 occurred in Malaysia, with a total of 2,628 cases from April to August and 29 deaths from April to June alone. The average age of the deceased was 1.5 years, the duration of the disease was only 2 days, 100% had fever, 62% had hand and foot rash, 66% had oral ulcers, 28% had rapidly developing disease, 17% had limb paralysis, and 17 cases had chest radiographs showing pulmonary edema. The disease was first seen in Shanghai in 1981 and later reported in Beijing, Hebei, Tianjin, Fujian, Jilin, Shandong, Hubei, Xining, Guangdong, and a dozen other provinces and cities. 1983 saw an outbreak of HFMD caused by Cox A16 in Tianjin, with more than 7,000 cases occurring between May and October, and after a 2-year epidemic, another outbreak occurred in 1986, with 2 outbreaks in nurseries and kindergartens. In 1995, EV 71 virus was isolated from HFMD patients at Wuhan Institute of Virus Research, and in 1998, 2 strains of EV 71 virus were also isolated from HFMD patients at Shenzhen Health and Epidemic Prevention Station. 1998 EV 71 infection caused a large number of HFMD and herpes pharyngitis in Taiwan Province of China, and in two waves of epidemic in June and October, a total of 129 106 cases were monitored, with 405 seriously ill patients and 78 deaths, mostly in children under 5 years of age, with complications including encephalitis, aseptic meningitis, pulmonary edema or pulmonary hemorrhage, acute flaccid paralysis, and myocarditis. From May to August 2000, a pandemic of pediatric HFMD broke out in Zhaoyuan City, Shandong Province. In more than three months, the Zhaoyuan People’s Hospital received 1,698 cases of children, including 1,025 males and 673 females, with a male to female ratio of 1.5:1, the youngest being 5 months old and the oldest 14 years old. The first case occurred on May 10, peaked in July, and the last case occurred on August 28. 128 cases were hospitalized, with an average length of stay of 5.1 d. Three of them died of combined fulminant myocarditis.