Hand Foot and Mouth Disease Virus in Bangladesh: Serotypes, Transmission Dynamics, and Control Measures

Abstract This systematic review explores the epidemiology, clinical characteristics, and control measures of hand, foot and mouth disease (HFMD) in Bangladesh, with a focus on identifying knowledge gaps and informing public health strategies. A comprehensive search was conducted across databases, including PubMed, Scopus, and Google Scholar, covering literature published from 2019 to 2025. Studies were selected based on relevance to HFMD in Bangladesh, encompassing clinical case reports, epidemiological surveys, virological analyses, and public health interventions. Findings indicate a consistent rise in HFMD incidence, particularly among children under five, with seasonal surges during the monsoon period. Coxsackievirus A16 and Enterovirus 71 remain the dominant causative agents, although emerging strains such as Coxsackievirus A6 have been detected in recent years. Urban areas with high population density and poor sanitation are disproportionately affected. Despite the increasing burden, surveillance remains fragmented and lacks integration of molecular diagnostics, which limits early detection and response. Current management relies heavily on symptomatic care and reactive outbreak control. Preventive strategies, such as community hygiene education and environmental sanitation, are inconsistently implemented. Notably, no national vaccination policy exists despite ongoing regional vaccine development initiatives. The review underscores the need for a coordinated, multisectoral response involving strengthened surveillance systems, investment in vaccine research, and public awareness campaigns. Future research should prioritize longitudinal studies to understand serotype dynamics and evaluate the efficacy of emerging vaccines. Addressing these gaps is essential to curbing the spread of HFMD and reducing its impact on public health in Bangladesh.