<unk>  most commonly occurs in children under the age of 10 and more often under the age of 5, but it can also affect adults with varying symptoms. It tends to occur in outbreaks during the spring, summer, and autumn seasons. This is believed to be due to heat and humidity improving spread.<unk>  is more common in rural areas than urban areas; however, socioeconomic status and hygiene levels need to be considered. Poor hygiene is a risk factor for<unk> . Outbreaks * In 1997, an outbreak occurred in Sarawak of Malaysia with 600 cases and over 30 children died. * In 1998, there was an outbreak in Taiwan, affecting mainly children. There were 405 severe complications, and 78 children died. The total number of cases in that epidemic is estimated to have been 1.5 million. * In 2008 an outbreak in China, beginning in March in Fuyang, Anhui, led to 25,000 infections, and 42 deaths, by May 13. Similar outbreaks were reported in Singapore (more than 2,600 cases as of April 20, 2008), Vietnam (2,300 cases, 11 deaths), Mongolia (1,600 cases), and Brunei (1053 cases from June–August 2008) * In 2009 17 children died in an outbreak during March and April 2009 in China's eastern Shandong Province, and 18 children died in the neighboring Henan Province. Out of 115,000 reported cases in China from January to April, 773 were severe and 50 were fatal. * In 2010 in China, an outbreak occurred in<unk> ern China's Guangxi Autonomous Region as well as Guangdong, Henan, Hebei and Shandong provinces. Until March, 70,756 children were infected and 40 died from the<unk> . By June, the peak season for the<unk> , 537 had died. * The World Health Organization reporting between January to October 2011 (1,340,259) states the number of cases in China had dropped by approx 300,000 from 2010 (1,654,866) cases, with new cases peaking in June. There were 437 deaths, down from 2010 (537 deaths). * In December 2011, the California Department of Public Health identified a strong form of the virus, coxsackievirus A6 (CVA6), where nail loss in children is common. * In 2012 in Alabama, United States there was an outbreak of an unusual type of the<unk> . It occurred in a season when it is not usually seen and affected teenagers and older adults. There were some hospitalizations due to the<unk>  but no reported deaths. * In 2012 in Cambodia, 52 of 59 reviewed cases of children reportedly dead () due to a mysterious<unk>  were diagnosed to be caused by a virulent form of<unk> . Although a significant degree of uncertainty exists with reference to the diagnosis, the WHO report states, "Based on the latest laboratory results, a significant proportion of the samples tested positive for enterovirus 71 (EV-71), which causes<unk> <unk>  and<unk><unk>  <unk> . The EV-71 virus has been known to generally cause severe complications amongst some patients." *<unk>  infected 1,520,274 people with up to 431 deaths reported at the end of July in 2012 in China. * In 2018, more than 50,000 cases have occurred through a nationwide outbreak in Malaysia with two deaths also reported.
Hand, foot, and mouth disease
Cowpox
Progressive vaccinia
Chickenpox
Smallpox
Shingles
Sealpox
Mumps