{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:09:22Z","timestamp":1788998962925,"version":"build-2803163510"},"reference-count":17,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2024,1,1]],"date-time":"2024-01-01T00:00:00Z","timestamp":1704067200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Prim Care Community Health"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:p>Hand-foot-and-mouth disease (HFMD), which is typically seen in the younger pediatric population, is uncommon in older adolescent and young adult populations. We report on an atypical outbreak of HFMD among college students at a mid-size university in the mid-Atlantic U.S. The outbreak included 138 qualifying cases of HFMD among students at the institution between August and November 2018. All tested samples were positive for CVA6, a less common cause of HFMD. Signs and symptoms and campus mitigation strategies are described. This case report aims to highlight an atypical outbreak of HFMD for clinicians who care for older adolescent and college-aged patients in primary care and community settings, and may see cases and\/or outbreaks of HFMD in these populations.<\/jats:p>","DOI":"10.1177\/21501319241266506","type":"journal-article","created":{"date-parts":[[2024,8,12]],"date-time":"2024-08-12T10:50:20Z","timestamp":1723459820000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["A Hand-Foot-and-Mouth Disease Outbreak in an Atypical Population of College Students"],"prefix":"10.1177","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1085-765X","authenticated-orcid":false,"given":"Nancy G.","family":"Russell","sequence":"first","affiliation":[{"name":"Johns Hopkins University, Baltimore, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9254-538X","authenticated-orcid":false,"given":"Roanna","family":"Kessler","sequence":"additional","affiliation":[{"name":"Johns Hopkins University, Baltimore, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,8,12]]},"reference":[{"key":"bibr1-21501319241266506","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2013.6777"},{"key":"bibr2-21501319241266506","unstructured":"Saguil A, Kane SF, Lauters R, Mercado MG. Hand-foot-and-mouth disease: rapid evidence review. Am Fam Physician. 2019;100(7):408-414. Accessed May 26, 2023. https:\/\/www.aafp.org\/afp\/2019\/1001\/p408.html"},{"key":"bibr3-21501319241266506","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6526a3"},{"key":"bibr4-21501319241266506","unstructured":"Fox M. Hand, foot and mouth disease plagues college campuses. NBC News. October 24, 2018. Accessed May 26, 2023. https:\/\/www.nbcnews.com\/health\/health-news\/hand-foot-mouth-disease-plagues-college-campuses-n924051"},{"key":"bibr5-21501319241266506","unstructured":"Whitford E. Campus contagion. Inside Higher Ed. October 17, 2018. Accessed May 26, 2023. https:\/\/www.insidehighered.com\/news\/2018\/10\/18\/college-campuses-are-fighting-outbreaks-hand-foot-and-mouth-disease?utm_source=Inside+Higher+Ed&utm_campaign=4e2d95c6d3-20181016_NEW_COPY_01&utm_medium=email&utm_term=0_1fcbc04421-4e2d95c6d3-197391869&mc_cid=4e2d95c6d3&mc_eid=81eed1f1e1"},{"key":"bibr6-21501319241266506","unstructured":"Belkin D. Colleges try to stop spread of hand, foot and mouth disease. Wall Street Journal. October 19, 2018. Accessed May 26, 2023. https:\/\/www.wsj.com\/articles\/colleges-try-to-stop-spread-of-hand-foot-and-mouth-disease-1539954000"},{"key":"bibr7-21501319241266506","unstructured":"Centers for Disease Control and Prevention. Hand, foot, and mouth disease (HFMD). May 11, 2023. Accessed May 26, 2023. https:\/\/www.cdc.gov\/hand-foot-mouth\/index.html"},{"key":"bibr8-21501319241266506","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-018-3206-x"},{"key":"bibr9-21501319241266506","doi-asserted-by":"publisher","DOI":"10.1111\/pde.12874"},{"key":"bibr10-21501319241266506","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcv.2018.11.03"},{"key":"bibr11-21501319241266506","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6429a8"},{"key":"bibr12-21501319241266506","unstructured":"Centers for Disease Control and Prevention. Notes from the field: severe hand, foot, and mouth disease associated with coxsackievirus A6\u2014Alabama, Connecticut, California, and Nevada, November 2011\u2013February 2012. MMWR Morb Mortal Wkly Rep. 2012;61:213-214. Accessed May 26, 2023. https:\/\/www.cdc.gov\/mmwr\/preview\/mmwrhtml\/mm6112a5.htm"},{"key":"bibr13-21501319241266506","doi-asserted-by":"publisher","DOI":"10.1097\/MOP.0000000000000303"},{"key":"bibr14-21501319241266506","unstructured":"Guerra AM, Orille E, Waseem M. Hand, foot and mouth disease. StatPearls. March 4, 2023. Accessed April 23, 2024. https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK431082\/"},{"key":"bibr15-21501319241266506","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanwpc.2021.100362"},{"key":"bibr16-21501319241266506","unstructured":"Whitt K. New virus spreads across campus. The Maroon. February 9, 2023. Accessed February 7, 2024. https:\/\/loyolamaroon.com\/10037675\/news\/new-virus-spreads-across-campus\/"},{"key":"bibr17-21501319241266506","unstructured":"Penner M. Duke sees over 60 hand, foot and mouth disease cases over past 4 weeks. October 18, 2023. 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