Although the CDC reports that the fall flu season in the US is currently mild, measles and hand-foot-mouth disease (HFMD) are surging this fall, according to recent data from Epic Research.

Getting a Handle on HFMD

The weekly medically attended HFMD rate in October more than tripled from the highest weekly rate in 2024 in the US overall, but several states are driving the trend, notably Tennessee, which experienced an outbreak involving nearly 178 children and staff at more than 30 child care centers, according to local news reports.

“Hand, foot, and mouth disease is a common viral illness in children caused by enteroviruses; children may feel unwell, with fever and poor appetite, or may limit their intake because of sores in their mouth,” said Lori Handy, MD, MSCE, associate director of the Vaccine Education Center at the Children’s Hospital of Philadelphia, and assistant professor of clinical pediatrics at the Perelman School of Medicine, both in Philadelphia, in an interview.

The HFMD rash typically appears on the hands and feet, but can affect any area of the body, Handy said. In most cases, the infection is self-resolving, and children only need supportive care, unless they are too uncomfortable to consume enough fluids, she said.

Proper handwashing remains the best way to reduce the spread of HFMD, which mainly circulates through contact with respiratory secretions as well as stool, said Handy. Caregivers should be reminded to help young children with handwashing after using the toilet, preparing food, or blowing their nose, she added.

More Measles in Vulnerable Spots

The number of measles cases in the US in 2025 is the highest it has been in more than 30 years, Handy told Medscape Medical News. “Measles continues to circulate in the United States, and with the growing trend of families declining measles vaccination, we are seeing outbreaks,” she said. Approximately 95% of the population needs to be vaccinated to prevent transmission, but communities where there are lower rates, some significantly lower, are at high risk for infections spreading, she said.

For example, fewer than 95% of students in some parts of South Carolina have been vaccinated against measles, and these areas are currently seeing outbreaks, said Handy.

As of November 14, 47 cases of measles have been reported in South Carolina since July 9, and 43 of these have occurred in the specific region of Spartanburg County, according to a statement  from the South Carolina Department of Public Health. Vaccination data  from the state show a trend toward declining vaccination rates in this region over the past several seasons.

“Additionally, some cases are being reported that have no known contact with another case of measles, meaning there is ongoing circulation in the community that is going undetected,” Handy added.

Utah remains another hot spot for measles, with 77 diagnosed cases in residents so far in 2025, including 13 cases in the last 3 weeks, according to the Utah Department of Health and Human Services.

What’s Up With Respiratory Diseases

It’s not too late to get vaccinated against the flu, Handy told Medscape Medical News.

Even if this year’s vaccine isn’t a perfect match, vaccination can reduce severity of illness, she said.

As recently reported by Medscape Medical News, an emerging flu variant may cause an increase in cases as the season progresses. Meanwhile, “RSV [respiratory syncytial virus] season is beginning, and infants eligible for monoclonal antibodies who have not yet received a dose should make an appointment with their care provider. Vaccines for pregnant women are also available at this time,” Handy said.

Handy disclosed having no financial conflicts of interest.