Cases of hand, foot and mouth disease are rising sharply across Japan, with infections exceeding the government¡¯s warning threshold in 27 prefectures and marking the first outbreak in two years, according to survey data released Tuesday.

A total of 15,845 patients were reported by about 2,000 designated pediatric medical institutions in the week from June 29 through July 5, according to the Japan Institute for Health Security.

The figure is equivalent to 7.03 patients per medical institution, more than 1.5 times the previous week¡¯s level. The nationwide warning threshold is five patients per institution. The figure has exceeded this level for the first time in two years, signaling that the infection is spreading widely as Japan enters the summer season, when cases typically increase.

Shimane Prefecture recorded the highest rate, with 18 patients per medical institution, followed by Saga at 11.83, Tokyo at 11.72 and Chiba at 11.59. Toyama reported 10.69 patients per institution, while Nara recorded 10.09.

Authorities recommend parents, schools and child care facilities to take necessary precautions to prevent the spread of the illness, including frequent handwashing with running water and soap, particularly after changing diapers or handling bodily waste, and avoiding the sharing of towels.

Hand, foot and mouth disease is a viral infection that mainly affects infants and young children. It typically causes small, blister-like rashes inside the mouth and on the palms, soles and tops of the feet three to five days after infection.

Fever is usually mild, and most patients recover within three to seven days. About half of reported cases occur among children younger than 2, though outbreaks can also affect elementary school-age children and adults.

The disease spreads through respiratory droplets, direct contact and the fecal-oral route. In rare cases, it can lead to serious complications including meningitis, encephalitis, myocarditis and acute flaccid paralysis.

There is no effective vaccine or preventive medication for the disease.