Because in China, several EV-A viruses were observed during AFP surveillance before the onset of large-scale HFMD outbreaks in 2007 and in 200817 and given that the rapid spread of HFMD outbreaks in Asia appears to be associated with the emergence of new groups and sub-groups that result from the co-circulation and recombination events between EV-A types43, surveillance systems to monitor HFMD and detect potential novel recombinants should be introduced in Africa to prevent outbreaks. This evidence concerns the gene AFP and hand, foot and mouth disease.