Epidemiological characteristics of hand, foot, and mouth disease in China

Chen, Bin; Yang, Ying; Xu, Xufeng; Zhao, Hao; Li, Yang; Yin, Shi; Yongquan, Chen

doi:10.1097/md.0000000000025930

Cited by 18 publications

(31 citation statements)

References 18 publications

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“…And CV-A16 infection reduced as the EV-A71 vaccine could enhance people's immunity against CV-A16 viruses to some extent. 10 The prevalence of CV-A16 showed obvious periodic fluctuations in Beijing from 2010 to 2018, with the detection rate increasing every other year. 11 Nonetheless, in recent years, CV-A6-associated HFMD outbreaks 12,13 and the overall trend of the epidemic of CV-A6-associated HFMD was increasing in China.…”

Section: Introductionmentioning

confidence: 97%

“…CV‐A16 associated HFMD usually present mild symptoms that resolve within a few weeks. And CV‐A16 infection reduced as the EV‐A71 vaccine could enhance people's immunity against CV‐A16 viruses to some extent 10 . The prevalence of CV‐A16 showed obvious periodic fluctuations in Beijing from 2010 to 2018, with the detection rate increasing every other year 11 …”

Section: Introductionmentioning

confidence: 99%

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Epidemiological characteristics of hand, foot, and mouth disease clusters during 2016–2020 in Beijing, China

Cui

Yang

Zheng

et al. 2022

Journal of Medical Virology

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Hand, foot, and mouth disease (HFMD) is an infectious disease that usually occurs in children under 5 years and is caused by a group of enteroviruses. This study aimed to investigate the epidemiological characteristics of HFMD clusters from 2016 to 2020 in Tongzhou, Beijing, and explored the genetic evolution of CV-A6. The HFMD case information came from the Information System of China Center for Disease Control and Prevention (CDC), as well as the clusters information verification and on-site investigation by Tongzhou CDC. ARIMA model was applied to forecast HFMD clusters in 2020. Totally 440 HFMD clusters were reported during 2016-2020. The large peak of the clusters occurred in April-July, followed by a smaller peak in October-November during 2016-2019. However, in 2020, the two peaks disappeared. The main site of HFMD clusters was childcare facilities (65.0%) and mostly occurred in urban areas (46.1%). The detection rate of CV-A6 was the highest (36.1%), and cases with CV-A6 infection had the highest proportion of fever. The phylogenetic analysis based on CV-A6 VP1 gene showed that the predominant strains mainly located in Group F during 2016-2017, while changed into Group A during 2018-2020. HFMD clusters presented seasonality, mainly located in childcare facilities and urban areas, and CV-A6 was the major causative agent. Targeted prevention and control measures should be taken to reduce HFMD clusters.

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Section: Introductionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Epidemiological characteristics of hand, foot, and mouth disease clusters during 2016–2020 in Beijing, China

Cui

Yang

Zheng

et al. 2022

Journal of Medical Virology

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“…Some studies have shown that latitude will affect the incidence of HFMD to a certain extent, and the incidence of HFMD is higher in low latitudes such as tropical and temperate regions [ 18 ]. Mainland China spans multiple temperature zones.…”

Section: Introductionmentioning

confidence: 99%

“…The incidence of HFMD in southern China is higher than that in the north, and there are two peaks (summer and autumn) of HFMD each year in southern China, while there is only one peak(summer) each year in northern China [ 1 ]. Natural and social factors vary greatly between the south and north, coastal and inland areas, and the prevalence patterns of HFMD are different in different regions [ 18 , 19 ]. Previous studies have found that precipitation, relative humidity, temperature, gross domestic products (GDP), and the population density are the main factors affecting the incidence of HFMD in China [ 20 – 22 ].…”

Section: Introductionmentioning

confidence: 99%

Spatiotemporal cluster patterns of hand, foot, and mouth disease at the province level in mainland China, 2011–2018

Wang

Zhao

et al. 2022

PLoS ONE

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Although three monovalent EV-A71 vaccines have been launched in mainland China since 2016, hand, foot, and mouth disease (HFMD) still causes a considerable disease burden in China. Vaccines’ use may change the epidemiological characters of HFMD. Spatial autocorrelation analysis and space-time scan statistics analysis were used to explore the spatiotemporal distribution pattern of this disease at the provincial level in mainland China. The effects of meteorological factors, socio-economic factors, and health resources on HFMD incidence were analyzed using Geodetector. Interrupted time series (ITS) was used to analyze the impact of the EV-A71 vaccine on the incidence of HFMD. This study found that the median annual incidence of HFMD was 153.78 per 100,000 (ranging from 120.79 to 205.06) in mainland China from 2011 to 2018. Two peaks of infections were observed per year. Children 5 years and under were the main morbid population. The spatial distribution of HFMD was presented a significant clustering pattern in each year (P<0.001). The distribution of HFMD cases was clustered in time and space. The range of cluster time was between April and October. The most likely cluster appeared in the southern coastal provinces (Guangxi, Guangdong, Hainan) from 2011 to 2017 and in the eastern coastal provinces (Shanghai, Jiangsu, Zhejiang) in 2018. The spatial heterogeneity of HFMD incidence could be attributed to meteorological factors, socioeconomic factors, and health resource. After introducing the EV-A71 vaccine, the instantaneous level of HFMD incidence decreased at the national level, and HFMD incidence trended downward in the southern coastal provinces and increased in the eastern coastal provinces. The prevention and control policies of HFMD should be adapted to local conditions in different provinces. It is necessary to advance the EV-A71 vaccination plan, expand the vaccine coverage and develop multivalent HFMD vaccines as soon as possible.

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“…The prevalence of HFMD also varies with season, weather, countries and other factors [ 12 ]. The incidence of HFMD is relatively high in tropical and temperate zones [ 13 ]. The majority of HFMD outbreaks are reported in some Asian-Pacific region countries such as China, India, Malaysia [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Epidemiological characteristics, routine laboratory diagnosis, clinical signs and risk factors for hand, -foot -and -mouth disease: A systematic review and meta-analysis

Pei

Suo

et al. 2022

PLoS ONE

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Background For the past few years, only a few monovalent EV71 vaccines have been developed, while other enterovirus vaccines are in short supply. We conducted a quantitative meta-analysis to explore the epidemiological characteristics, routine laboratory diagnosis, clinical signs and risk factors for hand, foot and mouth disease (HFMD). Methods PubMed, Embase and the Web of Science were searched for eligible reports published before April 16, 2021, with no publication time or language restrictions. The primary outcome was the odds ratio of the epidemiological characteristics, routine laboratory diagnosis, and clinical signs associated with HFMD severity and death. Results After screening 10522 records, we included 32 articles comprising 781903 cases of hand, foot and mouth disease. Patients with severe illness developed some clinical signs (hypersomnia (OR = 21.97, 95% CI: 4.13 to 116.74), convulsion (OR = 16.18, 95% CI: 5.30 to 49.39), limb shaking (OR = 47.96, 95% CI: 15.17 to 151.67), and breathlessness (OR = 7.48, 95% CI: 1.90 to 29.40)) and had some changes in laboratory parameters (interleukin-6 levels standardized mean difference (SMD) = 1.57, 95%CI: 0.55 to 2.60), an increased neutrophils ratio (SMD = 0.55, 95%CI: 0.17 to 0.93), cluster of differentiation 4 (CD4+) (SMD = -1.38, 95%CI: -2.33 to -0.43) and a reduced lymphocytes ratio (SMD = -0.48, 95%CI: -0.93 to -0.33)) compared with patients with mild illness. The risk factors for death included cyanosis (OR = 5.82, 95% CI: 2.29 to 14.81), a fast heart rate (OR = 3.22, 95% CI: 1.65 to 6.30), vomiting (OR = 2.70, 95% CI: 1.33 to 5.49) and an increased WBC count (SMD = 0.60, 95% CI: 0.27 to 0.93). Conclusions China has the highest incidence of HFMD. Our meta-analyses revealed important risk factors that are associated with the severity and mortality of HFMD.

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Epidemiological characteristics of hand, foot, and mouth disease in China

Cited by 18 publications

References 18 publications

Epidemiological characteristics of hand, foot, and mouth disease clusters during 2016–2020 in Beijing, China

Epidemiological characteristics of hand, foot, and mouth disease clusters during 2016–2020 in Beijing, China

Spatiotemporal cluster patterns of hand, foot, and mouth disease at the province level in mainland China, 2011–2018

Epidemiological characteristics, routine laboratory diagnosis, clinical signs and risk factors for hand, -foot -and -mouth disease: A systematic review and meta-analysis

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