Epidemiology of hand, foot, and mouth disease and the genetic characteristics of Coxsackievirus A16 in Taiyuan, Shanxi, China from 2010 to 2021

Abstract

Hand, foot, and mouth disease (HFMD) is a common childhood infectious disease caused by human enteroviruses (EV). This study aimed to describe the epidemiological features of HFMD and the genetic characteristics of Coxsackievirus A16 (CVA16) in Taiyuan, Shanxi, China, from 2010 to 2021. Descriptive epidemiological methods were used to analyze the time and population distribution of HFMD and the genetic characteristics of CVA16. Except being affected by the COVID-19 epidemic in 2020, HFMD epidemics were sporadic from January to March each year, and began to increase in April, with a major epidemic peak from May to August, which declined in September, followed by a secondary peak from October to December. The prevalence of EV infection was the highest in children aged one to five years (84.42%), whereas its incidence was very low in children under one year of age (5.48%). Enterovirus nucleic acid was detected by real-time reverse transcription polymerase chain reaction in 6641 clinical specimens collected from patients with HFMD from 2010 to 2021, and 4236 EV-positive specimens were detected, including 988 enterovirus A71 (EV-A71), 1488 CVA16, and 1760 other enteroviruses. CVA16 remains prevalent and has co-circulated with other EVs in Taiyuan from 2010 to 2021. A phylogenetic tree constructed based on the VP1 region showed that all CVA16 strains belonged to two different clades of the B1 genotype, B1a and B1b. They showed a nucleotide similarity of 86.5–100%, and an amino acid similarity of 96.9–100%. Overall, these findings add to the global genetic resources of CVA16, demonstrate the epidemiological characteristics of HFMD as well as the genetic features of CVA16 in Taiyuan City during 2010–2021, and provide supporting evidence for the prevention and control of HFMD.

Epidemiological and etiological investigations of hand, foot, and mouth disease in Jiashan, northeastern Zhejiang Province, China, during 2016 to 2022

“…Human beings are usually considered to be the only reservoir of HEVs. Children aged 1–5 years comprised the majority of cases of HFMD in Jiashan, similar to other reports ( 11 , 20 ). Children aged <1 year usually have maternal antibodies, while those aged 1–5 years have immature immune systems and undeveloped health habits when compared with older age groups.…”

“…A molecular typing system based on enterovirus VP1 was established because VP1 sequences correlate well with antigenic typing and identification ( 6 , 11 ). A surveillance system for HEV was established during 2002 in Zhejiang Province ( 12 ).…”

Clinical testing of pediatric mpox specimens: Unique features and challenges in a low prevalence population

“…One potential explanation for the elevated testing rate of 1- to 3-year olds may be the higher incidence of childhood rashes (e.g. varicella, hand foot and mouth disease, and molluscum contagiosum) in this age group [ 21 , 22 ]. We found positivity rates were strongly polarized to the less than 1-year-old and 17-year-old age groups.…”

Study on the epidemiological characteristics of enterovirus among pediatric patients in Hangzhou, China: A comparison between the pre‐COVID‐19, COVID‐19 pandemic, and post‐COVID‐19 periods

“…Understanding the potential influence of the COVID‐19 pandemic on the incidence of HFMD/HA is crucial for comprehending its broader public health implications. Previous studies have examined the effects of COVID‐19‐related NPIs on enteroviruses or enteric viruses such as rotavirus and adenovirus; these studies have focused primarily on the early phase of the outbreak, when strict measures were implemented 14,15 . However, a comprehensive assessment of the long‐term impact of relaxed anti‐epidemic policies, which were introduced after December 2022 in China, on the circulation of common HEVs is lacking.…”

“…Previous studies have examined the effects of COVID-19-related NPIs on enteroviruses or enteric viruses such as rotavirus and adenovirus; these studies have focused primarily on the early phase of the outbreak, when strict measures were implemented. 14,15 However, a comprehensive assessment of the long-term impact of relaxed anti-epidemic policies, which were the relevant enterovirus in the recovery phase, which is at least four times greater than that in the acute stage. 16 The diagnosis of HA can be made on the basis of a history of epidemiology, typical HA is an acute disease characterized by a sudden onset of fever and sore throat.…”