scholarly journals Epidemiological characteristics of hand, foot, and mouth disease in Yunnan Province, China, 2008–2019

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Li Jiang ◽  
Hongchao Jiang ◽  
Xin Tian ◽  
Xueshan Xia ◽  
Tian Huang
Keyword(s):  
Vaccination Coverage ◽  
Yunnan Province ◽  
Enterovirus 71 ◽  
Case Fatality ◽  
Foot And Mouth Disease ◽  
Mouth Disease ◽  
Vaccination Coverage Rate ◽  
Foot And Mouth ◽  
Before And After ◽  
Epidemiological Characteristics

Abstract Background Since 2016, enterovirus 71 (EV71) vaccines have been approved for market entry, and little is known about how the epidemiology of hand, foot, and mouth disease (HFMD) has been affected by the introduction of the vaccines in Yunnan Province. The study describes the epidemiological characteristics of HFMD before and after the introduction of EV71 vaccination in Yunnan Province. Methods Surveillance data collected between 2008 and 2019 were analyzed to produce epidemiological distribution on cases, etiologic composition, and EV71 vaccination coverage, as well as to compare these characteristics before and after EV71 vaccination. Results A total of 1,653,533 children received EV71 vaccines from 2016 through 2019 in Yunnan. The annual EV71 vaccination coverage rate ranged from 5.53 to 15.01% among children ≤5 years old. After the introduction of EV71 vaccines, the overall incidence of HFMD increased and reached over 200 cases per 100,000 population-years in 2018 and 2019. However, the case severity and case fatality rate decreased and remained lower than 1 and 0.005% after 2016, respectively. EV71-associated mild, severe and fatal cases sharply decreased. The predominant viral serotype changed to non-EV71/non-CV-A16 enteroviruses which were detected across the whole province. Conclusions Non-EV71/non-CV-A16 enteroviruses became the predominant strain and led to a higher incidence in Yunnan. Expanding EV71 vaccination and strengthening laboratory-based surveillance could further decrease the burden of severe HFMD and detect and monitor emerging enteroviruses.

scholarly journals Ongoing Epidemiological Changes in Hand, Foot, and Mouth Disease Following the Introduction of Enterovirus 71 Vaccines in Yunnan Province, China, 2008-2019

2021 ◽  
Author(s):  
Li Jiang ◽  
Hongchao Jiang ◽  
Xin Tian ◽  
Xueshan Xia ◽  
Tian Huang
Keyword(s):  
Vaccination Coverage ◽  
Yunnan Province ◽  
Enterovirus 71 ◽  
Case Fatality ◽  
Foot And Mouth Disease ◽  
Mouth Disease ◽  
Vaccination Coverage Rate ◽  
Foot And Mouth ◽  
Before And After ◽  
Epidemiological Changes

Abstract Background:Since 2016, enterovirus 71 (EV71) vaccines have been approved for market entry, and litter is known about how the epidemiology of hand, foot, and mouth disease (HFMD) has been affected by the introduction of the vaccines in Yunnan Province. The study describes the ongoing epidemiological changes in HFMD following the introduction of EV71 vaccination in Yunnan.Methods:Surveillance data collected between 2008 and 2019 were analyzed to produce EV71 vaccination coverage, epidemiological distribution on cases, and etiologic composition as well as to compare these characteristics before and after EV71 vaccination.Results:A total of 1,653,533 people received EV71 vaccines from 2016 through 2019 in Yunnan. The cumulative EV71 vaccination coverage rate was 68.14%. After the introduction of EV71 vaccines, the overall incidence of HFMD increased and reached over 200 cases per 100,000 population-years in 2018 and 2019. However, the case severity and case fatality rate decreased and remained lower than 1% and 0.005% after 2016, respectively. EV71-associated mild, severe and fatal cases sharply decreased. The predominant viral serotype changed to non-EV71/non-CV-A16 enteroviruses which were detected across the whole province.Conclusions: EV71 vaccination helped to reduce severe HFMD. However, other enteroviruses became the predominant strain and let to a higher incidence. Expanding EV71 vaccination and strengthening laboratory-based surveillance could further decrease the burden of severe HFMD and reveal the existence of emerging enteroviruses.

Case-fatality of hand, foot and mouth disease associated with EV71: a systematic review and meta-analysis

2015 ◽  
Vol 143 (14) ◽  
pp. 3094-3102 ◽  
Author(s):  
Y. Y. ZHAO ◽  
H. JIN ◽  
X. F. ZHANG ◽  
B. WANG
Keyword(s):  
Random Effects ◽  
Meta Analysis ◽  
Enterovirus 71 ◽  
Case Fatality ◽  
Foot And Mouth Disease ◽  
Model Potential ◽  
Mouth Disease ◽  
Control Measures ◽  
Health Concern ◽  
Foot And Mouth

SUMMARYHand, foot and mouth disease (HFMD) associated with enterovirus 71 (EV71) is a growing public health concern. This study aimed to estimate the case-fatality of HFMD associated with EV71 on the basis of a meta-analysis. We searched PubMed, Cochrane, Web of Science, Elsevier, CNKI, Wanfang, and VIP databases. Two authors independently selected relevant studies. The pooled estimate of case-fatality was calculated using a random-effects model. Potential sources of heterogeneity were explored using subgroup analysis, sensitivity analysis and meta-regression. We identified 14 eligible studies with a total population of 112 546. The random-effects pooled case-fatality was 1·7% (95% confidence interval 1·2–2·4). The funnel plot was asymmetrical. The estimate of case-fatality was highest in mainland China (1·8%). Removal of eight local Chinese studies decreased the original estimate. The pooled case-fatality in the period of 1998–2007 (1·5%) was lower than that in the period 2008–2012 (1·8%). Control measures for HFMD associated with EV71 are essential because of the increased case-fatality over time, especially in East Asia.

The epidemiological and clinical characteristics of hand, foot and mouth disease in Hangzhou, China, 2016-2018

2019 ◽  
Author(s):  
Jie Wang ◽  
Jun Zhou ◽  
Guoliang Xie ◽  
Shufa Zheng ◽  
Bin Lou ◽  
...  
Keyword(s):  
Clinical Status ◽  
Enterovirus 71 ◽  
Foot And Mouth Disease ◽  
Mouth Disease ◽  
Human Enterovirus ◽  
Rt Pcr ◽  
Foot And Mouth ◽  
Epidemiological Characteristics ◽  
The Relationship ◽  
Children Under 5

Abstract Background Hand, foot and mouth disease (HFMD) is most frequently caused by several serotypes of human enterovirus (EV) including Enterovirus 71 (EV71), Coxsackievirus A16 (CV-A16) or other types of EV. Children under 5 years old are the most susceptible to HFMD. The aim of this study was to determine the epidemiological characteristics and the relationship between severe and mild HFMD. Methods We collected 4760 probable HFMD cases with skin papular or vesicular rashes on the hands, feet, mouth or buttocks in Hangzhou from 2016 to 2018. Specimens of these cases were collected and the pathogen of EV71, CV-A16, CV-A6, CV-A10, CV-A2 and CV-A5 was classified by RT-PCR. Then the pathogen distribution and clinical status of children with HFMD were described. Results From Jan. 1, 2016 to Dec. 31, 2018, the incidence and prevalence of HFMD were seasonal each year. Among the 4760 probable HFMD cases, 3559 cases were confirmed (74.8%, 3559/4760), including 426 cases of EV71 infections (8.9%, 426/4760, 249 cases of CV-A16 infections (5.2%, 249/4760) and 2884 cases of other enteroviruses infections (60.6%, 2884/4760). The percentage of EV positive HFMD cases with non-EV71 and non-CV-A16 was more than 80% (2884/3559), which increased year by year. The percentage of EV71 decreased year by year in the last three years especially in 2018. Among the 1297 cases randomly selected of other EV infections in 2017 and 2018, there were 835 (64.4%) cases of CV-A6 infections, 177 (13.6%) cases of CV-A10 infections, 100 (7.7%) cases of CV-A2 infections, 40 (3.1%) cases of CV-A5 infections, 3 (0.02%) cases of mixed infections and 11.0% untyped enteroviruses infections. Preschool children were still the primary population susceptible to HFMD, and the age of the children infected with other enteroviruses tended to be younger. In severe cases, EV71 infection was the main cause. Conclusions The other EV especially CV-A6 increased obviously and EV71 decreased obviously in the three years. Characterizing the epidemiology and the relationship between severe and common cases of HFMD would provide relevant evidences for the prevention and treatment of HFMD.

scholarly journals Clinical and Etiological Characteristics of Atypical Hand-Foot-and-Mouth Disease in Children from Chongqing, China: A Retrospective Study

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Xiang Yan ◽  
Zhen-Zhen Zhang ◽  
Zhen-Hua Yang ◽  
Chao-Min Zhu ◽  
Yun-Ge Hu ◽  
...  
Keyword(s):  
Enterovirus 71 ◽  
Foot And Mouth Disease ◽  
Good Prognosis ◽  
Mouth Disease ◽  
Coxsackievirus A16 ◽  
Neurologic Involvement ◽  
Coxsackievirus A6 ◽  
Foot And Mouth ◽  
Two Peaks ◽  
Epidemiological Characteristics

Background. Hand-foot-and-mouth disease (HFMD) is a disease that had similar manifestations to chickenpox, impetigo, and measles, which is easy to misdiagnose and subsequently causes delayed therapy and subsequent epidemic. To date, no study has been conducted to report the clinical and epidemiological characteristics of atypical HFMD.Methods. 64 children with atypical HFMD out of 887 HFMD children were recruited, stool was collected, and viral VP1 was detected.Results. The atypical HFMD accounted for 7.2% of total HFMD in the same period (64/887) and there were two peaks in its prevalence in nonepidemic seasons. Ten children (15.6%) had manifestations of neurologic involvement, of whom 4 (6.3%) were diagnosed with severe HFMD and 1 with critically severe HFMD, but all recovered smoothly. Onychomadesis and desquamation were found in 14 patients (21.9%) and 15 patients (23.4%), respectively. The most common pathogen was coxsackievirus A6 (CV-A6) which accounted for 67.2%, followed by nontypable enterovirus (26.6%), enterovirus 71 (EV-A71) (4.7%), and coxsackievirus A16 (A16) (1.5%).Conclusions. Atypical HFMD has seasonal prevalence. The manifestations of neurologic involvement in atypical HFMD are mild and usually have a good prognosis. CV-A6 is a major pathogen causing atypical HFMD, but not a major pathogen in Chongqing, China.

scholarly journals The Epidemiological and Clinical Characteristics of Hand, Foot, and Mouth Disease in Hangzhou, China, 2016 to 2018

2020 ◽  
Vol 59 (7) ◽  
pp. 656-662
Author(s):  
Jie Wang ◽  
Jun Zhou ◽  
Guoliang Xie ◽  
Shufa Zheng ◽  
Bin Lou ◽  
...  
Keyword(s):  
Enterovirus 71 ◽  
Foot And Mouth Disease ◽  
Mouth Disease ◽  
Human Enterovirus ◽  
Foot And Mouth ◽  
Polymerase Chain ◽  
Epidemiological Characteristics ◽  
The Relationship ◽  
Epidemiologic Characteristics ◽  
Selection Of

Hand, foot, and mouth disease (HFMD) is most frequently caused by several serotypes of human enterovirus (EV) including Enterovirus 71 (EV-A71), coxsackievirus A16 (CV-A16), or other types of EV. The aim of this study was to determine the epidemiological characteristics of HFMD and to describe the epidemiologic characteristics of HFMD among severe and mild cases. We collected 4760 HFMD cases in Hangzhou from 2016 to 2018. Specimens from these cases were collected and tested for EV-A71, CV-A16, CV-A6, CV-A10, CV-A2, and CV-A5 by reverse transcriptase polymerase chain reaction. From 2016 to 2018, the prevalence of HFMD was seasonal each year. Among the 4760 probable HFMD cases, 3559 cases were confirmed (74.8%), including 426 cases of EV-A71 infections (8.9%), 249 cases of CV-A16 infections (5.2%), and 2884 cases of other EV infections (60.6%). The percentage of other EV infections was more than 80%, which increased year by year. Random selection of samples for detection of other EV infections in 2017 and 2018, among the 1297 cases, showed there were 835 (64.4%) cases of CV-A6 infections, 177 (13.6%) cases of CV-A10 infections, 100 (7.7%) cases of CV-A2 infections, 40 (3.1%) cases of CV-A5 infections, 3 (0.02 %) cases of mixed infections, and 11.0% untyped EV infections. Preschool children were still the primary population susceptible to HFMD. In severe cases, EV-A71 infection was the main cause. Characterizing the epidemiology and the relationship between severe and common cases of HFMD would provide relevant evidences for the prevention and treatment of HFMD.

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