Population based hospitalization burden of laboratory-confirmed hand, foot and mouth disease caused by multiple enterovirus serotypes in Southern China

AbstractBackgroundHand, foot and mouth disease (HFMD) is spread widely across Asia, and the hospitalization burden is as yet not well understood. Here, we estimated serotype-specific and age-specific hospitalization rates of HFMD in Southern China.MethodsWe enrolled pediatric patients admitted to 3/3 county-level hospitals and 3/23 township level hospitals in Anhua county, Hunan (CN) with HFMD, and collected samples to identify enterovirus serotypes by RT-PCRs between October 2013 and September 2016. The information of other eligible but un-enrolled patients were retrospectively collected from the same six hospitals. Monthly number of hospitalizations for all causes was collected from each of 23 township level hospitals to extrapolate hospitalizations associated with HFMD among these.ResultsDuring the three years, an estimated 3,236 pediatric patients were hospitalized with lab-confirmed HFMD, and among these only one patient was severe. The mean hospitalization rates were 660 (95% CI: 638-684) per 100,000 person-years for lab-confirmed HFMD, with higher rates among CV-A16 and CV-A6 associated HFMD (213 vs 209 per 100,000 person-years), and lower among EV-A71, CV-A10 and other enteroviruses associated HFMD (134, 39 and 66 per 100,000 person-years, p<0.001). Children aged 12-23 months had the highest hospitalization rates (3,594/100,000 person-years), followed by those aged 24-35 months (1,828/100,000 person-years) and 6-11 months (1,572/100,000 person-years). Compared with other serotypes, CV-A6-associated hospitalizations were evident at younger ages.ConclusionsOur study indicates a substantial hospitalization burden associated with non-severe HFMD in a rural county in southern China. Future mitigation policies should take into account the disease burden identified, and optimize interventions for HFMD.

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HAND-FOOT-AND-MOUTH DISEASE EPIDEMIOLOGICAL STATUS AND RELATIONSHIP WITH METEOROLOGICAL VARIABLES IN GUANGZHOU, SOUTHERN CHINA, 2008-2012

Revista do Instituto de Medicina Tropical de São Paulo ◽

10.1590/s0036-46652014000600014 ◽

2014 ◽

Vol 56 (6) ◽

pp. 533-539 ◽

Cited By ~ 21

Author(s):

Tiegang Li ◽

Zhicong Yang ◽

Xiangyi Liu ◽

Yan Kang ◽

Ming Wang

Keyword(s):

Negative Binomial ◽

Southern China ◽

Foot And Mouth Disease ◽

Negative Binomial Regression ◽

Incidence Rates ◽

Mouth Disease ◽

Meteorological Variables ◽

High Morbidity ◽

Weather Factors ◽

Foot And Mouth

Hand-foot-and-mouth disease (HFMD) is becoming one of the extremely common airborne and contact transmission diseases in Guangzhou, southern China, leading public health authorities to be concerned about its increased incidence. In this study, it was used an ecological study plus the negative binomial regression to identify the epidemic status of HFMD and its relationship with meteorological variables. During 2008-2012, a total of 173,524 HFMD confirmed cases were reported, 12 cases of death, yielding a fatality rate of 0.69 per 10,000. The annual incidence rates from 2008 to 2012 were 60.56, 132.44, 311.40, 402.76, and 468.59 (per 100,000), respectively, showing a rapid increasing trend. Each 1 °C rise in temperature corresponded to an increase of 9.47% (95% CI 9.36% to 9.58%) in the weekly number of HFMD cases, while a one hPa rise in atmospheric pressure corresponded to a decrease in the number of cases by 7.53% (95% CI -7.60% to -7.45%). Similarly, each one percent rise in relative humidity corresponded to an increase of 1.48% or 3.3%, and a one meter per hour rise in wind speed corresponded to an increase of 2.18% or 4.57%, in the weekly number of HFMD cases, depending on the variables considered in the model. These findings revealed that epidemic status of HFMD in Guangzhou is characterized by high morbidity but low fatality. Weather factors had a significant influence on the incidence of HFMD.

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Changing epidemiology of hand, foot, and mouth disease in China, 2013−2019: a population-based study

The Lancet Regional Health - Western Pacific ◽

10.1016/j.lanwpc.2021.100370 ◽

2022 ◽

Vol 20 ◽

pp. 100370

Author(s):

Jie Hong ◽

Fengfeng Liu ◽

Hongchao Qi ◽

Wei Tu ◽

Michael P. Ward ◽

...

Keyword(s):

Foot And Mouth Disease ◽

Population Based ◽

Mouth Disease ◽

Population Based Study ◽

Foot And Mouth

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Epidemiological and clinical characteristics of severe hand-foot-and-mouth disease (HFMD) among children: a 6-year population-based study

BMC Public Health ◽

10.1186/s12889-020-08961-6 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Yanhao Wang ◽

Han Zhao ◽

Rong Ou ◽

Hua Zhu ◽

Lidan Gan ◽

...

Keyword(s):

Clinical Characteristics ◽

Foot And Mouth Disease ◽

Population Based ◽

Mouth Disease ◽

Population Based Study ◽

Foot And Mouth

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Hand-foot-and-mouth disease and weather factors in Guangzhou, southern China

Epidemiology and Infection ◽

10.1017/s0950268813002938 ◽

2013 ◽

Vol 142 (8) ◽

pp. 1741-1750 ◽

Cited By ~ 27

Author(s):

T. LI ◽

Z. YANG ◽

B. DI ◽

M. WANG

Keyword(s):

Public Health ◽

Negative Binomial ◽

Southern China ◽

Foot And Mouth Disease ◽

Incidence Rates ◽

Mouth Disease ◽

Control Measures ◽

High Morbidity ◽

Weather Factors ◽

Foot And Mouth

SUMMARYHand-foot-and-mouth disease (HFMD) is becoming one of the common airborne and contact transmission diseases in Guangzhou, southern China, leading public health authorities to be concerned about its increased incidence. In this study, we aimed to examine the effect of weather patterns on the incidence of HFMD in the subtropical city of Guangzhou for the period 2009–2012, and assist public health prevention and control measures. A negative binomial multivariable regression was used to identify the relationship between meteorological variables and HFMD. During the study period, a total of 166 770 HFMD-confirmed cases were reported, of which 11 died, yielding a fatality rate of 0·66/10 000. Annual incidence rates from 2009 to 2012 were 132·44, 311·40, 402·76, and 468·59/1 000 00 respectively. Each 1°C rise in temperature corresponded to an increase of 9·38% (95% CI 8·17–10·51) in the weekly number of HFMD cases, while a 1 hPa rise in atmospheric pressure corresponded to a decrease in the number of cases by 6·80% (95% CI −6·99 to −6·65), having an opposite effect. Similarly, a 1% rise in relative humidity corresponded to an increase of 0·67% or 0·51%, a 1 m/h rise in wind velocity corresponded to an increase of 4·01% or 2·65%, and a 1 day addition in the number of windy days corresponded to an increase of 24·73% or 25·87%, in the weekly number of HFMD cases, depending on the variables considered in the model. Our findings revealed that the epidemic status of HFMD in Guangzhou is characterized by high morbidity but low fatality. Weather factors had a significant influence on occurrence and transmission of HFMD.

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