scholarly journals Transmissibility of hand, foot, and mouth disease in 97 counties of China.

2021 ◽  
Author(s):  
Wei Zhang ◽  
Jia Rui ◽  
Xiaoqing Cheng ◽  
Bin Deng ◽  
Hesong Zhang ◽  
...  
Keyword(s):  
Incidence Rate ◽  
Foot And Mouth Disease ◽  
Mouth Disease ◽  
Jiangsu Province ◽  
Asia Pacific ◽  
Seasonal Characteristics ◽  
High Incidence ◽  
Foot And Mouth ◽  
Low Incidence ◽  
Serious Disease

Abstract Background Hand, foot, and mouth disease (HFMD) has been a serious disease burden in the Asia Pacific region represented by China, and the transmission characteristics of HFMD in regions haven’t been clear. This study calculated the transmissibility of HFMD at county levels in Jiangsu Province, China, analyzed the differences of transmissibility and explored the reasons. Methods We built susceptible-exposed-infectious-asymptomatic-removed (SEIAR) model for seasonal characteristics of HFMD, estimated effective reproduction number (Reff) by fitting the incidence of HFMD in 97 counties of Jiangsu Province from 2015 to 2020, compared incidence rate and transmissibility in different counties by non -parametric test, rapid cluster analysis and rank-sum ratio. Results The average daily incidence rate was between 0 and 4 per 100,000 in Jiangsu province from 2015–2020. The 97 counties could be divided into three levels: low incidence, medium incidence and high incidence, and occurred that the average daily incidence rate dropped sharply in 2016–2017, and increased sharply in 2017–2018 years. The Quartile of Reff in Jiangsu Province from 2015 to 2020 was 1.54 (0.49, 2.50), Rugao district in Central Jiangsu and Jianhu district in Northern Jiangsu had the highest transmissibility by rank-sum ratio. Reff generally decreased in 2017 and increased in 2018 in most counties, and the median level of Reff was lowest in 2017 (P < 0.05). Conclusion Transmissibility was different in 97 counties of Jiangsu Province, and the reasons for the differences may be related to the climate, demographic characteristics, virus subtypes, vaccination and other infectious diseases.

scholarly journals Transmissibility of Hand, Foot, and Mouth Disease in 97 Counties of Jiangsu Province, China, 2015- 2020

2021 ◽  
Author(s):  
Wei Zhang ◽  
Jia Rui ◽  
Xiaoqing Cheng ◽  
Bin Deng ◽  
Hesong Zhang ◽  
...  
Keyword(s):  
Incidence Rate ◽  
Foot And Mouth Disease ◽  
Mouth Disease ◽  
Jiangsu Province ◽  
Asia Pacific ◽  
Seasonal Characteristics ◽  
High Incidence ◽  
Foot And Mouth ◽  
Low Incidence ◽  
Serious Disease

Abstract Background: Hand, foot, and mouth disease (HFMD) has been a serious disease burden in the Asia Pacific region represented by China, and the transmission characteristics of HFMD in regions haven’t been clear. This study calculated the transmissibility of HFMD at county levels in Jiangsu Province, China, analyzed the differences of transmissibility and explored the reasons.Methods: We built susceptible-exposed-infectious-asymptomatic-removed (SEIAR) model for seasonal characteristics of HFMD, estimated effective reproduction number (Reff) by fitting the incidence of HFMD in 97 counties of Jiangsu Province from 2015 to 2020, compared incidence rate and transmissibility in different counties by non -parametric test, rapid cluster analysis and rank-sum ratio.Results: The average daily incidence rate was between 0 and 4 per 100,000 in Jiangsu province from 2015-2020. The 97 counties could be divided into three levels: low incidence, medium incidence and high incidence, and occurred that the average daily incidence rate dropped sharply in 2016-2017, and increased sharply in 2017-2018 years. The Quartile of Reff in Jiangsu Province from 2015 to 2020 was 1.54 (0.49, 2.50), Rugao district in Central Jiangsu and Jianhu district in Northern Jiangsu had the highest transmissibility by rank-sum ratio. Reff generally decreased in 2017 and increased in 2018 in most counties, and the median level of Reff was lowest in 2017 (P<0.05).Conclusion: Transmissibility was different in 97 counties of Jiangsu Province, and the reasons for the differences may be related to the climate, demographic characteristics, virus subtypes, vaccination and other infectious diseases.

scholarly journals Early Evidence of Inactivated Enterovirus 71 Vaccine Impact Against Hand, Foot, and Mouth Disease in a Major Center of Ongoing Transmission in China, 2011–2018: A Longitudinal Surveillance Study

2019 ◽  
Author(s):  
Jennifer R Head ◽  
Philip A Collender ◽  
Joseph A Lewnard ◽  
Nicholas K Skaff ◽  
Ling Li ◽  
...  
Keyword(s):  
Time Series ◽  
Incidence Rate ◽  
Enterovirus 71 ◽  
Foot And Mouth Disease ◽  
Mouth Disease ◽  
Asia Pacific ◽  
Full Time ◽  
Study Region ◽  
Foot And Mouth ◽  
Vaccine Impact

Abstract Background Enterovirus 71 (EV71) is a major causative agent of hand, foot, and mouth disease (HFMD), associated with severe manifestations of the disease. Pediatric immunization with inactivated EV71 vaccine was initiated in 2016 in the Asia-Pacific region, including China. We analyzed a time series of HFMD cases attributable to EV71, coxsackievirus A16 (CA16), and other enteroviruses in Chengdu, a major transmission center in China, to assess early impacts of immunization. Methods Reported HFMD cases were obtained from China’s notifiable disease surveillance system. We compared observed postvaccination incidence rates during 2017–2018 with counterfactual predictions made from a negative binomial regression and a random forest model fitted to prevaccine years (2011–2015). We fit a change point model to the full time series to evaluate whether the trend of EV71 HFMD changed following vaccination. Results Between 2011 and 2018, 279 352 HFMD cases were reported in the study region. The average incidence rate of EV71 HFMD in 2017–2018 was 60% (95% prediction interval [PI], 41%–72%) lower than predicted in the absence of immunization, corresponding to an estimated 6911 (95% PI, 3246–11 542) EV71 cases averted over 2 years. There were 52% (95% PI, 42%–60%) fewer severe HFMD cases than predicted. However, the incidence rate of non-CA16 and non-EV71 HFMD was elevated in 2018. We identified a significant decline in the trend of EV71 HFMD 4 months into the postvaccine period. Conclusions We provide the first real-world evidence that programmatic vaccination against EV71 is effective against childhood HFMD and present an approach to detect early vaccine impact or intended consequences from surveillance data.

scholarly journals Spatiotemporal Characteristics and meteorological determinants of Hand, Foot and Mouth Disease in Shaanxi Province, China: a county-level analysis

2021 ◽  
Author(s):  
Li Ding ◽  
Ning Zhang ◽  
Bin Zhu ◽  
Jinlin Liu ◽  
Xue Wang ◽  
...  
Keyword(s):  
Incidence Rate ◽  
Meteorological Factors ◽  
Foot And Mouth Disease ◽  
Mouth Disease ◽  
Shaanxi Province ◽  
County Level ◽  
Spatiotemporal Characteristics ◽  
High Incidence ◽  
Foot And Mouth ◽  
The Government

Abstract Background: Hand, foot and mouth disease (HFMD) is one of the common intestinal infectious diseases worldwide and has caused huge economic and disease burdens in many countries. The average annual incidence rate of HFMD was 11.66% in Shaanxi during the time span from 2009 to 2018. There are distinct differences within Shaanxi, as it is a special region that crosses three temperature zones. Hence, in this study, a spatiotemporal analysis of Shaanxi was performed to reveal the characteristics of the distribution of HFMD and to explore the meteorological determinants of HFMD.Methods: The county-level and municipal data from Shaanxi Province from 2009 to 2018 were applied to research the spatiotemporal characteristics of HFMD and its meteorological determinants. Time series and spatial autocorrelation analyses were applied to assess the spatiotemporal characteristics of HFMD. This study used spatial econometric panel models to explore the relationship between HFMD and meteorological factors based on the data of 107 counties and 10 municipalities.Results: The incidence rate of HFMD displayed no variable trend throughout the whole research period. A high incidence rate of HFMD was observed from June to September, corresponding to a time when the climate is characterized by heavy rain, high temperature, and high humidity. The high-incidence areas were mainly located in the central region in Shaanxi, whereas the low-incidence spots were mainly found in Northern Shaanxi. Regarding the meteorological factors analysed in this study, in general, the incidence rate of HFMD in specific regions was positively associated with the rainfall, temperature and humidity.Conclusion: These results could be applied by the government and the general public to take effective measures to prevent disease. Region-targeted policies could be enacted and implemented in the future according to specific situations in different areas and the relevant meteorological determinants. Additionally, meteorological conditions normally extend to a wide-ranging region; thus, cooperation among surrounding regions is necessary.

scholarly journals Spatiotemporal characteristics and meteorological determinants of hand, foot and mouth disease in Shaanxi Province, China: a county-level analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Li Ding ◽  
Ning Zhang ◽  
Bin Zhu ◽  
Jinlin Liu ◽  
Xue Wang ◽  
...  
Keyword(s):  
Incidence Rate ◽  
Meteorological Factors ◽  
Foot And Mouth Disease ◽  
Mouth Disease ◽  
Shaanxi Province ◽  
County Level ◽  
Spatiotemporal Characteristics ◽  
High Incidence ◽  
Foot And Mouth ◽  
The Government

Abstract Background Hand, foot and mouth disease (HFMD) is one of the common intestinal infectious diseases worldwide and has caused huge economic and disease burdens in many countries. The average annual incidence rate of HFMD was 11.66% in Shaanxi during the time span from 2009 to 2018. There are distinct differences within Shaanxi, as it is a special region that crosses three temperature zones. Hence, in this study, a spatiotemporal analysis of Shaanxi was performed to reveal the characteristics of the distribution of HFMD and to explore the meteorological determinants of HFMD. Methods The county-level and municipal data from Shaanxi Province from 2009 to 2018 were applied to research the spatiotemporal characteristics of HFMD and its meteorological determinants. Time series and spatial autocorrelation analyses were applied to assess the spatiotemporal characteristics of HFMD. This study used spatial econometric panel models to explore the relationship between HFMD and meteorological factors based on the data of 107 counties and 10 municipalities. Results The incidence rate of HFMD displayed no variable trend throughout the whole research period. A high incidence rate of HFMD was observed from June to September, corresponding to a time when the climate is characterized by heavy rain, high temperature, and high humidity. The high-incidence areas were mainly located in the central region in Shaanxi, whereas the low-incidence spots were mainly found in Northern Shaanxi. Regarding the meteorological factors analysed in this study, in general, the incidence rate of HFMD in specific regions was positively associated with the rainfall, temperature and humidity. Conclusion These results could be applied by the government and the general public to take effective measures to prevent disease. Region-targeted policies could be enacted and implemented in the future according to specific situations in different areas and the relevant meteorological determinants. Additionally, meteorological conditions normally extend to a wide-ranging region; thus, cooperation among surrounding regions is necessary.

scholarly journals Trend analysis and forecast of daily reported incidence of hand, foot and mouth disease in Hubei, China by Prophet model

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Cong Xie ◽  
Haoyu Wen ◽  
Wenwen Yang ◽  
Jing Cai ◽  
Peng Zhang ◽  
...  
Keyword(s):  
Moving Average ◽  
Arima Model ◽  
Foot And Mouth Disease ◽  
Mouth Disease ◽  
Spring Festival ◽  
High Incidence ◽  
Foot And Mouth ◽  
Accurate Forecast ◽  
Changing Patterns ◽  
Two Peaks

AbstractHand, foot, and mouth disease (HFMD) is common among children below 5 years. HFMD has a high incidence in Hubei Province, China. In this study, the Prophet model was used to forecast the incidence of HFMD in comparison with the autoregressive-integrated moving average (ARIMA) model, and HFMD incidence was decomposed into trends, yearly, weekly seasonality and holiday effect. The Prophet model fitted better than the ARIMA model in daily reported incidence of HFMD. The HFMD incidence forecast by the Prophet model showed that two peaks occurred in 2019, with the higher peak in May and the lower peak in December. Periodically changing patterns of HFMD incidence were observed after decomposing the time-series into its major components. In specific, multi-year variability of HFMD incidence was found, and the slow-down increasing point of HFMD incidence was identified. Relatively high HFMD incidences appeared in May and on Mondays. The effect of Spring Festival on HFMD incidence was much stronger than that of other holidays. This study showed the potential of the Prophet model to detect seasonality in HFMD incidence. Our next goal is to incorporate climate variables into the Prophet model to produce an accurate forecast of HFMD incidence.

scholarly journals Meteorological factors and its association with hand, foot and mouth disease in Southeast and East Asia areas: a meta-analysis

2018 ◽  
Vol 147 ◽  
Author(s):  
Chunxiao Duan ◽  
Xuefeng Zhang ◽  
Hui Jin ◽  
Xiaoqing Cheng ◽  
Donglei Wang ◽  
...  
Keyword(s):  
East Asia ◽  
Meteorological Factors ◽  
Global Climate ◽  
Meta Analysis ◽  
Foot And Mouth Disease ◽  
Correlation Coefficients ◽  
Mouth Disease ◽  
Asia Pacific ◽  
China National Knowledge Infrastructure ◽  
Foot And Mouth

AbstractSince the late 1990s, hand, foot and mouth disease (HFMD) has become a common health problem that mostly affects children and infants in Southeast and East Asia. Global climate change is considered to be one of the major risk factors for HFMD. This study aimed to assess the correlation between meteorological factors and HFMD in the Asia-Pacific region. PubMed, Web of Science, Embase, China National Knowledge Infrastructure, Wanfang Data and Weipu Database were searched to identify relevant articles published before May 2018. Data were collected and analysed using R software. We searched 2397 articles and identified 51 eligible papers in this study. The present study included eight meteorological factors; mean temperature, mean highest temperature, mean lowest temperature, rainfall, relative humidity and hours of sunshine were positively correlated with HFMD, with correlation coefficients (CORs) of 0.52 (95% confidence interval (CI) 0.42–0.60), 0.43 (95% CI 0.23–0.59), 0.43 (95% CI 0.23–0.60), 0.27 (95% CI 0.19–0.35), 0.19 (95% CI 0.02–0.35) and 0.19 (95% CI 0.11–0.27), respectively. There were sufficient data to support a negative correlation between mean pressure and HFMD (COR = −0.51, 95% CI −0.63 to −0.36). There was no notable correlation with wind speed (COR = 0.10, 95% CI −0.03 to 0.23). Our findings suggest that meteorological factors affect the incidence of HFMD to a certain extent.

Virulence of enterovirus-A71 fluctuates depending on the phylogenetic clade formed in the epidemic year and epidemic region

2021 ◽  
Author(s):  
Kyousuke Kobayashi ◽  
Hidekazu Nishimura ◽  
Katsumi Mizuta ◽  
Tomoha Nishizawa ◽  
Son T. Chu ◽  
...  
Keyword(s):  
Transgenic Mice ◽  
Foot And Mouth Disease ◽  
Virus Genome ◽  
Mouth Disease ◽  
Asia Pacific ◽  
Enterovirus A71 ◽  
Viral Virulence ◽  
Foot And Mouth ◽  
Potential Risks ◽  
A Minor

Although epidemics of hand, foot, and mouth disease (HFMD) caused by enterovirus A71 (EV-A71) have occurred worldwide, the Asia-Pacific region has seen large sporadic outbreaks with many severe neurological cases. This suggests that the virulence of the circulating viruses fluctuates in each epidemic and that HFMD outbreaks with many severe cases occur when highly virulent viruses are circulating predominantly, which has not been experimentally verified. Here, we analyzed 32 clinically isolated strains obtained in Japan from 2002 to 2013, along with 27 Vietnamese strains obtained from 2015 to 2016 that we characterized previously using human SCARB2 transgenic mice. Phylogenetic analysis of the P1 region classified them into five clades belonging to subgenogroup B5 (B5-I to B5-V) and five clades belonging to subgenogroup C4 (C4-I to C4-V) according to the epidemic year and region. Interestingly, the clade B5-I and B5-II were very virulent, while clades B5-III, B5-IV, and B5-V were less virulent. Clades C4-II, C4-III, C4-IV, and C4-V were virulent, while clade C4-I was not. The result experimentally showed for the first time that several clades with different virulence levels emerged one after another. The experimental virulence evaluation of circulating viruses using SCARB2 transgenic mice is helpful to assess potential risks of circulating viruses. These results also suggest that a minor nucleotide or amino acid substitution in the EV-A71 genome during circulation may cause fluctuations in virulence. The data presented herein may increase our understanding of the dynamics of viral virulence during epidemics. IMPORTANCE Outbreaks of hand, foot, and mouth disease (HFMD) with severe enterovirus A71 (EV-A71) cases have occurred repeatedly, mainly in Asia. In severe cases, central nervous system complications can lead to death, making it an infectious disease of importance to public health. An unanswered question about this disease is why outbreaks of HFMD with many severe cases sometimes occur. Here, we collected EV-A71 strains that were prevalent in Japan and Vietnam over the past 20 years and evaluated their virulence in a mouse model of EV-A71 infection. This method clearly revealed that viruses belonging to different clades have different virulence, indicating that the method is powerful to assess the potential risks of the circulating viruses. The results also suggested that factors in the virus genome may potentially cause an outbreak with many severe cases and that further studies may facilitate the prediction of large epidemics of EV-A71 in the future.

scholarly journals Forecasting incidence of hand, foot and mouth disease using BP neural networks in Jiangsu province, China

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Wendong Liu ◽  
Changjun Bao ◽  
Yuping Zhou ◽  
Hong Ji ◽  
Ying Wu ◽  
...  
Keyword(s):  
Public Health ◽  
Neural Networks ◽  
Meteorological Factors ◽  
Arima Model ◽  
Foot And Mouth Disease ◽  
Public Health Problem ◽  
Mouth Disease ◽  
Jiangsu Province ◽  
Foot And Mouth ◽  
Bp Model

Abstract Background Hand, foot and mouth disease (HFMD) is a rising public health problem and has attracted considerable attention worldwide. The purpose of this study was to develop an optimal model with meteorological factors to predict the epidemic of HFMD. Methods Two types of methods, back propagation neural networks (BP) and auto-regressive integrated moving average (ARIMA), were employed to develop forecasting models, based on the monthly HFMD incidences and meteorological factors during 2009–2016 in Jiangsu province, China. Root mean square error (RMSE) and mean absolute percentage error (MAPE) were employed to select model and evaluate the performance of the models. Results Four models were constructed. The multivariate BP model was constructed using the HFMD incidences lagged from 1 to 4 months, mean temperature, rainfall and their one order lagged terms as inputs. The other BP model was fitted just using the lagged HFMD incidences as inputs. The univariate ARIMA model was specified as ARIMA (1,0,1)(1,1,0)12 (AIC = 1132.12, BIC = 1440.43). And the multivariate ARIMAX with one order lagged temperature as external predictor was fitted based on this ARIMA model (AIC = 1132.37, BIC = 1142.76). The multivariate BP model performed the best in both model fitting stage and prospective forecasting stage, with a MAPE no more than 20%. The performance of the multivariate ARIMAX model was similar to that of the univariate ARIMA model. Both performed much worse than the two BP models, with a high MAPE near to 40%. Conclusion The multivariate BP model effectively integrated the autocorrelation of the HFMD incidence series. Meanwhile, it also comprehensively combined the climatic variables and their hysteresis effects. The introduction of the climate terms significantly improved the prediction accuracy of the BP model. This model could be an ideal method to predict the epidemic level of HFMD, which is of great importance for the public health authorities.

scholarly journals Epidemiological study on hand, foot and mouth disease in Tongzhou District, Beijing, 2013–2017

2019 ◽  
Vol 47 (6) ◽  
pp. 2615-2625 ◽  
Author(s):  
Xiao-Feng Liu ◽  
Xiu-Mei Sun ◽  
Xiao-Wei Sun ◽  
Yu-Qing Yang ◽  
Cong-Hui Huang ◽  
...  
Keyword(s):  
Incidence Rate ◽  
Local Population ◽  
Foot And Mouth Disease ◽  
Mouth Disease ◽  
Migrant Population ◽  
Enterovirus A71 ◽  
Tongzhou District ◽  
Foot And Mouth ◽  
Polymerase Chain ◽  
Epidemiological Characteristics

Objective To study the epidemiological characteristics of hand, foot and mouth disease (HFMD) in Tongzhou District, Beijing between 2013 and 2017. Methods Data on HFMD infections from 1 January 2013 to 31 December 2017 were collected from the Notifiable Infectious Diseases Reporting Information System and analysed. Serotyping of enteroviruses from samples from patients with HFMD was undertaken using reverse transcription–polymerase chain reaction. Results A total of 15 341 patients with HFMD were reported and 32 patients (0.2%) were classified as having severe HFMD. The annual mean incidence rate of HFMD was 219.3/100 000 of the general population. The incidence and case-severity rates of HFMD generally decreased between 2013 and 2017. In the floating migrant population, the incidence and cases-severity rates of HFMD were significantly higher than in the local population. The peak incidence and severity-case rates were at 2 years of age and > 90% of patients were ≤5 years. Enterovirus A71 and Coxsackievirus A16 were the predominant pathogens in 2013–2017. Conclusions During the 5-year period 2013–2017, the incidence rate and case-severity rate of HFMD generally decreased in Tongzhou District, Beijing. The floating migrant population and children ≤5 years of age were at the highest risk of HFMD.

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