Epidemic and etiological characteristics of hand-foot-mouth disease in Hunan Province, 2019-2020
ZHANG Si-yu1, DONG Rui2, ZHAO Shan-lu1, LI Shi-kang1, DAI Zhi-hui1, ZHOU Shuai-feng1, LIU Zi-yan1, ZHANG Fan1, YAN Jun-xia2, LUO Kai-wei1, HU Shi-xiong1
1. Hunan Provincial Center for Disease Control and Prevention, Changsha, Hunan 410005, China; 2. Xiangya School of Public Health, Central South University, Changsha, Hunan 410078, China
Abstract:Objective To understand the epidemic features of hand-foot-mouth disease (HFMD) and virus changes of pathogens by analyzing the monitoring data of HFMD in Hunan Province from 2019 to 2020, and to provide a basis for formulating prevention and control strategies for HFMD. Methods Descriptive epidemiological analysis was conducted based on the HFMD surveillance data in Hunan Province in 2019-2020collected from China Information System forDiseases Prevention and Control.Fluorescent quantitative RT-PCR was used to detect EV71, CVA16 and other enteroviruses in specimens of clinically-diagnosed HFMD cases. Results A total of 97,110 HFMD cases were reported in Hunan Province in 2019, with an incidence rate of140.76 /100,000. 114,400 cases of HFMD were reported in 2020, with an incidence rate of 165.35/100,000. The number and the incidence rate of HFMD cases in 2020, as compared with those in 2019, increased by 15.1% and 14.9%, respectively. And the incidence of HFMD showed a unimodal prevalence, with the peak occurring in June in 2019 as well as in October in 2020. The high incidence was mainly in central and western Hunan (like Changsha City, Xiangxi Autonomous Prefecture and Xiangtan City). The main population of the disease was scattered children under 5 years old, and the ratio of male to female was 1.27:1. A total of 276 clusters of HFMD cases were reported in Hunan Province in 2020, which showed an increase of 64.3% compared with 168 cases in 2019. A total of 444 clusters of HFMD cases were reported during 2019-2020, of which 200 (44.9%) cases occurred in child-care institutions, and 244 (55.1%) cases in communities. A total of 12,398 HFMD specimens were collected, among which 7,222 were positive, with a total positive rate of 58.2%. The composition of pathogens in the positive samples was as follows: 39 samples with EV71 (0.5%), 874 with CVA16 (12.1%) and 6,306 with other enteroviruses (87.3%). Among thesamples detected withother enteroviruses, there were 159 (2.5%) samples tested positive for CA6, 14 (0.2%) for CA10, 10 (0.2%) for CA4, and 6,123 (97.1%) for untyped enteroviruses, which became the dominant type in Hunan Province in 2019-2020. There were statisticallysignificant differences in the composition of pathogens from HFMD in different years (χ2=486.38, P<0.001), regions (χ2=229.89, P<0.001) and ages (χ2=128.44, P<0.001). But no statistically significant difference was found in the composition of pathogens among different type cases of HFMD between 2019 and 2020(χ2=4.56,P>0.05;χ2=2.36,P>0.05). Conclusion The prevalence of HFMD in Hunan Province in 2019-2020 showed obvious seasonal and regional characteristics. Children under 5 years old were the key population for HFMD prevention and control. Other enteroviruses became the dominant pathogen. It is crucial to strengthen health education and pathogen monitoring of scattered children, and take control of the changes of HFMD pathogen in time.
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