Molecular Epidemiology and Clinical Characteristics of Hand, Foot and Mouth Disease in North Sichuan Region, China, 2018-2023: A Descriptive Study — Oak Academic Publishing
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Molecular Epidemiology and Clinical Characteristics of Hand, Foot and Mouth Disease in North Sichuan Region, China, 2018-2023: A Descriptive Study
Department of Pediatrics, Guangyuan Central Hospital, Guangyuan, China
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Department of Clinical Laboratory, Guangyuan Central Hospital, Guangyuan, China
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Department of Dermatology, Guangyuan Central Hospital, Guangyuan, China
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Precision Medical Centre, Guangyuan Central Hospital, North Sichuan Regional Medical Centre, Guangyuan, China
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Precision Medical Centre, Guangyuan Central Hospital, North Sichuan Regional Medical Centre, Guangyuan, China
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Department of Pulmonary and Critical Care Medicine, Guangyuan Central Hospital, Guangyuan, China
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Department of Pulmonary and Critical Care Medicine, Guangyuan Central Hospital, Guangyuan, China
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Precision Medical Centre, Guangyuan Central Hospital, North Sichuan Regional Medical Centre, Guangyuan, China
,
Precision Medical Centre, Guangyuan Central Hospital, North Sichuan Regional Medical Centre, Guangyuan, China
1 Department of Pediatrics, Guangyuan Central Hospital, Guangyuan, China
2 Department of Clinical Laboratory, Guangyuan Central Hospital, Guangyuan, China
3 Department of Dermatology, Guangyuan Central Hospital, Guangyuan, China
4 Precision Medical Centre, Guangyuan Central Hospital, North Sichuan Regional Medical Centre, Guangyuan, China
5 Precision Medical Centre, Guangyuan Central Hospital, North Sichuan Regional Medical Centre, Guangyuan, China
6 Department of Pulmonary and Critical Care Medicine, Guangyuan Central Hospital, Guangyuan, China
7 Department of Pulmonary and Critical Care Medicine, Guangyuan Central Hospital, Guangyuan, China
8 Precision Medical Centre, Guangyuan Central Hospital, North Sichuan Regional Medical Centre, Guangyuan, China
9 Precision Medical Centre, Guangyuan Central Hospital, North Sichuan Regional Medical Centre, Guangyuan, China
Background : Hand, foot and mouth disease (HFMD) remains an important public health problem in China. Many studies on the epidemiological characteristics of HFMD have been reported, but studies in North Sichuan region have been neglected. Methods : HFMD-related enterovirus infected cases were clinically confirmed and underwent real-time RT-PCR (rRT-PCR) from May 2018 to October 2023 in Guangyuan Central Hospital. Results : During 2018-2023, other EV (437 cases, 81.08%) was the most predominant serotype followed by CV-A16 (94 cases, 17.44%), EV-A71 (8 cases, 1.48%) was the least predominant serotype. Peak infections occurred in July and October. There were no significant differences in gender, age and serotypes. HFMD was concentrated in children under 47 months of age, with the highest incidence in children aged 12 - 23 months and the highest proportion of other EV infections in the whole age group. COVID-19 did not cause significant changes in gender, age and serotype. Overall, there was a significant increase in the proportion of children aged 12 - 23 months infected with CV-A16, and an increase in the proportion of children aged over 36 months infected with other EVs. Conclusions : The incidence of HFMD caused by EV-A71 has decreased significantly, and other EVs have become the main pathogens of HFMD in North Sichuan region in recent years. In the prevention and control of CV-A16, more attention should be paid to children aged 12 - 23 months and the dominant serotype should be closely monitored. Our study highlights the importance of developing of new diagnostic reagents and vaccines for the prevention and control of enterovirus infection. This study for the first time provides insights into district interventions to local conditions.
Cox, B. and Levent, F. (2018) Hand, Foot, and Mouth Disease. JAMA , 320, 2492. https://doi.org/10.1001/jama.2018.17288
Zhu, P., Ji, W., Li, D., Li, Z., Chen, Y., Dai, B., et al. (2023) Current Status of Hand-Foot-and-Mouth Disease. Journal of Biomedical Science , 30, Article No. 15. https://doi.org/10.1186/s12929-023-00908-4
Bubba, L., Broberg, E.K., Jasir, A., Simmonds, P., Harvala, H., Redlberger-Fritz, M., et al. (2020) Circulation of Non-polio Enteroviruses in 24 Eu and Eea Countries between 2015 and 2017: A Retrospective Surveillance Study. The Lancet Infectious Diseases , 20, 350-361. https://doi.org/10.1016/s1473-3099(19)30566-3
Phyu, W.K., Ong, K.C. and Wong, K.T. (2017) Modelling Person-to-Person Transmission in an Enterovirus A71 Orally Infected Hamster Model of Hand-Foot-and-Mouth Disease and Encephalomyelitis. Emerging Microbes & I n fections , 6, 1-9. https://doi.org/10.1038/emi.2017.49
Luo, Z., Su, R., Wang, W., Liang, Y., Zeng, X., Shereen, M.A., et al. (2019) Ev71 Infection Induces Neurodegeneration via Activating Tlr7 Signaling and Il-6 Production. PLOS Pathogens , 15, e1008142. https://doi.org/10.1371/journal.ppat.1008142
Gonzalez, G., Carr, M.J., Kobayashi, M., Hanaoka, N. and Fujimoto, T. (2019) Enterovirus-Associated Hand-Foot and Mouth Disease and Neurological Complications in Japan and the Rest of the World. International Journal of Mo lecular Sciences , 20, Article 5201. https://doi.org/10.3390/ijms20205201
Ang, P.Y., Chong, C.W.H. and Alonso, S. (2021) Viral Determinants That Drive Enterovirus-a71 Fitness and Virulence. Emerging Microbes & Infections , 10, 713-724. https://doi.org/10.1080/22221751.2021.1906754
Chavda, V.P., Patel, K. and Apostolopoulos, V. (2023) Tomato Flu Outbreak in India. The Lancet Respiratory Medicine , 11, E1-E2. https://doi.org/10.1016/s2213-2600(22)00300-9
Liu, Y., Wang, X., Pang, C., Yuan, Z., Li, H. and Xue, F. (2015) Spatio-temporal Analysis of the Relationship between Climate and Hand, Foot, and Mouth Disease in Shandong Province, China, 2008-2012. BMC Infectious Diseases , 15, Article No. 146. https://doi.org/10.1186/s12879-015-0901-4
Gui, J., Liu, Z., Zhang, T., Hua, Q., Jiang, Z., Chen, B., et al. (2015) Epidemiological Characteristics and Spatial-temporal Clusters of Hand, Foot, and Mouth Disease in Zhejiang Province, China, 2008-2012. PLOS ONE , 10, e0139109. https://doi.org/10.1371/journal.pone.0139109
Han, Y., Ji, H., Shen, W., Duan, C., Cui, T., Chen, L., et al. (2022) Disease Burden in Patients with Severe Hand, Foot, and Mouth Disease in Jiangsu Province: A Crosssectional Study. Human Vaccines & Immunotherapeutics , 18, Article ID: 2049168. https://doi.org/10.1080/21645515.2022.2049168
Head, J.R., Collender, P.A., Lewnard, J.A., Skaff, N.K., Li, L., Cheng, Q., et al. (2019) 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. Clinical Infectious Disea ses , 71, 3088-3095. https://doi.org/10.1093/cid/ciz1188
Takahashi, S., Liao, Q., Van Boeckel, T.P., Xing, W., Sun, J., Hsiao, V.Y., et al. (2016) Hand, Foot, and Mouth Disease in China: Modeling Epidemic Dynamics of Enterovirus Serotypes and Implications for Vaccination. PLOS Medicine , 13, e1001958. https://doi.org/10.1371/journal.pmed.1001958
Kimmis, B.D., Downing, C. and Tyring, S. (2018) Hand-Foot-and-Mouth Disease Caused by Cox-Sackievirus A6 on the Rise. Cutis , 102, 353-356.
Chen, Y., Xiao, Y., Ye, Y., Jiang, F., He, H., Luo, L., et al. (2022) Immunogenicity and Safety of an Inactivated Enterovirus 71 Vaccine Coadministered with Trivalent Split-Virion Inactivated Influenza Vaccine: A Phase 4, Multicenter, Randomized, Controlled Trial in China. Frontiers in Immunology , 13, Article 1080408. https://doi.org/10.3389/fimmu.2022.1080408
He, X., Zhang, M., Zhao, C., Zheng, P., Zhang, X. and Xu, J. (2020) From Monovalent to Multivalent Vaccines, the Exploration for Potential Preventive Strategies against Hand, Foot, and Mouth Disease (HFMD). Virologica Sinica , 36, 167-175. https://doi.org/10.1007/s12250-020-00294-3
Yi, E., Kim, Y., Song, J., Ko, H., Ahn, S.H., Lee, H.J., et al. (2023) Potential of a Bivalent Vaccine for Broad Protection against Enterovirus 71 and Coxsackie Virus 16 Infections Causing Hand, Foot, and Mouth Disease. Vaccine , 41, 6055-6063. https://doi.org/10.1016/j.vaccine.2023.08.029
Xia, F., Deng, F., Tian, H., He, W., Xiao, Y. and Sun, X. (2020) Estimation of the Reproduction Number and Identification of Periodicity for HFMD Infections in Northwest China. Journal of Theoretical Biology , 484, Article ID: 110027. https://doi.org/10.1016/j.jtbi.2019.110027
Li, X., Ni, X., Qian, S., Wang, Q., Jiang, R., Xu, W., et al. (2018) Chinese Guidelines for the Diagnosis and Treatment of Hand, Foot and Mouth Disease (2018 Edition). World Journal of Pediatrics , 14, 437-447. https://doi.org/10.1007/s12519-018-0189-8
Song, S., Wang, P., Li, J., Nie, X., Liu, L., Liu, S., et al. (2022) The Indirect Impact of Control Measures in Covid-19 Pandemic on the Incidence of Other Infectious Diseases in China. Public Health in Practice , 4, Article ID: 100278. https://doi.org/10.1016/j.puhip.2022.100278
Paiva, R., Martins, C., Rodrigues, F. and Domingues, M. (2021) Impact of Covid-19 on a Paediatric Emergency Service. European Journal of Pediatrics , 180, 2571-2579. https://doi.org/10.1007/s00431-021-04095-y
Muselli, M., Cofini, V., Mammarella, L., Carmignani, C., Fabiani, L., Desideri, G. and Necozione, S. (2022) The Impact of COVID-19 Pandemic on Emergency Services. Annali di igiene : Medicina preventiva e di comunita , 34, 248-258.
Yang, Q., Liu, F., Chang, L., Lai, S., Teng, J., Duan, J., et al. (2023) Molecular Epidemiology and Clinical Characteristics of Enteroviruses Associated HFMD in Chengdu, China, 2013-2022. Virology Journal , 20, Article No. 202. https://doi.org/10.1186/s12985-023-02169-x
Li, Y., Zhou, Y., Cheng, Y., Wu, P., Zhou, C., Cui, P., et al. (2019) Effectiveness of EV-A71 Vaccination in Prevention of Paediatric Hand, Foot, and Mouth Disease Associated with EV-A71 Virus Infection Requiring Hospitalisation in Henan, China, 2017-18: A Test-negative Case-control Study. The Lancet Child & Adolescent Health , 3, 697-704. https://doi.org/10.1016/s2352-4642(19)30185-3
Peng, Y., He, W., Zheng, Z., Pan, P., Ju, Y., Lu, Z., et al. (2023) Factors Related to the Mortality Risk of Severe Hand, Foot, and Mouth Diseases (HFMD): A 5-year Hospital-Based Survey in Guangxi, Southern China. BMC Infectious Diseases , 23, Article No. 144. https://doi.org/10.1186/s12879-023-08109-y
Han, Y., Chen, Z., Zheng, K., Li, X., Kong, J., Duan, X., et al. (2020) Epidemiology of Hand, Foot, and Mouth Disease before and after the Introduction of Enterovirus 71 Vaccines in Chengdu, China, 2009-2018. Pediatric Infectious Disease Journal , 39, 969-978. https://doi.org/10.1097/inf.0000000000002745
Peng, D., Ma, Y., Liu, Y., Lv, Q. and Yin, F. (2020) Epidemiological and Aetiological Characteristics of Hand, Foot, and Mouth Disease in Sichuan Province, China, 2011-2017. Scientific Reports , 10, Article No. 6117. https://doi.org/10.1038/s41598-020-63274-3
Li, C., Mao, J., Wu, Y., Zhang, B., Zhuang, X., Qin, G., et al. (2023) Combined Impacts of Environmental and Socioeconomic Covariates on HFMD Risk in China: A Spatiotemporal Heterogeneous Perspective. PLOS Neglected Tropical Diseases , 17, e0011286. https://doi.org/10.1371/journal.pntd.0011286
Zhang, W., Rui, J., Cheng, X., Deng, B., Zhang, H., Huang, L., et al. (2022) Transmissibility of Hand, Foot, and Mouth Disease in 97 Counties of China. Scientific Reports , 12, Article No. 4103. https://doi.org/10.1038/s41598-022-07982-y
Duan, C., Zhang, X., Jin, H., Cheng, X., Wang, D., Bao, C., et al. (2018) Meteorological Factors and Its Association with Hand, Foot and Mouth Disease in Southeast and East Asia Areas: A Meta-Analysis. Epidemiology and Infection , 147, e50. https://doi.org/10.1017/s0950268818003035
Liao, Y., He, Y., Lu, Y., Yang, H., Su, Y., Chiang, Y., et al. (2019) Relative Transmissibility of Hand, Foot and Mouth Disease from Male to Female Individuals. Epid e miology and Infection , 147, e284. https://doi.org/10.1017/s0950268819001729
Fong, S.Y., Mori, D., Rundi, C., Yap, J.F., Jikal, M., Latip, A.L.L.B.A., et al. (2021) A Five-Year Retrospective Study on the Epidemiology of Hand, Foot and Mouth Disease in Sabah, Malaysia. Scientific Reports , 11, Article No. 17814. https://doi.org/10.1038/s41598-021-96083-3
Li, P., Rui, J., Niu, Y., Xie, F., Wang, Y., Li, Z., et al. (2022) Analysis of HFMD Transmissibility among the Whole Population and Age Groups in a Large City of China. Frontiers in Public Health , 10, Article 850369. https://doi.org/10.3389/fpubh.2022.850369
Le, J., Hong, J., Zhao, Z., Chen, Y., Hu, Y., Chang, Z., et al. (2022) Age-Specific Transmission for Different Virus Serotypes of Hand, Foot and Mouth Disease and the Impact of Interventions in East China, 2009-2015. Heliyon , 8, e12042. https://doi.org/10.1016/j.heliyon.2022.e12042
Hong, J., Liu, F., Qi, H., Tu, W., Ward, M.P., Ren, M., et al. (2022) Changing Epidemiology of Hand, Foot, and Mouth Disease in China, 2013-2019: A Population-Based Study. The Lancet Regional Health — Western Pacific , 20, Article ID: 100370. https://doi.org/10.1016/j.lanwpc.2021.100370
Zhao, Z., Zheng, C., Qi, H., Chen, Y., Ward, M.P., Liu, F., et al. (2022) Impact of the Coronavirus Disease 2019 Interventions on the Incidence of Hand, Foot, and Mouth Disease in Mainland China. The Lancet Regional Health — Western Pacific , 20, Article ID: 100362. https://doi.org/10.1016/j.lanwpc.2021.100362
Yang, C., An, S., Qiao, B., Guan, P., Huang, D. and Wu, W. (2022) Exploring the Influence of COVID-19 on the Spread of Hand, Foot, and Mouth Disease with an Automatic Machine Learning Prediction Model. Environmental Science and Poll u tion Research , 30, 20369-20385. https://doi.org/10.1007/s11356-022-23643-z
Zhang, L., Yang, F., Zhu, Z., Zeng, W., Rong, Z., Hu, J., et al. (2024) Assessing the Impact of COVID-19 Interventions on the Hand, Foot and Mouth Disease in Guangdong Province, China: A Bayesian Modeling Study. Frontiers in Public Health , 11, Article 1307321. https://doi.org/10.3389/fpubh.2023.1307321
Duan, X., Zhang, C., Wang, X., Ren, X., Peng, H., Tang, X., et al. (2022) Molecular Epidemiology and Clinical Features of Hand, Foot and Mouth Disease Requiring Hospitalization after the Use of Enterovirus A71 Inactivated Vaccine in Chengdu, China, 2017-2022: A Descriptive Study. Emerging Microbes & Infections , 11, 2510-2519. https://doi.org/10.1080/22221751.2022.2125346