Epidemiological Characteristics of Hand, Foot, and Mouth Dis-ease Outbreaks in Qingdao, 2009-2018
Background: In China, hand, foot, and mouth disease (HFMD) outbreaks have become an important issue recent years. We analyzed the epidemiological characteristics of HFMD outbreaks in Qingdao during 2009-2018, and provided evidences for prevention and control of the disease.
Methods: Data were analyzed by descriptive analysis and correlation analysis, and throat swabs were detected for enterovirus RNA using RT-PCR.
Results: Overall, 116 HFMD outbreaks were reported in Qingdao during 2009-2018, with the epidemic of the outbreaks exhibiting a decreasing tendency. The characteristics of outbreaks presented two patterns, including two-peak pattern and rural area to urban-rural fringe area to urban areas pattern. Male patients were predominant in these outbreaks. The location of the outbreaks changed from nursery to community. Non-EV71/CA16 enteroviruses were gradually becoming predominant enteroviruses serotypes. The durations of outbreaks were positively correlated with response times and the number of cases.
Conclusion: The epidemiological characteristics analysis of HFMD outbreaks could provide a scientific basis for the prevention and control the disease. Reporting and handling promptly are the keys to control epidemic outbreaks of HFMD.
2. Gopalkrishna V, Patil PR, Patil GP, et al (2012). Circulation of multiple enterovirus serotypes causing hand, foot and mouth disease in Indian. J Med Microbiol, 61(Pt 3):420-425.
3. Solomon T, Lewthwaite P, Perera D, et al (2010). Virology, epidemiology, patho-genesis, and control of enterovirus 71. Lancet Infect Dis, 10(11): 778-90.
4. Ooi MH, Wong SC, Lewthwaite P, et al (2010). Clinical features, diagnosis, and management of enterovirus 71. Lancet Neurol, 9(11): 1097-105.
5. Sabanathan S, Tan le V, Thwaites L, et al (2014). Enterovirus 71 related severe hand, foot and mouth disease outbreaks in South-East Asia: current situation and ongoing challenges. J Epidemiol Community Health, 68(6): 500-2.
6. Ooi, EE, Phoon, MC, Ishak B, et al (2002). Seroepidemiology of human enterovirus 71, Singapore. Emerg Infect Dis, 8(9):995-997.
7. Duff MF (1968). Hand-foot-and-mouth synodrome in humans:coxackie A10 in-fections in New Zealand. Br Med J, 2(5606): 661-664.
8. Blomberg J, Lycke E, Ahlfors K, et al (1974). New enterovirus type associated with epidemic of aseptic meningitis and-or hand, foot, and mouth disease. Lancet, 2(7872): 112.
9. Tagaya I, Takayama R, Hagiware A (1981). A large-scale epidemic of hand, foot, and mouth disease associated with enterovi-rus 71 infection in Japan in 1978. Jpn J Med Sci Biol, 34(3):191-6.
10. Samuda GM, Chang WK, Yeung CY, et al (1987). Monoplegia caused by Enterovi-rus 71: an outbreak in Hong Kong. Pedi-atr Infect Dis J, 6(2): 206-8.
11. Ma E, Lam T, Chan KC, et al (2010). Changing Epidemiology of hand, foot and mouth disease in Hong Kong, 2001-2009.Jpn J Infect Dis, 63(6):422-6.
12. Hosoya M, Kawasaki Y, Sato M, et al (2006). Genetic diversity of enterovirus 71 asso-ciated with hand, foot and mouth disease epidemic in Japan from 1983 to 2003. Pe-diatr Infect Dis J, 25(8): 691-4.
13. Xing W, Liao Q, Viboud C, et al (2014). Hand, foot, and mouth disease in China, 2008-12: an epidemiological study. Lancet Infect Dis, 14(4): 308-319.
14. Fujimoto T, Chikahira M, Yoshida S, et al (2002). Outbreak of central nervous sys-tem disease associated with hand, foot, and mouth disease in Japan during the summer of 2000: detection and molecular epidemiology of enterovirus 71. Microbiol Immunol, 46(9), 621-7.
15. Van TP, Thao NTT, Perera D, et al (2007). Epidemiologic and virologic investigation of hand, foot, and mouth disease, south-ern Vietnam. Emerg Infect Dis, 13(11): 1733–1741.
16. Wu Y, Yeo A, Poon MC, et al (2010). The largest outbreak of hand, foot and mouth disease in Singapore in 2008: the role of enterovirus 71 and coxsackievirus A strains. Int J Infect Dis, 14(12): e1076-81.
17. Zhang Y, Tan XJ, Wang HY, et al (2009). An outbreak of hand, foot, and mouth disease associated with subgenotype C4 of human enterovirus 71 in Shandong , China. J Clin Virol, 44(4):262-7.
18. Zhang Y, Zhu Z, Yang W, et al (2010). An emerging recombinant human enterovi-rus 71 responsible for the 2008 outbreak of hand, foot and mouth disease in Fuyang city of China. Virol J, 7: 94.
19. Chinese Center For Disease Control And Prevention. The health topics. Infectious diseases. Hand, foot, and mouth dis-ease(HFMD). Available at http://www.chinacdc.cn/jkzt/crb/bl/szkb/jszl_2275/
20. Li Z, Xu HR, Cheng HQ, et al (2013). Epi-demiological analysis of hand-foot-mouth disease clustering among Jinan kindergartens in 2012. Chin J Sch Health, 34(7): 851-3. Chinese.
21. Zhou JH, Zhang Y, Qiu S, et al (2017). Epi-demiological and etiological characteristics of hand foot and mouth disease in Jiax-ing, 2011-2015. Chin Rural Health Service Administration, 37(8): 938-41. Chinese.
22. Dai WJ, Yi QH, Luo F, et al (2016). Epide-miological and etiological characteristics of hand foot and mouth disease in Tai-zhou, 2011-2014. Modern Prevent Med, 43(9): 15502. Chinese.
23. Zhao SL, Luo KW, Hu SX, et al (2016). Ep-idemiological characteristics of hand foot and mouth disease outbreaks in Hunan Province, 2008-2015. Chin Tropical Med, 16(9): 890-1. Chinese.
24. Guo C, Yang J, Guo Y, et al (2016). Short-term effects of meteorological factors on pediatric hand, foot, and mouth disease in Guangdong, China: a multi-city time-series analysis. BMC Infectious Diseases, 16(1): 524.
25. Zhang Z, Xie X, Chen X, et al (2016). Short-term effects of meteorological fac-tors on hand, foot and mouth disease among children in Shenzhen, China: Non-linearity, threshold and interaction. Sci Total Environ, 539: 576-582.
26. Li M, Zhao Y, Duan K, et al (2012). Epide-miological characteristics of clustering cases of hand, foot and mouth disease in child care settings in Licheng, Jinan, 2011. Disease Surveillance, 27(7): 524-526.
27. Jiang YC, Wei L, Xia Y, et al (2017). Epide-miology and etiology of hand, foot and mouth disease outbreaks in Changning, 2011-2015. Dis Surveillance, 32(7): 568-70. Chinese.
28. Wang J, Hu T, Sun D, et al (2017). Epidemi-ological characteristics of hand, foot, and mouth disease in Shandong, China, 2009-2016. Sci Rep, 7(1): 8900.
29. Wang J, Cao Z, Zeng DD, et al (2014). Epi-demiological analysis, detection, and comparison of space-time patterns of Beijing hand-foot-mouth disease (2008-2012). PLoS One, 9(3): e92745.
30. Wang XF, Lu J, Liu XX, et al (2018). Epi-demiological features of hand, foot and mouth disease outbreaks among Chinese Preschool Children: a Meta-analysis. Iran J Pubic Health, 47(9): 1234–1243.
31. Chen KT, Chang HL, Wang ST, et al (2007). Epidemiologic features of hand-foot-mouth disease and herpangina caused by enterovirus 71 in Taiwan, 1998-2005. Pe-diatrics, 120(2): e244-52.
32. Mao LX, Wu B, Bao WX, et al (2010). Epi-demiology of hand, foot, and mouth dis-ease and genotype characterization of Enterovirus 71 in Jiangsu, China. Journal of Clinical Virology, 49(2): 100-104.
33. Mao LX, Fu XM, Wu J et al (2018). The dy-namics of the hand, foot and mouth dis-ease epidemic from 2008 to 2016 in Zhenjiang city, China. Future Microbiol, 13:1029-1040.
34. Kar BR, Dwibedi B, Kar SK (2013). An out-break of hand, foot and mouth disease in Bhubaneswar, Odisha. Indian Pediatr, 50(1): 139-42.
35. Li J, Zhu R, Huo D et al (2018). An out-break of Coxsackievirus A6-associated hand, foot, and mouth disease in a kin-dergarten in Beijing in 2015. BMC Pediatr, 18(1): 277.
36. Wang G, Liu Y, Luo S et al (2010). Epide-miological investigation of an outbreak of hand foot and mouth disease in a kin-dergarten in Shenzhen, Guangdong. Chi-na Heal Mon, 29(2): 82-3. Chinese.
37. Anh NT, Nhu LNT, Van HMT, et al (2018). Emerging Coxsackievirus A6 causing hand, foot and mouth disease, Vietnam. Emerg Infect Dis, 24(4): 654-662.
|Issue||Vol 50 No 5 (2021)|
|Hand Foot Mouth disease Outbreak Epidemiology|
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