Research on Epidemiological Characteristics and Etiology of Hand, Foot and Mouth Disease in Jiangxi Province, China, 2009–2017

WANG Xiaowen1 SHI Yong1 LI Jianxiong1 GONG Tian1 XIONG Ying1

(1.Jiangxi Center for Disease Control and Prevention, Nanchang, China 330029)
【Novelty】This paper analyzes the epidemic characteristics of hand-foot-and-mouth disease (HFMD) in Jiangxi Province,China, from 2009 to 2017 in detail for the first time, and discusses its epidemic trend to provide scientific basis for the next prevention and control work. This paper analyzed the genotypes of enterovirus EV-A71 and coxsackie virus CV-A16,which were the pathogens of HFMD in Jiangxi Province from 2009 to 2017,for the first time,and analyzed the variation of the important pathogens from the perspective of molecular biology. The distribution of pathogens in the confirmed cases of HFMD in Jiangxi Province from 2009 to 2017 was analyzed in detail,and it was suggested that further typing and detection of other enteroviruses should be carried out to understand their pathogenic composition and prevent them early.

【Abstract】The epidemiological characteristics of hand, foot and mouth disease (HFMD) in Jiangxi Province, China, between 2009 and 2017 were analyzed and the epidemic trend was explored, so as to provide scientific basis for the prevention and treatment of HFMD. The genetic characteristics of enterovirus A71 (EV-A71) and coxsackievirus A16 (CV-A16) were analyzed. The HFMD epidemic data of Jiangxi Province were collected based on the China Disease Reporting Information System for descriptive epidemiological analysis from 2009 to 2017. There were 373 966 HFMD cases reported during this period in Jiangxi Province. The average annual incidence was 92.33/100 000. The incidence of HFMD showed obvious seasonal variation with peak seasons in summer and winter. The cases mainly occurred in children under 5 years old. The proportion of other enterovirus infections was increased, accounting for 44.10% of the cases diagnosed in the laboratory. Severe cases and death cases were mainly EV-A71 infection. The gene determination and analysis of 34 EV-A71 isolates from HFMD in Jiangxi Province showed that the EV-A71 isolates belong to the C4a evolutionary branch of the C4 gene subtype. Gene determination and analysis of VP1 coding region of 27 HFMD isolates in Jiangxi Province showed that the CV-A16 isolates belong to the B1 gene subtype. HFMD prevention and control work was focused on publicity and education for parents of small age group children. It is necessary to carry out the detection of other enteroviruses, understand the pathogen and conduct early prevention. It is necessary to speed up the use and promotion of enterovirus EV-A71 vaccine, so as to reduce the incidence of severe case of HFMD and death cases and the burden of disease.

【Keywords】 Hand, foot and mouth disease (HFMD) ; Epidemiological analysis; Other enteroviruses;

【DOI】

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    References

    [1] Ministry of Health of China. 手足口病预防控制指南 [S]. Beijing: Ministry of Health of China, 2009 (in Chinese).

    [2] Zhang Y, Tan X J, Wang H Y, Yan D M, Zhu S L, Wang D Y, Ji F, Wang X J, Gao Y J, Chen Y J, Chen L, An H Q, Li D X, Wang S W, Xu A Q, Wang Z J, Xu W B. An outbreak of hand, foot and mouth disease associated with subgenotype C4of human enterovirus 71in Shandong, China [J]. J Virol, 2009, 44 (4): 262–267.

    [3] Huang K Q, Zhang Y, Xu W B. Genotypic distribution of the globally emerging enterovirus type A71 [J]. Chinese Journal of Virology, 2017, 33 (3): 469–476 (in Chinese).

    [4] Zhang Y, Tan X J, Cui A L, Mao N Y, Xu S T, Zhu Z, Zhou J H, Shi J, Zhao Y P, Wang X J, Huang X Y, Zhu S L, Zhang Y, Tang W, Ling H, Xu W B. Complete genome analysis of the C4subgenotype strains of enterovirus 71: predominant recombination C4viruses persistently circulating in China for 14 years [J]. PLoS One, 2013, 8 (2): e56341.

    [5] Li J, Qu M, Jia L, Zhang X, Liu B W, Huang F, Li X Y, Wang Q Y. Etiological detection of severe hand-food-mouth disease and related genetic characteristics of enterovirus type 71 infection in Beijing, 2010 [J]. Chinese Journal of Epidemiology, 2012, 33 (9): 926–929 (in Chinese).

    [6] Cun J P, Yin J, Jiang L L, Zhou X F, Tian B J, Xu W, Fu X Q, Zhang Y. Genetic analysis on coxsackievirus A type 16 in Yunnan Province in 2012 [J]. Chinese Journal of Viral Diseases, 2016, 6 (3): 202–205 (in Chinese).

    [7] Qiao M K, Shi L M, Wang Y, Wang X, Yong W. Epidemiology and Etiology of Hand, Foot and Mouth Disease in Nanjing 2011 [J]. Medical Innovation of China,2013, 10 (1): 89–91 (in Chinese).

    [8] Li T, Yang Z, Di B, M Wang. Hand-foot-and-mouth disease andweather factors in guangzhou, southern China [J]. Epidemiology and Infection, 2014, 142 (8): 1741–1750.

    [9] Li J, Su C, Chen X N. Analysis of the HFMD laboratory test results in Tongchuan during 2010–2013 [J]. Chinese Journal of Health Laboratory Technology, 2015, 25 (5): 686–688 (in Chinese).

    [10] WHO. Report on the Hand, Foot and Mouth Disease Outbreak in Fuyang City, Anhui Province and the Prevention and Control in China [R/OL]. http://www.wpro.who.int/NR/rdonlyres/7578E706–51B4–479B-B11B.

    [11] Zhang X, Deng H, Zheng Y J. 2009–2012年新疆手足口病流行病学分析 [J]. Bulletin of Disease Control & Prevention (China) [J]. 2014, 29 (2): 67–69 (in Chinese).

    [12] Xiong Y, Gong T, Shi Y, Zhou J, Liu L P, Zeng Y W, Liu S W, Xiao F. Seroepidemiology investigation on HEV71 in the population in Nanchang in early 2010 [J]. Modern Preventive Medicine, 2013, 40 (1): 7–10 (in Chinese).

    [13] Liao Y X, Lu Y, Mei S J, Zhang Z, Liang H, Tang G X. 2009–2013年深圳市手足口病流行特征分析 [J]. Practical Preventive Medicine, 2015, 22 (1): 69–71 (in Chinese).

    [14] Zhao Q, Zhu J P. Prevalence and analyses of the changing etiology of hand, foot and mouth disease in China [J]. Chinese Journal of Virology, 2015, 31 (5): 554–559 (in Chinese).

    [15] Yang X H, Yan Y S. 手足口病的病原学研究进展 [J]. Infectious Disease Information, 2008, 21 (3): 129–131 (in Chinese).

    [16] Teng Z, Shao J J, Zhu Z K, Zhao B H, Chen M. 上海市手足口病常见病原体基因分析 [J]. Shanghai Journal of Preventive Medicine,2008, 20 (3): 483–484 (in Chinese).

    [17] Oberste M S, Maher K, Kilpatrick D R, Pallansch M A. Molecular evolution of the human enteroviruses: correlation of serotype with VP1sequence and application to picornavirus classification [J]. J Virol, 1999, 73 (3): 1941–1948.

    [18] Zhang Y, Wang J T, Guo W S, Wang H Y, Zhu S L, Wang D Y, Bai R Y, Li X L, Yan D M, Wang H L, Zhang Y, Zhu Z, Tan X J, An H Q, Xu A Q, Xu W B. Emergence and transmission pathways of rapidly evolving evolutionary branch C4 astrains of human enterovirus 71 in the central plain of China[J/OL]. PLoS One, 2011, 6 (11): e27895.

    [19] Perera D, Yusof M A, Podin Y, Ooi M H, Thao N T, Wong K K, Zaki A, Chua K B, Malik Y A, Tu P V, Tien N T, Puthavathana P, McMinn P C, Cardosa M J. Molecular phylogeny of modern coxsackievirus A16 [J]. Arch Virol, 2007, 152 (6): 1201–1208.

    [20] Huang Y, Zhou L, Chao G X, Rui M Z, Bi P P, Bu P. Pathogen spectrum of hand-foot-and-mouth disease and genetic characteristics of VP1 from coxsackievirus A16 in Yangzhou from 2010 to 2012 [J]. Modern Preventive Medicine, 2014, 41 (13): 2318–2322, 2329 (in Chinese).

    [21] Zhang J H, Jiang B F, Cheng X F, You X H, Meng J H. Genetic characterization of the capsid protein VP1 of enterovirus 71and coxsackievirus A16 strains [J]. Journal of Southeast University (Medical Science Edition), 2013, 32 (2): 173–179 (in Chinese).

This Article

ISSN:1000-8721

CN: 11-1865/R

Vol 34, No. 06, Pages 844-849

November 2018

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Novelty

Abstract

  • Materials and methods
  • Results
  • Discussion
  • References