1887
  1. Home
  2. Eurosurveillance
  3. Volume 22, Issue 50, 14/Dec/2017
  4. Article
Research article Open Access
Like 0
Download

Abstract

Introduction

Hand, foot and mouth disease (HFMD) is usually caused by several serotypes from human enterovirus A species, including enterovirus 71 (EV-A71) and coxsackievirus A16 (CV-A16). Two inactivated monovalent EV-A71 vaccines have been recently licensed in China and monovalent CV-A16 vaccine and bivalent EV-A71 and CV-A16 vaccine are under development. : Using notifications from the national surveillance system, we describe the epidemiology and dynamics of HFMD in the country, before the introduction of EV-A71 vaccination, from 2008 through 2015. Laboratory-identified serotype categories, i.e. CV-A16, EV-A71 and other enteroviruses, circulated annually. EV-A71 remained the most virulent serotype and was the major serotype for fatal cases (range: 88.5–95.4%) and severe cases (range: 50.7–82.3%) across years. Except for 2013 and 2015, when other enteroviruses were more frequently found in mild HFMD (48.8% and 52.5%), EV-A71 was more frequently detected from mild cases in the rest of the years covered by the study (range: 39.4–52.6%). The incidence rates and severity risks of HFMD associated with all serotype categories were the highest for children aged 1 year and younger, and decreased with increasing age. : This study provides baseline epidemiology for evaluation of vaccine impact and potential serotype replacement.

© Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Loading

Article metrics loading...

/content/10.2807/1560-7917.ES.2017.22.50.16-00824
2017-12-14
2024-12-22
/content/10.2807/1560-7917.ES.2017.22.50.16-00824
Loading
Loading full text...

Full text loading...

/deliver/fulltext/eurosurveillance/22/50/eurosurv-22-50-6.html?itemId=/content/10.2807/1560-7917.ES.2017.22.50.16-00824&mimeType=html&fmt=ahah

References

  1. Xing W, Liao Q, Viboud C, Zhang J, Sun J, Wu JT, et al. Hand, foot, and mouth disease in China, 2008-12: an epidemiological study. Lancet Infect Dis. 2014;14(4):308-18.  https://doi.org/10.1016/S1473-3099(13)70342-6  PMID: 24485991 
  2. Solomon T, Lewthwaite P, Perera D, Cardosa MJ, McMinn P, Ooi MH. Virology, epidemiology, pathogenesis, and control of enterovirus 71. Lancet Infect Dis. 2010;10(11):778-90.  https://doi.org/10.1016/S1473-3099(10)70194-8  PMID: 20961813 
  3. International Committee on Taxonomy of Viruses. ICTV Virus Taxonomy 2015.2015. [Accessed 30 Oct 2016]. Available from: http://ictvonline.org/virusTaxonomy.asp
  4. European Centre for Disease Prevention and Control (ECDC). Outbreak of enterovirus A71 with severe neurological symptoms among children in Catalonia, Spain 14 June 2016. Stockholm: ECDC; 2016.
  5. Antona D, Kossorotoff M, Schuffenecker I, Mirand A, Leruez-Ville M, Bassi C, et al. Severe paediatric conditions linked with EV-A71 and EV-D68, France, May to October 2016. Euro Surveill. 2016;21(46):30402.  https://doi.org/10.2807/1560-7917.ES.2016.21.46.30402  PMID: 27918268 
  6. Hongyan G, Chengjie M, Qiaozhi Y, Wenhao H, Juan L, Lin P, et al. Hand, foot and mouth disease caused by coxsackievirus A6, Beijing, 2013. Pediatr Infect Dis J. 2014;33(12):1302-3.  https://doi.org/10.1097/INF.0000000000000467  PMID: 25037037 
  7. Blomqvist S, Klemola P, Kaijalainen S, Paananen A, Simonen ML, Vuorinen T, et al. Co-circulation of coxsackieviruses A6 and A10 in hand, foot and mouth disease outbreak in Finland. J Clin Virol. 2010;48(1):49-54.  https://doi.org/10.1016/j.jcv.2010.02.002  PMID: 20189452 
  8. Han JF, Xu S, Zhang Y, Zhu SY, Wu DL, Yang XD, et al. Hand, foot, and mouth disease outbreak caused by coxsackievirus A6, China, 2013. J Infect. 2014;69(3):303-5.  https://doi.org/10.1016/j.jinf.2014.03.015  PMID: 24704297 
  9. China Food and Drug Administration. Announcement on licensed drugs approved by China Food and Drug Administration (No. 4 in 2016).2016. [Accessed 21 Mar 2016]. Available from: http://www.sfda.gov.cn/WS01/CL0087/142000.html
  10. Zhu F, Xu W, Xia J, Liang Z, Liu Y, Zhang X, et al. Efficacy, safety, and immunogenicity of an enterovirus 71 vaccine in China. N Engl J Med. 2014;370(9):818-28.  https://doi.org/10.1056/NEJMoa1304923  PMID: 24571754 
  11. Li R, Liu L, Mo Z, Wang X, Xia J, Liang Z, et al. An inactivated enterovirus 71 vaccine in healthy children. N Engl J Med. 2014;370(9):829-37.  https://doi.org/10.1056/NEJMoa1303224  PMID: 24571755 
  12. Li B. The State Council report on implementation of communicable disease control and the Communicable Disease Prevention Act.2013. [Accessed 25 Nov 2015]. Available from: http://www.npc.gov.cn/npc/xinwen/2013-08/28/content_1804522.htm
  13. Wang Y, Feng Z, Yang Y, Self S, Gao Y, Longini IM, et al. Hand, foot, and mouth disease in China: patterns of spread and transmissibility. Epidemiology. 2011;22(6):781-92.  https://doi.org/10.1097/EDE.0b013e318231d67a  PMID: 21968769 
  14. Grenfell BT, Bjørnstad ON, Kappey J. Travelling waves and spatial hierarchies in measles epidemics. Nature. 2001;414(6865):716-23.  https://doi.org/10.1038/414716a  PMID: 11742391 
  15. Torrence C, Compo GP. A practical guide to wavelet analysis. Bull Am Meteorol Soc. 1998;79(1):61-78.  https://doi.org/10.1175/1520-0477(1998)079<0061:APGTWA>2.0.CO;2 
  16. Takahashi S, Liao Q, Van Boeckel TP, Xing W, Sun J, Hsiao VY, et al. Hand, foot, and mouth disease in China: modeling epidemic dynamics of enterovirus serotypes and implications for vaccination. PLoS Med. 2016;13(2):e1001958.  https://doi.org/10.1371/journal.pmed.1001958  PMID: 26882540 
  17. Yang F, Yuan J, Wang X, Li J, Du J, Su H, et al. Severe hand, foot, and mouth disease and coxsackievirus A6-Shenzhen, China. Clin Infect Dis. 2014;59(10):1504-5.  https://doi.org/10.1093/cid/ciu624  PMID: 25091307 
  18. Li JL, Yuan J, Yang F, Wu ZQ, Hu YF, Xue Y, et al. Epidemic characteristics of hand, foot, and mouth disease in southern China, 2013: coxsackievirus A6 has emerged as the predominant causative agent. J Infect. 2014;69(3):299-303.  https://doi.org/10.1016/j.jinf.2014.04.001  PMID: 24731881 
  19. Lu J, Zeng H, Zheng H, Yi L, Guo X, Liu L, et al. Hand, foot and mouth disease in Guangdong, China, in 2013: new trends in the continuing epidemic. Clin Microbiol Infect. 2014;20(7):O442-5.  https://doi.org/10.1111/1469-0691.12468  PMID: 24428125 
  20. Guo WP, Lin XD, Chen YP, Liu Q, Wang W, Wang CQ, et al. Fourteen types of co-circulating recombinant enterovirus were associated with hand, foot, and mouth disease in children from Wenzhou, China. J Clin Virol. 2015;70:29-38.  https://doi.org/10.1016/j.jcv.2015.06.093  PMID: 26305816 
  21. Tan X, Li L, Zhang B, Jorba J, Su X, Ji T, et al. Molecular epidemiology of coxsackievirus A6 associated with outbreaks of hand, foot, and mouth disease in Tianjin, China, in 2013. Arch Virol. 2015;160(4):1097-104.  https://doi.org/10.1007/s00705-015-2340-3  PMID: 25680566 
  22. Zhang C, Zhu R, Yang Y, Chi Y, Yin J, Tang X, et al. Phylogenetic analysis of the major causative agents of hand, foot and mouth disease in Suzhou City, Jiangsu province, China, in 2012-2013. Emerg Microbes Infect. 2015;4(2):e12.  https://doi.org/10.1038/emi.2015.12  PMID: 26038764 
  23. Li J, Sun Y, Du Y, Yan Y, Huo D, Liu Y, et al. Characterization of coxsackievirus A6- and enterovirus 71-associated hand foot and mouth Disease in Beijing, China, from 2013 to 2015. Front Microbiol. 2016;7:391. PMID: 27065963 
  24. Liu Y, Fu C, Wu S, Chen X, Shi Y, Zhou B, et al. A novel finding for enterovirus virulence from the capsid protein VP1 of EV71 circulating in mainland China. Virus Genes. 2014;48(2):260-72.  https://doi.org/10.1007/s11262-014-1035-2  PMID: 24442718 
  25. Zhang Y, Tan X, Cui A, Mao N, Xu S, Zhu Z, et al. Complete genome analysis of the C4 subgenotype strains of enterovirus 71: predominant recombination C4 viruses persistently circulating in China for 14 years. PLoS One. 2013;8(2):e56341.  https://doi.org/10.1371/journal.pone.0056341  PMID: 23441179 
  26. Ooi MH, Wong SC, Podin Y, Akin W, del Sel S, Mohan A, et al. Human enterovirus 71 disease in Sarawak, Malaysia: a prospective clinical, virological, and molecular epidemiological study. Clin Infect Dis. 2007;44(5):646-56.  https://doi.org/10.1086/511073  PMID: 17278054 
  27. Zeng H, Lu J, Zheng H, Yi L, Guo X, Liu L, et al. The epidemiological study of coxsackievirus A6 revealing hand, foot and mouth disease epidemic patterns in Guangdong, China. Sci Rep. 2015;5(1):10550.  https://doi.org/10.1038/srep10550  PMID: 25993899 
  28. Yang B, Wu P, Wu JT, Lau EH, Leung GM, Yu H, et al. Seroprevalence of enterovirus 71 antibody among children in China: a systematic review and meta-analysis. Pediatr Infect Dis J. 2015;34(12):1399-406.  https://doi.org/10.1097/INF.0000000000000900  PMID: 26368058 
  29. Zhao YY, Jin H, Zhang XF, Wang B. Case-fatality of hand, foot and mouth disease associated with EV71: a systematic review and meta-analysis. Epidemiol Infect. 2015;143(14):3094-102.  https://doi.org/10.1017/S095026881500028X  PMID: 25721492 
  30. Wu JT, Jit M, Zheng Y, Leung K, Xing W, Yang J, et al. Routine pediatric enterovirus 71 vaccination in China: a cost-effectiveness analysis. PLoS Med. 2016;13(3):e1001975.  https://doi.org/10.1371/journal.pmed.1001975  PMID: 26978565 
Epidemiology of hand, foot and mouth disease in China, 2008 to 2015 prior to the introduction of EV-A71 vaccine
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Bingyi+Yang&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Yang Bingyi</a>, <a href="/search?value1=Fengfeng+Liu&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Liu Fengfeng</a>, <a href="/search?value1=Qiaohong+Liao&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Liao Qiaohong</a>, <a href="/search?value1=Peng+Wu&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Wu Peng</a>, <a href="/search?value1=Zhaorui+Chang&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Chang Zhaorui</a>, <a href="/search?value1=Jiao+Huang&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Huang Jiao</a>, <a href="/search?value1=Lu+Long&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Long Lu</a>, <a href="/search?value1=Li+Luo&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Luo Li</a>, <a href="/search?value1=Yu+Li&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Li Yu</a>, <a href="/search?value1=Gabriel+M.+Leung&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Leung Gabriel M.</a>, <a href="/search?value1=Benjamin+J.+Cowling&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Cowling Benjamin J.</a>, <a href="/search?value1=Hongjie+Yu&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Yu Hongjie</a></span>. Epidemiology of hand, foot and mouth disease in China, 2008 to 2015 prior to the introduction of EV-A71 vaccine. <a href="/content/ecdc">Euro Surveill.</a> 2017;22(50):pii=16-00824. <a href="https://doi.org/10.2807/1560-7917.ES.2017.22.50.16-00824" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2017.22.50.16-00824</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 22 Dec 2016;&nbsp;&nbsp; <span class="generated">Accepted</span>: 09 Jun 2017 </span> </p>
/content/10.2807/1560-7917.ES.2017.22.50.16-00824
/content/10.2807/1560-7917.ES.2017.22.50.16-00824
Loading

Data & Media loading...

Submit comment
Close
Comment moderation successfully completed
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error