ABSTRACT
Objective:To investigate the epidemiological and etiological characteristics of hand-feet-mouth disease (HFMD) in Dali Bai Autonomous Prefecture and to provide scientific evidence for the prevention of HFMD.Methods:The HFMD cases during January 2015 to December 2019 in Dali Bai Autonomous Prefecture were collected through the Chinese Information System for Disease Control and Prevention. The demographic data, incidence rate of HFMD and epidemiological characteristics were analysed. Coxsackie virus A16(CoxA16), enterovirus 71(EV71) and other enterovirus nucleic acid in stool samples of HFMD patients were detected by real-time reverse transcription polymerase chain reaction. Chi-square test was used as statistical method.Results:From 2015 to 2019, 30 730 cases of HFMD were reported in Dali Bai Autonomous Prefecture. The annual incidence rate was 171.50/100 000, and the incidence rate was on rise from 2016 to 2019. There were 24(0.08%) severe cases. Yongping County, Binchuan County and Dali City were with the top three average annual incidence rate. The peak incidence was from June to July in summer, 9 168 cases (29.83%) were reported. The peak incidence was from September to October in autumn, 5 988 cases (19.49%) were reported. The epidemic intensity in summer was higher than that in autumn. Among 30 730 cases, there were 17 373 males and 13 357 females. The annual incidence rate of male patients was 120.29/100 000, and that of female was 75.83/100 000. The difference was statistically significant ( χ2=1 637.467, P<0.01). The highest incidence was in infancy (one to <three years old), followed by preschool stage (three to <six years old) and the incidence rate was 4 158.96/100 000 and 1 953.11/100 000, respectively. From infancy, the incidence decreased with age. Severe cases concentrated in infancy with a total of 16 cases, accounting for 66.67% of severe cases. The affected population was mainly scattered children, and a total of 20 516 cases (66.76%) were reported. Among the 1 294 laboratory confirmed cases, 792 (61.21%) were CoxA16 infected cases, 320 (24.73%) were EV71 infected cases, and 182(14.06%) were other enterovirus infected cases. Conclusions:The incidence of HFMD in Dali Bai Autonomous Prefecture has obvious seasonal, age and population characteristics. It is necessary to strengthen the cooperation among departments, health education and strict implementation of prevention and control measures in order to reduce the incidence and improve the ability of early identification and treatment of severe cases.
ABSTRACT
Objective:To analyze the etiological spatialtemporal distribution characteristics of coxsackievirus A16 (CoxA16) and enterovirus 71 (EV71) in children with hand, foot, and mouth disease (HFMD) in Dali Bai Autonomous Prefecture, and to provide references for its prevention and control.Methods:Real-time polymerase chain reaction(PCR) was used to detect the etiology of children with HFMD in Dali Bai Autonomous Prefecture from January 1, 2013 to December 31, 2018, including CoxA16 and EV71. Spatialtemporal correlation analysis of CoxA16 and EV71 were performed by ArcGIS 10 and SaTScanv 9.6 softwares.Results:Among 3 527 pathogen samples, EV71 was dominant with 12.0%(91/758) in 2013, 40.4%(180/446) in 2014, and 26.7%(155/581) in 2017. CoxA16 was the dominant pathogen with 29.9%(162/541) in 2015, 40.0%(219/547) in 2016, and 13.8%(90/654) in 2018. According to the pathogen detection data from 2013 to 2018, the detection rate of CoxA16 pathogen was higher than that of EV71 ( χ2=1 128.72, P<0.05). CoxA16 and EV71 were aggregated from summer to autumn. CoxA16 was presented with clustered distribution ( Moran′ s index=0.344, P<0.05), and the hot spots of CoxA16 were Xiangyun County ( Z=2.72, P<0.01) and Midu County ( Z=1.68, P<0.1). The radius radiates was 39.00 km from the center of Xiangyun County (log likelihood ratio ( LLR)=40.178, P<0.05). EV71 was presented with discretely distribution ( Moran′ s index=-0.194, P>0.05), and the hot spots of EV71 were Heqing County ( Z=2.14, P<0.05), Jianchuan County ( Z=1.76, P<0.1) and Dali City ( Z=1.71, P<0.1). The main gathering area was the radiation radius of 64.21 km centered of Eryuan County ( LLR=39.376, P<0.05). Conclusions:There are spatiotemporal aggregations of CoxA16 and EV71 in childhood cases with HFMD. The monitoring should be strengthened, and the disease should be scientifically prevented and controlled.