ABSTRACT
Objective To estimate the serotype and age-specific hospitalization burden associated with hand,foot and mouth disease (HFMD) in Anhua county of Hunan province,between October 2013 and September 2016.Methods We collected hospitalization records of HFMD patients from 6 virological surveillance hospitals,and reimbursement records through new rural cooperative medical system from 23 township health centers to estimate the age-specific hospitalization burden of HFMD in Anhua.Combined with the results of virological surveillance,the serotype-specific hospitalization burden of HFMD in Anhua,was estimated.Results During the three years,it was estimated that 3 541 clinical diagnosed HFMD cases,including 3 146 laboratory-confirmed HFMD cases,were hospitalized in Anhua,but only one was diaguosed as being severe.The estimated average hospitalization rate was 723/100 000(95％C1:699/100 000-747/100 000) for clinical diagnosed HFMD and 642/100 000 (95％ CI:620/100 000-665/100 000) for laboratory-confirmed HFMD between October 2013 and September 2016.The cases caused by Cox A16 (208/100 000) and Cox A6 (202/100 000) had higher hospitalization rates compared with the cases caused by EV71 (130/100 000),Cox A10 (38/100 000) and other enterovirus (64/100 000),and the difference was statistically significant (P＜0.001).HFMD-associated hospitalization rates peaked in children aged 1 year (3 845/100 000),and then decreased with age.Compared with the hospitalized HFMD caused by EV71 and Cox A16,Cox A6-associated hospitalizations mainly occurred in younger age groups (P＜0.001).Conclusion Our study revealed a substantial hospitalization burden associated with mild HFMD caused by EV71,Cox A16,Cox A6 and Cox A10,especially in young children,in Anhua.
ABSTRACT
Objective@#To understand the characteristics relating to the etiology and complications of hand, foot and mouth disease (HFMD) based on data from the pilot National Sentinel Surveillance (NSS) program so as to explore the feasibility, advantages and disadvantages of the NSS.@*Methods@#Data were extracted from the NSS system, conducted in 11 provinces of China from November 2015 to October 2016. Characteristics regarding the etiology, complications of HFMD and factors related to the positive rates of HFMD specimens were analyzed under the logistic regression method by SPSS 20.0 software.@*Results@#A total of 4 783 specimens were collected, including 3 390 from mild, 1 390 from severe and 3 from death cases. The overall positive rate was 81.43% (3 895/4 783). Other enteroviruses (non EV71/Cox A16 enteroviruses) appeared the major serotype (52.68%, 1 482/2 813) for mild infection of the disease while EV71 was for the severe cases (65.31%, 706/1 081). The serotype spectrum revealed by the pilot NSS was almost identical with the existing surveillance system. Other enteroviruses tended to infect younger children (χ2=130.17, P<0.001) than EV71 and Cox A16, in China. The multivariate logistic regression results showed that higher positive rate was associated with specimens which were collected from males, at children’ hospitals, in peak seasons, timely and in stools. The positive rates presented downwarding trends with the extension of the onset-sampling interval (χ2=14.47, P<0.001 in stool specimen; χ2=31.99, P<0.001 in throat swab; χ2=24.26, P<0.001 in anal swab). Aseptic meningitis, non-brainstem encephalitis and brainstem encephalitis appeared the top three complications of both EV71-associated and other enteroviruses-associated severe HFMD cases.@*Conclusions@#Factors as gender, season/place/timeliness of specimen collection, and types of hospital all appeared independently influenced the positive rates. NSS seemed feasible to be used as an alternative or supplement tool to the existing surveillance program in China.
ABSTRACT
Objective To estimate the serotype and age-specific hospitalization burden associated with hand,foot and mouth disease (HFMD) in Anhua county of Hunan province,between October 2013 and September 2016.Methods We collected hospitalization records of HFMD patients from 6 virological surveillance hospitals,and reimbursement records through new rural cooperative medical system from 23 township health centers to estimate the age-specific hospitalization burden of HFMD in Anhua.Combined with the results of virological surveillance,the serotype-specific hospitalization burden of HFMD in Anhua,was estimated.Results During the three years,it was estimated that 3 541 clinical diagnosed HFMD cases,including 3 146 laboratory-confirmed HFMD cases,were hospitalized in Anhua,but only one was diaguosed as being severe.The estimated average hospitalization rate was 723/100 000(95％C1:699/100 000-747/100 000) for clinical diagnosed HFMD and 642/100 000 (95％ CI:620/100 000-665/100 000) for laboratory-confirmed HFMD between October 2013 and September 2016.The cases caused by Cox A16 (208/100 000) and Cox A6 (202/100 000) had higher hospitalization rates compared with the cases caused by EV71 (130/100 000),Cox A10 (38/100 000) and other enterovirus (64/100 000),and the difference was statistically significant (P＜0.001).HFMD-associated hospitalization rates peaked in children aged 1 year (3 845/100 000),and then decreased with age.Compared with the hospitalized HFMD caused by EV71 and Cox A16,Cox A6-associated hospitalizations mainly occurred in younger age groups (P＜0.001).Conclusion Our study revealed a substantial hospitalization burden associated with mild HFMD caused by EV71,Cox A16,Cox A6 and Cox A10,especially in young children,in Anhua.
ABSTRACT
Objective To understand the epidemiological and molecular characteristics of typhoid and paratyphoid in China from 2009 to 2013,and provide evidence for the prevention and control of typhoid and paratyphoid,the development and improvement of surveillance strategies.Methods Epidemiological analysis was conducted on the incidence data of typhoid and paratyphoid,and related public health emergencies in China during 2009-2013.Pathogen isolation and culture,serologic test were conducted for the typhoid and paratyphoid cases from 13 national surveillance sites.The isolates were subjected to antimicrobial susceptibility testing.Pulsed-field gel electrophoresis (PFGE) was performed for the molecular typing of these isolates.Results The average incidence of typhoid and paratyphoid in China during this period was 1.03/100 000.The reported case number and incidence decreased with year.The provinces reporting high case numbers were Yunnan,Guizhou,Guangxi,Hunan,Zhejiang,Guangdong and Xinjiang.The incidence of age group 0-4 years was highest.The proportion of farmers and children outside child care settings showed an increasing tendency over time.The annual incidence peak was during July-August.Twenty five outbreaks occurred during 2009-2013.The results of pathogen isolation and culture showed that the positive rate was 3.00％ (940/31 322),among the positive isolates,the proportion of Salmonella paratyphi A accounted for higher proportion (68.19％,641/940) compared with Salmonella typhi (31.60％,297/940).The drug resistances of Salmonella typhi and Salmonella paratyphi varied,but their resistances to nalidixic acid were highest (50.22％ and 85.33％) respectively.A certain amount of Salmonella typhi isolates showed the resistance to the 3rd generation cephalosporins.PFGE analysis showed divergent patterns of Salmonella typhi compared with limited patterns of Salmonella paratyphi A.Conclusion The epidemic level of typhoid and paratyphoid in China was relatively low,but the outbreak occurred occasionally.It is necessary to enhance the laboratory-based surveillance,particularly the capability of etiological diagnosis,outbreak investigation,response and antibiotic resistance monitoring,and conduct risk factor investigation in provinces with high incidences in recent years.
ABSTRACT
Objective To understand the epidemiological and molecular characteristics of typhoid and paratyphoid in China from 2009 to 2013,and provide evidence for the prevention and control of typhoid and paratyphoid,the development and improvement of surveillance strategies.Methods Epidemiological analysis was conducted on the incidence data of typhoid and paratyphoid,and related public health emergencies in China during 2009-2013.Pathogen isolation and culture,serologic test were conducted for the typhoid and paratyphoid cases from 13 national surveillance sites.The isolates were subjected to antimicrobial susceptibility testing.Pulsed-field gel electrophoresis (PFGE) was performed for the molecular typing of these isolates.Results The average incidence of typhoid and paratyphoid in China during this period was 1.03/100 000.The reported case number and incidence decreased with year.The provinces reporting high case numbers were Yunnan,Guizhou,Guangxi,Hunan,Zhejiang,Guangdong and Xinjiang.The incidence of age group 0-4 years was highest.The proportion of farmers and children outside child care settings showed an increasing tendency over time.The annual incidence peak was during July-August.Twenty five outbreaks occurred during 2009-2013.The results of pathogen isolation and culture showed that the positive rate was 3.00％ (940/31 322),among the positive isolates,the proportion of Salmonella paratyphi A accounted for higher proportion (68.19％,641/940) compared with Salmonella typhi (31.60％,297/940).The drug resistances of Salmonella typhi and Salmonella paratyphi varied,but their resistances to nalidixic acid were highest (50.22％ and 85.33％) respectively.A certain amount of Salmonella typhi isolates showed the resistance to the 3rd generation cephalosporins.PFGE analysis showed divergent patterns of Salmonella typhi compared with limited patterns of Salmonella paratyphi A.Conclusion The epidemic level of typhoid and paratyphoid in China was relatively low,but the outbreak occurred occasionally.It is necessary to enhance the laboratory-based surveillance,particularly the capability of etiological diagnosis,outbreak investigation,response and antibiotic resistance monitoring,and conduct risk factor investigation in provinces with high incidences in recent years.
ABSTRACT
Objective To investigate the clinical severity,etiological classification and risk factors of severe cases with hand,foot and mouth disease (HFMD).Methods A total of 1 489 records on severe and fatal HFMD cases reported to the national pilot surveillance system of HFMD were used to analyze the demographic,medical treatment,etiological classification of the cases.Treatment outcome related risk factors were also studied with multi-variable stepwise logistic regression method.Results Seven out of the 1 489 severe HFMD cases died of this disease.A total of 960 (72.9％) were under three years old and 62.9％ were male and most of the cases (937,62.9％) resided in rural areas.Among all the cases,494 (33.2％) went to seek the first medical assistance at the institutions of village or township level.Durations between disease onset and first medical attendance,being diagnosed as the disease or diagnosed as severe cases were 0(0-1) d,1 (0-2) d and 2 (1-4) d,respectively.In total,773 (51.9％) of the severe HFMD cases were diagnosed as with aseptic meningitis,260 (17.5％) with brainstem encephalitis,377 (25.3 ％) with non-brainstem encephalitis,6 (0.4％) with encephalomyelitis,1 (0.1％) with acute flaccid paralysis,4 (0.3％) with pulmonary hemorrhage/pulmonary edema and 68 (4.6％) with cardiopulmonary failure.Of the etiologically diagnosed 1 217 severe and fatal HFMD cases,642 (52.8％) were with EV71,other enterovirus 261 (21.5％),Cox A16 36 (3.0％),1 (0.1％) with both EV71 and Cox A16.However,277 (22.8％) showed negative on any pathogenic virus.Complication (Z=3.15,P=0.002) and duration between onset and diagnosed as severe cases (Z=3.95,P＜0.001) were shown as key factors related to treatment outcomes.Conclusions Most severe HFMD cases appeared in boys,especially living in the rural areas.Frequently seen complications would include aseptic meningitis,non-brainstem encephalitis and brainstem encephalitis.EV71 was the dominant etiology for severe and fatal cases.Early diagnosis and complication control were crucial,related to the treatment outcome of HFMD.
ABSTRACT
Objective Through analyzing the surveillance data on typhoid fever and paratyphoid fever in 2015 to understand the related epidemiological features and most possible clustering areas of high incidence.Methods Individual data was collected from the passive surveillance program and analyzed by descriptive statistic method.Characteristics on seasonal,regional and distribution of the diseases were described.Spatial-temporal clustering characteristics were estimated,under the retrospective space-time method.Results A total of 8 850 typhoid fever cases were reported from the surveillance system,with incidence rate as 0.65/100 000.The number of paratyphoid fever cases was 2 794,with incidence rate as 0.21/100 000.Both cases of typhoid fever and paratyphoid fever occurred all year round,with high epidemic season from May to October.Most cases involved farmers (39.68％),children (15.89％) and students (12.01％).Children under 5 years showed the highest incidence rate.Retrospective space-time analysis for provinces with high incidence rates would include Yurnan,Guangxi,Guizhou,Hunan and Guangdong,indicating the first and second class clusters were mainly distributed near the bordering adjacent districts and counties among the provinces.Conclusion In 2015,the prevalence rates of typhoid fever and paratyphoid fever were low,however with regional high prevalence areas.Cross regional transmission existed among provinces with high incidence rates which might be responsible for the clusters to appear in these areas.
ABSTRACT
Objective To evaluate the health related quality of life (HRQoL) for severe hand,foot and mouth disease (HFMD) patients with different complications.Methods A national telephone interview under the EQ-5D proxy2 questionnaire (EQ-SD and EQ-VAS),was conducted to obtain the HRQoL of lab-confirmed severe HFMD patients,aged between six months and five-year-olds from the national communicable disease surveillance system from January 1,2012 to December 31,2013.Results A total of 685 severe HFMD cases were included in the study.A total of 456 (66.6％) of them were males with 75.8％ of them younger than three years old.A total of 337 (49.2％) and 407 (59.4％) of the participants reported that they had problems in mobility or daily activities.A total of 569 (83.1％) and 616 (89.9％) of the cases reported having problems in pain/discomfort or anxiety/depression.The average EQ-5D and EQ-VAS scores were 0.58 ± 0.23 and 53.6 ± 25.7,both were positively associated with the duration of illness.Mean quality adjusted life years loss during the HFMD episode for the severe patients was (15.45 ± 13.75) years/1 000 persons.The QALY losses for severe patients with each of below complication were:respiratory diseases (11.17 ± 8.83) years/1 000 persons,aseptic meningitis (13.56 ± 11.99) years/1 000 persons,encephalitis/brainstem encephalitis/acute flaccid paralysis (AFP) (15.31 ± 12.63) years/1 000 persons,Myocarditis (17.28 ± 18.16) years/1 000 persons,pulmonary hemorrhage/pulmonary edema (17.34 ±14.98) years/1 000 persons,cardiopulmonary failure (25.47 ± 20.53) years/1 000 persons.Among patients with lab confirmed Entero virus A71 (EV71) (16.51 ± 14.48) years/l 000 persons,the QALY loss was seen higher than Coxsackie virus A16 (Cox A16) (13.02± 11.45) years/1 000 persons and other Enter virus (14.74 ± 14.22) years/1 000 persons (Z=11.83,P=0.003).Conclusion The HRQoL loss for severe HFMD patients substantially increased under complications exacerbation and related to the duration of illness.
ABSTRACT
Objective To clarify the age patterns and types of differences so as to provide reference on prevention and interventions of hand,foot and mouth disease (HFMD) cases,in Hubei province.Methods We collected the HFMD case information of Hubei province from the Chinese National Notifiable Infectious Disease Reporting System in 2009-2015 while the information on pathogens from the laboratory monitoring system of Center for Disease Control and Prevention at all levels in Hubei province.All the data were stratified by age,disease severity,laboratory confirmation status,and serotypes of enterovirus.Results There were 495 783 reported HFMD cases from 2009 to 2015,in Hubei province,of which 1 045 were severe with 99 fatal.The annual notification rate was 1 231.0/106.HFMD cases were concentrated mainly in 0.5-5 year olds,with highest severity and mortality seen in 6-11 month-olds.The predominated pathogen in mild laboratory-confirmed cases each year,in order during 2009-2015 as:EV71,Cox A16,Cox A16,Cox A16,EV71,Cox A16 and other EV.HFMD showed semiannual peaks in April-June,November-December,and with more cases in the even years than in the odd years.Conclusions Children aged 0.5 to 5 years with 6 to 11 month-olds in particular,were the focused groups of attention in Hubei province.Our findings provided evidence for the improvement on monitoring program.Targeted intervention approaches should be strengthened to reduce the mortality and morbidity of HFMD in the province.
ABSTRACT
Objective@#To estimate the direct medical cost of severe hand, foot and mouth disease (HFMD) in patients aged less than five years.@*Methods@#A stratified sampling method was used to collect data on severe HFMD cases reported in the National HFMD surveillance database between Jan 1, 2012, and Dec 31, 2013. The sampling was referenced with the national aetiologic distribution of Enterovirus A71 (EV-A71), Coxsackievirus A16 (CV-A16) and other Enteroviruses (OEV) for severe HFMD cases and the included cases were distributed among seven geographic regions (Northeast, North China, Northwest, Central China, Southwest, East China and South China). A nationwide telephone interview using a structured questionnaire was conducted to obtain the direct medical cost and any complications that occurred in patients during the outbreak of laboratory-confirmed HFMD. After excluding the cases who could not recall their medical expenses or complications, a total of 685 cases were included in the analysis. Kruskal-Wallis H test was used to analyze the differences among patients who reported different complications. Multiple linear regression with bootstrap analysis of 500 replicates was used to explore the factors that influenced the direct medical costs.@*Results@#Of 685 patients analyzed, 456 (66.6%) were male and 229 (33.4%) were female. The direct medical costs P50 (P25, P75) were 14 250 (10 301, 20 600) Yuan. In total, 127 (18.5%) patients were diagnosed with severe HFMD patients with respiratory disease, 38 (5.5%) patients were diagnosed with aseptic meningitis, and 378 (55.2%) with encephalitis/brainstem encephalitis/acute flaccid paralysis. Furthermore, 53 (18.5%) patients were diagnosed with myocarditis, 39 (5.7%) with pulmonary hemorrhage/pulmonary edema and 50 (7.3%) with cardiopulmonary failure. The median (interquartile range) direct medical costs were 12 360 (7 313, 16 480) Yuan for severe HFMD patients with respiratory disease, 13 803 (9 064, 19 930) Yuan for aseptic meningitis, 14 438 (11 000, 20 015) Yuan for encephalitis/brainstem encephalitis/acute flaccid paralysis, 14 800 (8 500, 21 218) Yuan for myocarditis, 20 600 (12 500, 31 130) Yuan for pulmonary hemorrhage/pulmonary edema, and 20 043 (12 772, 28 840) Yuan for cardiopulmonary failure (H=17.70, P<0.001). The results of multiple linear regression with bootstrap analysis revealed that the direct medical cost for severe HFMD patients from Central China was 7 881 (95% CI: 3 814-11 949) Yuan higher than that of North China; severe HFMD patients diagnosed with OEV had direct medical costs of 1 987 (95%CI: 206-3 769) Yuan less those associated with EV-A71; severe HFMD patients whose duration of illness was ≥21 d had 20 480 (95% CI: 10 985- 29 974) Yuan higher direct medical costs those whose illness lasted ≤5 d; the direct medical costs for severe HFMD patients with pulmonary hemorrhage/pulmonary edema and cardiopulmonary failure were 7 874 (95%CI: 3 723-12 026) and 9 855 (95% CI: 328- 19 382) Yuan higher, respectively, than that associated with respiratory disease.@*Conclusion@#The direct medical costs associated with severe HFMD were found to be substantial. The total cost was affected by the duration of the illness and the severity of any complications.
ABSTRACT
Objective To investigate the clinical severity,etiological classification and risk factors of severe cases with hand,foot and mouth disease (HFMD).Methods A total of 1 489 records on severe and fatal HFMD cases reported to the national pilot surveillance system of HFMD were used to analyze the demographic,medical treatment,etiological classification of the cases.Treatment outcome related risk factors were also studied with multi-variable stepwise logistic regression method.Results Seven out of the 1 489 severe HFMD cases died of this disease.A total of 960 (72.9％) were under three years old and 62.9％ were male and most of the cases (937,62.9％) resided in rural areas.Among all the cases,494 (33.2％) went to seek the first medical assistance at the institutions of village or township level.Durations between disease onset and first medical attendance,being diagnosed as the disease or diagnosed as severe cases were 0(0-1) d,1 (0-2) d and 2 (1-4) d,respectively.In total,773 (51.9％) of the severe HFMD cases were diagnosed as with aseptic meningitis,260 (17.5％) with brainstem encephalitis,377 (25.3 ％) with non-brainstem encephalitis,6 (0.4％) with encephalomyelitis,1 (0.1％) with acute flaccid paralysis,4 (0.3％) with pulmonary hemorrhage/pulmonary edema and 68 (4.6％) with cardiopulmonary failure.Of the etiologically diagnosed 1 217 severe and fatal HFMD cases,642 (52.8％) were with EV71,other enterovirus 261 (21.5％),Cox A16 36 (3.0％),1 (0.1％) with both EV71 and Cox A16.However,277 (22.8％) showed negative on any pathogenic virus.Complication (Z=3.15,P=0.002) and duration between onset and diagnosed as severe cases (Z=3.95,P＜0.001) were shown as key factors related to treatment outcomes.Conclusions Most severe HFMD cases appeared in boys,especially living in the rural areas.Frequently seen complications would include aseptic meningitis,non-brainstem encephalitis and brainstem encephalitis.EV71 was the dominant etiology for severe and fatal cases.Early diagnosis and complication control were crucial,related to the treatment outcome of HFMD.
ABSTRACT
Objective Through analyzing the surveillance data on typhoid fever and paratyphoid fever in 2015 to understand the related epidemiological features and most possible clustering areas of high incidence.Methods Individual data was collected from the passive surveillance program and analyzed by descriptive statistic method.Characteristics on seasonal,regional and distribution of the diseases were described.Spatial-temporal clustering characteristics were estimated,under the retrospective space-time method.Results A total of 8 850 typhoid fever cases were reported from the surveillance system,with incidence rate as 0.65/100 000.The number of paratyphoid fever cases was 2 794,with incidence rate as 0.21/100 000.Both cases of typhoid fever and paratyphoid fever occurred all year round,with high epidemic season from May to October.Most cases involved farmers (39.68％),children (15.89％) and students (12.01％).Children under 5 years showed the highest incidence rate.Retrospective space-time analysis for provinces with high incidence rates would include Yurnan,Guangxi,Guizhou,Hunan and Guangdong,indicating the first and second class clusters were mainly distributed near the bordering adjacent districts and counties among the provinces.Conclusion In 2015,the prevalence rates of typhoid fever and paratyphoid fever were low,however with regional high prevalence areas.Cross regional transmission existed among provinces with high incidence rates which might be responsible for the clusters to appear in these areas.
ABSTRACT
Objective To evaluate the health related quality of life (HRQoL) for severe hand,foot and mouth disease (HFMD) patients with different complications.Methods A national telephone interview under the EQ-5D proxy2 questionnaire (EQ-SD and EQ-VAS),was conducted to obtain the HRQoL of lab-confirmed severe HFMD patients,aged between six months and five-year-olds from the national communicable disease surveillance system from January 1,2012 to December 31,2013.Results A total of 685 severe HFMD cases were included in the study.A total of 456 (66.6％) of them were males with 75.8％ of them younger than three years old.A total of 337 (49.2％) and 407 (59.4％) of the participants reported that they had problems in mobility or daily activities.A total of 569 (83.1％) and 616 (89.9％) of the cases reported having problems in pain/discomfort or anxiety/depression.The average EQ-5D and EQ-VAS scores were 0.58 ± 0.23 and 53.6 ± 25.7,both were positively associated with the duration of illness.Mean quality adjusted life years loss during the HFMD episode for the severe patients was (15.45 ± 13.75) years/1 000 persons.The QALY losses for severe patients with each of below complication were:respiratory diseases (11.17 ± 8.83) years/1 000 persons,aseptic meningitis (13.56 ± 11.99) years/1 000 persons,encephalitis/brainstem encephalitis/acute flaccid paralysis (AFP) (15.31 ± 12.63) years/1 000 persons,Myocarditis (17.28 ± 18.16) years/1 000 persons,pulmonary hemorrhage/pulmonary edema (17.34 ±14.98) years/1 000 persons,cardiopulmonary failure (25.47 ± 20.53) years/1 000 persons.Among patients with lab confirmed Entero virus A71 (EV71) (16.51 ± 14.48) years/l 000 persons,the QALY loss was seen higher than Coxsackie virus A16 (Cox A16) (13.02± 11.45) years/1 000 persons and other Enter virus (14.74 ± 14.22) years/1 000 persons (Z=11.83,P=0.003).Conclusion The HRQoL loss for severe HFMD patients substantially increased under complications exacerbation and related to the duration of illness.
ABSTRACT
Objective To clarify the age patterns and types of differences so as to provide reference on prevention and interventions of hand,foot and mouth disease (HFMD) cases,in Hubei province.Methods We collected the HFMD case information of Hubei province from the Chinese National Notifiable Infectious Disease Reporting System in 2009-2015 while the information on pathogens from the laboratory monitoring system of Center for Disease Control and Prevention at all levels in Hubei province.All the data were stratified by age,disease severity,laboratory confirmation status,and serotypes of enterovirus.Results There were 495 783 reported HFMD cases from 2009 to 2015,in Hubei province,of which 1 045 were severe with 99 fatal.The annual notification rate was 1 231.0/106.HFMD cases were concentrated mainly in 0.5-5 year olds,with highest severity and mortality seen in 6-11 month-olds.The predominated pathogen in mild laboratory-confirmed cases each year,in order during 2009-2015 as:EV71,Cox A16,Cox A16,Cox A16,EV71,Cox A16 and other EV.HFMD showed semiannual peaks in April-June,November-December,and with more cases in the even years than in the odd years.Conclusions Children aged 0.5 to 5 years with 6 to 11 month-olds in particular,were the focused groups of attention in Hubei province.Our findings provided evidence for the improvement on monitoring program.Targeted intervention approaches should be strengthened to reduce the mortality and morbidity of HFMD in the province.
ABSTRACT
Most common causative agents for hand, foot and mouth disease (HFMD) are enterovirus 71 (EV-A71) and coxsackievirus A16 (CV-A16). The symptomatic and asymptomatic cases could transmit the disease in population. Many sero-epidemiological surveys were launched to estimate the sero-incidence of EV-A71 and CV-A16 enterovirus, the susceptibility of different sub-population, and to observe the dynamics of neutralizing antibody. A literature search of sero-epidemiological study focused on EV-A71 or CV-A16 was conducted via PubMed and China Hospital Knowledge Database. Based on the 20 selected studies, the different age groups' antibody level, the susceptibility, the dynamics of antibody and sero-incidence of EV-A71 or CV-A16 were analyzed. From our results, the antibody level against EV-A71 or CV-A16 in neonates was associated with their mothers, which was similar with that of adults. The antibody level against EV-A71 or CV-A16 in neonates dropped to lowest level at one years-old, and started to dramatically increase until four years-old, and reached a plateau at five years-old. In conclusion, the infants aged 6-12 months were the priority group to receive vaccination when the EV-A71 vaccine is licensed in the future.
Subject(s)
Adult , Child , Humans , Infant , Infant, Newborn , Adaptive Immunity , Age Factors , Antibodies, Neutralizing , China , Enterovirus , Enterovirus A, Human , Immunity, Maternally-Acquired , Mothers , Seroepidemiologic Studies , VaccinationABSTRACT
<p><b>OBJECTIVE</b>To investigate the epidemiology characteristics of norovirus among diarrheal outpatients in China.</p><p><b>METHODS</b>Diarrhea cases were monitored at emergency/outpatient departments at 173 hospitals in 27 provinces of China, with clinical and epidemiological data, and fecal specimens collected and sent to 58 network-laboratories to detect norovirus by RT-PCR method, and to analyze the positive rate of norovirus in various regions, population and time during 2009-2013.</p><p><b>RESULTS</b>11.6% of the 34 031 diarrheal cases under surveillance were found with norovirus. Age group of 6-23 month-old children and that of people over 45 years old were found with the highest positive percentage, 13.7% and 12.4% respectively. Positive percentage of norovirus peaks in autumn and winter in a year; it peaks in mid-temperate zones (10.7%) and warm-temperate zones (11.6%) in winter. It peaks in sub-tropical zones in autumn (14.3%). The most prevalent genogroups detected were norovirus G II, accounting for 89.9% of identified strains.</p><p><b>CONCLUSION</b>Norovirus affects all ages and was most prevalent in children and the elderly among diarrhea outpatients. Norovirus' positive percentage showed strong seasonal pattern, and peaks at different times of a year in different climate zones of China. Since no effective preventive measures existed, further study on norovirus epidemiology and intervention strategies should be conducted in future.</p>
Subject(s)
Adolescent , Adult , Aged , Child , Child, Preschool , Humans , Middle Aged , Caliciviridae Infections , Epidemiology , China , Epidemiology , Diarrhea , Epidemiology , Virology , Genotype , Hospitals , Laboratories , Norovirus , Outpatients , Prevalence , SeasonsABSTRACT
OBJECTIVE To understand the nurses′ awareness of specimen collection and explore the impact of acquisition-related factors and provide the basis for standardized training.METHODS A questionnaire was designed for specimen collection survey about microorganisms in level-3 hospital.RESULTS 90.38 percent of nurses consulted the laboratory,80.77 percent communicated with other nurses to solve the problom about microbiology specimen collection and 94.2% thought it necessary about continuing education.The ward nurses′ knowledge about microbiology specimen collection was better than these from surgical department.CONCLUSIONS It is urgent that stundard training of specimen collection should be implement in medintely due to lacking the awareness.