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@#ObjectiveTo analyse the coverage of inactivated enterovirus 71(EV71)vaccine and the impact on hand-foodmouth disease(HFMD)epidemiological and etiological changes in Jinshan District,Shanghai,and provide evidence for improving the prevention and control strategy of HFMD in this area.MethodsThe vaccination data of inactivated EV71vaccine from 2016 to 2019 was collected in Jinshan Immunization Information Management System of Shanghai to describe the vaccination characteristics;The data of HFMD cases in Jinshan District from 2013 to 2019 were extracted from Chinese Disease Prevention and Control Information System,and the surveillance etiological information of HFMD in the same period was obtained,which was compared for the differences of HFMD incidence and pathogen positive detection rate before and after vaccination.ResultsFrom November 2016 to December 2019,a total of 63 521 doses of inactivated EV71vaccine were applied in Jinshan District,with the first shot coverage of 22.57%,the full shot coverage of 21.05% and the two-dose completion coverage of 94.65%.There were significant differences in coverage between different years,months,current addresses,age groups and registers(P < 0.05).The highest coverage of first short was in 2018(33.45%),while full short in 2017(30.78%).More doses were applied during May to August,with highest coverage in 6 to 11 months old group and most doses in 1 year old group.The coverage of children in this city was higher than that of migrant children.There was no significant difference in the incidence of HFMD before and after vaccination(χ2= 0.427,P =0.513 ),while the incidence of severe disease,the positive detection rate of EV71 and the estimated incidence of HFMD infected with EV71 decreased significantly after vaccination(χ2= 15.312,41.431 and 432.342 respectively,each P <0.001).ConclusionVaccination with inactivated EV71 vaccine reduced the occurrence of HFMD EV71 infection and severe disease in Jinshan District,while the coverage was low,so it was necessary to pay attention to HFMD etiological changes to prevent other enterovirus infections.It is suggested to strengthen publicity and information technology to improve coverage,speed up the development of combined vaccine and provide more antibody protection.
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Objective To analyze the epidemic characteristics of the hand-foot-mouth disease (HFMD) in four years before and after EV71 vaccine inoculation, and to provide a basis for better EV71 vaccination and prevention and control of HFMD. Methods The descriptive epidemiology method was used to analyze the monitoring data of HFMD from 2013 to 2020 and EV71 vaccination from 2017 to 2020 in Xinwu District of Wuxi City. Results A total of 9 589 HFMD cases including 104 severe cases (accounting for 1.08%) were reported in four years before EV71 vaccination, and the reported average annual incidence rate was 431.15/100 000. A total of 7 396 HFMD cases including 21 severe cases (accounting for 0.28%) were reported in four years after vaccine inoculation, and the reported average annual incidence rate was 325.28/100,000. Annual incidence rate and severe illness rate decreased significantly before and after vaccine inoculation. The HFMD incidences displayed two epidemic peaks, from May to June and from October to November. The three streets with the highest average annual incidence were Jiangxi, Meicun, and Shuofang. The HFMD cases were mainly children under 5 years old, and there were more men than women. A total of 394 samples were sent for examination from 2013-2020, and 231 were positive, with a total positive rate of 58.63%. There were significant changes in the etiological composition before and after vaccine inoculation. The composition of EV71 virus decreased significantly (χ2=69.70, P2=22.35, P<0. 05). From 2017 to 2020, a total of 12 472 people were inoculated with EV71 vaccine in Xinwu District of Wuxi City, with estimated annual vaccination rates of 3.78%, 10.96%, 8.40% and 7.63%, respectively. Conclusion There is no significant change in time, region and population distribution of HFMD before and after EV71 vaccination in Xinwu District of Wuxi City, but the annual incidence rate and severe illness rate show a decreasing trend, and the dominant intestinal pathogens have changed. It is suggested to strengthen the use of EV71 vaccine and the development of multivalent HFMD-related vaccine.
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[Objective]To explore the prevalence trend and pathogenic characteristics of hand-food-mouth disease (HFMD) in Jiading District of Shanghai from 2007 to 2016. [Methods] Information on cases of hand-food-mouth disease in Jiading District from 2007 to 2016 was collected and analyzed. [Results]There were 37 520 reported cases from 2007 to 2016 with average age of 2.81 years old, in which 92.05％ cases were aged 5 years old or below. The incidence rate showed fluctuation over years was from the lowest incidence of 217.03/105 in 2015 to the highest of 461.83/105 in 2016. There were 55.95％ of reported cases from the period of April to July and 94.98％ were from rural and urban-rural areas. Samples from 799 patients as pharynx swab and anal swab, etc. were found to be enterovirus 71 (EV71) , the dominant pathogen, accounting for 44.56％ of total isolation. There were 0.59％ severe cases, 96.23％ of which were positive of EV71. [Conclusion] The HFMD prevalence in Jiading District of Shanghai showed periodicity and seasonality. Children aged 5 years old below and living in non-urban areas showed higher incidence risk. EV71 is the dominant pathogen, especially for the severe cases. These findings suggested that targeted measures should be carried out according to the prevalence and pathogenic characteristics, strengthening the prevention and control of HFMD among preschool children in rural and urban-rural areas.
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Severe hand-food-mouth disease can be accompanied by neurogenic pulmonary edema,whicn can rapidly lead to death.The pathogenesis of neurogenic pulmonary edema may be related to the comprehensive influences on neural factors,humoral factors and multiple bioactive substances after the central nervous system is damaged.It is of great impotance to investingate the pathogenesis of neurogenic pulmonary edema,which facilitates timely treatment and prevention of the complications.
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Objective To study the etiological detection on samples from severe hand-footmouth disease (HFMD) cases and the genetic characteristics of enterovirus type 71 (EV71) isolates lrom severe patients in Beijing,2010.Methods Real-time RT-PCR was used to detect EV71 and Coxsackievirus A16 (CoxA16) and RD cells were used to separate virus strains from samples.Homogeneity of EV71 isolated strains were also analyzed. Results Four hundred and fourty-two severe cases were detected and 253 were positive,taking up 57.24％ of the total (253/442).The overall positive detection rate on EV71 was 54.55％ (138/253),with CoxA16 as 5.93％(15/253),and with other enterovirus group was 39.53％(100/253).The nucleotide homogencity of VP1 within these 12 strains was 97.2％ 100.0％,and with Beijing strains in 2007-2010,Shandong strains in 2007 and Anhui Fuyang strains in 2008 and the Guangdong strains in 2008 as 94.0％-99.9％.Conclusion Severe HFMD cases were most oftenly caused by EV71 but less caused by CoxA16 or other cnterovirus.The HFMD in 2010 in Beijing was mainly caused by EV71 subgenotype C4a with 4 transmission chains.Twclve isolated EV71 strains had high homogeneity with strains isolated from severe cases in Anhui Fuyang in 2007.