Suspected pathogen detection and epidemiological analysis of hand, foot and mouth disease in Minhang District of Shanghai from 2009 to 2016 / 复旦学报（医学版）

ABSTRACT

Objective To investigate the etiological agents of the outbreak of hand,foot and mouth disease (HFMD) in Minhang District of Shanghai from 2009 to 2016,and to provide evidence for the prevention and management policy of HFMD by collecting suspected HFMD samples for laboratory testing from HFMD sentinel hospitals,the Children's Hospitals of Fudan University and jurisdiction community health service centers.Methods Specimens including stools,throat swabs and anal swabs were collected from patients suspected of HFMD from surveillance hospitals,i.e.,Children's Hospital of Fudan University and jurisdiction community health service centers during 2009 and 2016.The specimens were detected by real-time RT-PCR with the five types of viruses including panenterovirus (EV),enterovirus 71 (EV71),Coxsackie virus A16 (CVA16),Coxsackie virus A6 (CVA6) and Coxsackie virus A10 (CVA10).The distribution characteristics of pathogens were analyzed.Results During 2009 and 2016 we collected 3 744 cases of HFMD,the positive detection rate of pan-enterovirus were 84.83％ (3 176 cases),including EV71 (64.45％) and CVA16 (15.77％),then were CVA6 (9.23％) and other EV (8.78％),and CVA10 was only 0.76％.The major etiological agent was EV71.The advantage of different years and different season strain presented dynamic change,mainly EV71 and CVA16 co-popular in 2009,mainly EV71 epidemic from 2010 to 2011,EV71 and CVA16 were co-popular again in 2012,and the priority was EV71,then EV71 and other EV were co-popular in 2013.After 2014,CVA6 gradually increased,mainly CVA6 was popular 2015 and 2016,especially in 2016,the proportion of CVA6 ranged as high as 40.55％.CVA10 showed sporadic distribution trend in very low proportion.From the difference of age and gender in HFMD cases,the males were more than the females (1.68 ∶ 1),and the incidence was the highest in children of 1-3 years old.The peak of incidence occured in April to July,then in September to November.Conclusions HFMD onset seasons mainly were summer and fall-and-winter in bimodal popular models.It happens in children under 5 years of age.The incidence was higher in male than in female.The advantage of different years and different season strains present dynamic change,and the prevalence has obvious age and season limit.