Abstract
Enterovirus 71 (EV71) usually causes hand-foot-and-mouth disease (HFMD) with severe clinical symptoms and even deaths in China. There is no efficient antiviral drug to protect against severe EV71-associated HFMD, making the development of EV71 vaccines therefore a priority. However, the potential target subject population(s) to be immunized with EV71 vaccine are not well understood. In this study, we characterized the epidemiology regarding EV71-associated HFMD on the basis of provincial-level surveillance. We extracted data on EV71-associated HFMD from the National Notifiable Disease Reporting System in Zhejiang Province, China between 1 January 2009 and 31 December 2013 (n = 7650). The higher incidence rate of EV71 cases occurred in those children aged 12–23 months, with boys being predominant. Interestingly, different peaks activities of EV71 infection was observed in different calendar year, with one peak in 2009 and 2013 and two peaks in 2010–2012. However, EV71 infection seemed to predominately occur in warm season and a distinguished cyclic peak that seemed to be of about 12 months. Children aged 12–23 months are thus identified as an important target population for public health intervention, for example, it is recommended that these key subjects immunized with EV71 vaccine. In addition, an enhanced surveillance system for EV71-associated with HFMD needs to focus on generic and phylogenetic analysis.
Highlights
Hand-foot-and-mouth disease (HFMD) is an emerging infectious disease caused by a group of viruses, including enteroviruses, coxsackieviruses, echoviruses, and polioviruses
12–23 months are identified as an important target population for public health intervention, for example, it is recommended that these key subjects immunized with enterovirus 71 (EV71) vaccine
This study will focus on the epidemiological study of EV71-associated HFMD in Zhejiang Province based on the surveillance data from the National Notifiable Disease Reporting
Summary
Hand-foot-and-mouth disease (HFMD) is an emerging infectious disease caused by a group of viruses, including enteroviruses, coxsackieviruses, echoviruses, and polioviruses. EV71-associated HFMD, which causes fever, skin rash, blisters and ulcers on hands, feet and mouth, and may further develop into pulmonary oedema, aseptic meningitis, encephalitis of the brainstem, and other complications, has become an important public health issue in China in recent years [6]. National notifiable diseases surveillance on EV71-associated HFMD showed that this disease had a high incidence rate (1.2 cases per 1000 person-years) and accounted for approximately 500–900 reported deaths per year in China from 2008 through 2012 [7]. The study of epidemiological characteristics is critical to provide the baseline data for future vaccine clinical trials. This study will focus on the epidemiological study of EV71-associated HFMD in Zhejiang Province based on the surveillance data from the National Notifiable Disease Reporting
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