Abstract
Hand, foot, and mouth disease (HFMD) remains a threat to the Asia-Pacific region. The epidemiological characteristics and pathogen spectrum of HFMD vary with space and time. These variations are crucial for HFMD interventions but poorly understood in Sichuan Province, China, particularly after the introduction of the EV-A71 vaccine. Using descriptive methods, regression analyses, spatial autocorrelation analysis, and space-time scan statistics, we analysed the epidemiological and aetiological characteristics of HFMD surveillance data in Sichuan Province between 2011 and 2017 to identify spatio-temporal variations. The dominant serotypes of HFMD have changed from enterovirus 71 and coxsackievirus A16 to other enteroviruses since 2013. The seasonal pattern of HFMD showed two peaks generally occurring from April to July and November to December; however, the seasonal pattern varied by prefecture and enterovirus serotype. From 2011 to 2017, spatio-temporal clusters were increasingly concentrated in Chengdu, with several small clusters in northeast Sichuan. The clusters observed in southern Sichuan from 2011 to 2015 disappeared in 2016–2017. These findings highlight the importance of pathogen surveillance and vaccination strategies for HFMD interventions; future prevention and control of HFMD should focus on Chengdu and its vicinity.
Highlights
Hand, foot, and mouth disease (HFMD) is an acute infectious disease that is prevalent in the Asia-Pacific region
Based on the HFMD surveillance data for Sichuan in 2011–2017, we provide comprehensive insight into the epidemiological and aetiological characteristics of HFMD using descriptive methods, regression analysis, spatial autocorrelation analysis and space-time scan statistics to identify high-risk areas and periods and dominant serotypes of HFMD to provide a basis for HFMD interventions
We found that HFMD mainly occurred in children under 5 years old, the dominant serotypes of HFMD were other enterovirus, HFMD peaked from April to May and from November to December, and the high-risk regions were concentrated in Chengdu
Summary
Foot, and mouth disease (HFMD) is an acute infectious disease that is prevalent in the Asia-Pacific region. Sichuan Province is located in Southwest China; it has complex terrain and climate systems, leading to distinct epidemiological characteristics of HFMD compared to other regions[21,22]. A previous study briefly described the epidemiological characteristics and detected spatio-temporal clusters of HFMD in Sichuan Province from 2008 to 201323. Considering the increase in the number of HFMD in Sichuan Province in recent years, the amount of data analysed in the previous study was relatively small, and the epidemiological characteristics of HFMD may have changed. Based on the HFMD surveillance data for Sichuan in 2011–2017, we provide comprehensive insight into the epidemiological and aetiological characteristics of HFMD using descriptive methods, regression analysis, spatial autocorrelation analysis and space-time scan statistics to identify high-risk areas and periods and dominant serotypes of HFMD to provide a basis for HFMD interventions
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