Epidemiological characteristics and etiological analysis of hand, foot and mouth disease in Xuzhou and the surrounding area in 2015

Abstract

Objective To investigate the pathogen types and epidemic characteristics of the hospitalized children with hand, foot and mouth disease (HFMD), and to provide reference for the prevention and treatment of HFMD. Methods The clinical data of the hospitalized children with HFMD in Xuzhou Children’s Hospital during 2015 were collected, the demographic characteristics and clinical manifestations were analyzed, and an epidemiological investigation was carried out. The fecal samples were collected and virus RNA was detected by real-time fluorescence quantitative PCR for enterovirus 71 (EV71) and Coxsackievirus A16 (CoxA16). Results During 2015, a total of 2 792 cases with HFMD were collected, including 1 842 males and 950 females, 10 severe cases and 3 death cases. The age was from 72 days to 11 years old. Patients with HFMD mainly concentrated around March to July. A total of 1 738 cases (62.24%) were diagnosed and the peak was reached in April with 425 diagnosed cases (15.22%). The children with HFMD were concentrated among 1-3 years old (1 471 cases, 52.68%), and residentially-scattered children and childcare were the main targets of HFMD, among which stay-at-home children and secondary children accounted for 30% (837/ 2 792) and 20% (558/2 792), respectivly. Children suffered from respiratory or digestive tract diseases (39.68%, 1 108/2 792) within the last three months, poor nutritional status (59.81%, 1 670/2 792) and lower educational level of parents (64.97%, 1 814/2 792) were susceptible to HFMD. Etiological examination showed that the positive rate of EV71 was 56.2% (1 570/2 792), the positive rate of CoxA16 was 13.1% (368/ 2 792), and that of other enterovirus was 30% (854/2 792). The fecal specimens (102 cases) of the parents whose children suffered from HFMD and viral encephalitis were collected, and 44 samples were positive for EV71. Conclusions In Xuzhou and the surrounding areas, there were still more children with HFMD in 2015, and EV71 infection was the main infection. The proportion of severe patients in stay-at-home children and children with secondary infection was higher and the disease was more serious. The latent infection in adults might become another important source of infection. Key words: Hand, foot and mouth disease; Eetiology; Epidemic characteristics; Left-behind children; Second infection