Epidemiology characteristics and pathogen surveillance of hand, foot, and mouth disease in Shenzhen, 2008 - 2015

Abstract

Objective To investigate etiological and epidemiological characteristics of hand, foot, and mouth disease (HFMD) in Shenzhen from 2008 to 2015 so as to provide scientific basis for HFMD control. Methods Descriptive epidemiological study was performed to analyze the data of HFMD cases reported in the China information system for disease control and prevention from 2008 to 2015. A total of 5 148 clinical specimens from HFMD patients were screened for enterovirus 71 (EV71), coxsackievirus A16 (CV-A16) and pan-enterovirus (PE) by real-time reverse transcription polymerase chain reaction (RT-PCR). Results A total of 236 653 HFMD cases, including 506 severe cases and 34 fatal cases were reported in Shenzhen between 2008 and 2015. The number of HFMD cases and the morbidity rose every year in Shenzhen. Severe and fatal HFMD cases showed an incidence peak every one or two years. The major peak occurred between April and June, and a minor peak occurred between September and October in the past eight years except the year 2009. Male HFMD patients were more than female ones. Among the cases, 90.8% were less than 5 year-old and the patients of less than 1 year-old, 1 to 3 year-old, 3 to 5 year-old and ≥5 year-old children accounted for 15.9%, 51.4%, 23.6% and 9.2% of all cases, respectively. EV71 was the main pathogen of HFMD between 2008 and 2011, while non-EV71 and non-CVA16 enteroviruses turned to be predominant causes of HFMD from 2012 to 2015. EV71 accounted for 28.7%, 78.9% and 92.0% among pathogens causing mild, severe and fatal HFMD, respectively. Conclusions Morbidity of HFMD increased in recent years in Shenzhen. HFMD were common in 1-3 years old group. Non-EV71 and non-CV-A16 enteroviruses replaced EV71 and CV-A16 as the predominant causative agents of HFMD from 2012 to 2015 in Shenzhen. Anyhow, EV71 was still the most important pathogen in severe and death cases of HFMD. Key words: Hand, foot, and mouth disease; Epidemiology; Etiology