Characterization of an Outbreak of Hand, Foot, and Mouth Disease in Nanchang, China in 2010

Abstract

Recent outbreaks of human enterovirus 71 (EV71) infection and EV71-associated hand, foot, and mouth disease (HFMD) in China have affected millions and potentially lead to life-threatening complications in newborns. Furthermore, these outbreaks represent a significant global public health issue in the world. Understanding the epidemiology of HFMD and EV71 infection and their transmission patterns in China is essential for controlling outbreaks. However, no studies on the outbreaks of HFMD and EV71 infection in China during 2010 have been reported. In this report, we carried out an epidemiological analysis to study an outbreak of HFMD and EV71 infection in 2010 in the city of Nanchang in the Jiangxi province of People's Republic of China. From April 7 to May 11, 2010, a total of 109 HFMD cases were reported, and in this report the HFMD cases were studied by both epidemiological and laboratory analyses. The epidemiological study indicates that children aged younger than 8 years old represented more than 90% of the reported cases, with the age group of 1–3 years containing the highest number of cases. Laboratory studies detected a high prevalence of EV71 amongst the cases in our study, suggesting EV71 as a common enterovirus found in HFMD cases in Nanchang. Phylogenetic analysis of the sequence of the VP1 region of four EV71 isolates indicated that the Nanchang strains belong to the C4 subgenotype commonly found in China during outbreaks in 2008 but contain distinct variations from these strains. Our study for the first time characterizes the epidemiology of HFMD and EV71 infection in China in 2010 and furthermore, provides the first direct evidence of the genotype of EV71 circulating in Nanchang, China. Our study should facilitate the development of public health measures for the control and prevention of HFMD and EV71 infection in at-risk individuals in China.

Detecting the association between meteorological factors and hand, foot, and mouth disease using spatial panel data models

“…The seasonality of HFMD in Shandong Province showed that there were larger seasonal peaks between April and July, which is similar to the results of other studies. 6,25 In Shandong Province, the distribution patterns of HFMD at the county level were clustered, with high Moran's I from 0.30 to 0.46 (p < 0.001) during the study period. This is similar to the reported spatial autocorrelation patterns in the whole of mainland China at the province level.…”

“…2 Direct contact with respiratory droplets, feces, and blister fluid of an infective patient, or contact with a contaminated environment, e.g., water, food, or surfaces, can result in the spread of the disease. 3 In recent years, the HFMD outbreak trend has increased among children in China, [4][5][6] and this is regarded as an important public health problem by health officers. 1 Many studies have been performed to analyze the association between meteorological factors and climate-sensitive infectious diseases due to their potential as early warning tools.…”

Epidemiological and etiological characteristics of hand, foot, and mouth disease in Ningbo, China, 2008–2011

“…7 Recent outbreaks of HFMD in East and Southeast Asia have caused major public health concerns worldwide. [8][9][10][11][12][13][14] Several outbreaks in central China have been reported since 2007. [10][11][12][13][14] HFMD has been classified as a notifiable disease in China since an EV71-caused HFMD outbreak occurred in Fuyang, Anhui province in early 2008.…”

Characterization of enterovirus 71 infection and associated outbreak of Hand, Foot, and Mouth Disease in Shawo of China in 2012

“…1). We have recently reported the infection of enteroviruses and HFMD outbreaks in Wuhan and in northern Hubei Province29 as well as in the city of Nanchang in the adjacent Jiangxi Province between 2010 and 201130. However, HFMD outbreaks and their associated enterovirus infections in Shawo have not been reported.…”