Epidemiological profiles of hand, foot, and mouth disease, including meteorological factors, in Suzhou, China

Chen, Zhengrong; Sun, Hongpeng; Ya, Yan; Wang, Yuqing; Zhu, Canhong; Zhou, Weifang; Huang, Li; Wang, Meijuan; Mize, Maximillion T; Tian, Jianmei; Ji, Wei

doi:10.1007/s00705-014-2294-x

Cited by 24 publications

(8 citation statements)

References 20 publications

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“…Our finding of a positive correlation between the reported cases of EV-A71 infections and rainfall (Fig. 10d ) is supported by a previous study that demonstrated that some tropical and subtropical countries experienced more outbreaks in the rainy season [ 26 ]. The large values for N RF,E when 250 mm ≤ r < 400 mm (Fig.…”

Section: Discussionsupporting

confidence: 88%

Time series analysis of reported cases of hand, foot, and mouth disease from 2010 to 2013 in Wuhan, China

et al. 2015

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BackgroundHand, foot, and mouth disease (HFMD) is an infectious disease caused by a group of enteroviruses, including Coxsackievirus A16 (CVA16) and Enterovirus A71 (EV-A71). In recent decades, Asian countries have experienced frequent and widespread HFMD outbreaks, with deaths predominantly among children. In several Asian countries, epidemics usually peak in the late spring/early summer, with a second small peak in late autumn/early winter. We investigated the possible underlying association between the seasonality of HFMD epidemics and meteorological variables, which could improve our ability to predict HFMD epidemics.MethodsWe used a time series analysis composed of a spectral analysis based on the maximum entropy method (MEM) in the frequency domain and the nonlinear least squares method in the time domain. The time series analysis was applied to three kinds of monthly time series data collected in Wuhan, China, where high-quality surveillance data for HFMD have been collected: (i) reported cases of HFMD, (ii) reported cases of EV-A71 and CVA16 detected in HFMD patients, and (iii) meteorological variables.ResultsIn the power spectral densities for HFMD and EV-A71, the dominant spectral lines were observed at frequency positions corresponding to 1-year and 6-month cycles. The optimum least squares fitting (LSF) curves calculated for the 1-year and 6-month cycles reproduced the bimodal cycles that were clearly observed in the HFMD and EV-A71 data. The peak months on the LSF curves for the HFMD data were consistent with those for the EV-A71 data. The risk of infection was relatively high at 10 °C ≤ t < 15 °C (t, temperature [°C]) and 15 °C ≤ t < 20 °C, and peaked at 20 °C ≤ t < 25 °C.ConclusionIn this study, the HFMD infections occurring in Wuhan showed two seasonal peaks, in summer (June) and winter (November or December). The results obtained with a time series analysis suggest that the bimodal seasonal peaks in HFMD epidemics are attributable to EV-A71 epidemics. Our results suggest that controlling the spread of EV-A71 infections when the temperature is approximately 20–25 °C should be considered to prevent HFMD infections in Wuhan, China.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-015-1233-0) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 88%

Time series analysis of reported cases of hand, foot, and mouth disease from 2010 to 2013 in Wuhan, China

et al. 2015

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“…[12][13][14] In Jiangsu province, EV71 and CVA16 were the major etiologic agents of HFMD 20 from 2009 to 2012. For example, a previous study 21 showed that EV71 was the main pathogen causing HFMD in Suzhou, Jiangsu Province from April to July 2013. However, another study 14 showed that CVA6 was already the main causative agent of HFMD in Nanjing, Jiangsu Province in 2013.…”

Section: Discussionmentioning

confidence: 99%

Profiles of Human Enteroviruses Associated with Hand, Foot, and Mouth Disease in Nanjing, China

Chen

Zhang

2019

Disaster med. public health prep.

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ObjectiveHand, foot, and mouth disease (HFMD) is a common infectious disease caused by a group of viruses. The causative viruses have changed over time, and there is a need for a more effective protective vaccine. In this study, we investigated the profiles of human enteroviruses that caused HFMD outbreaks in Nanjing in 2015, with the goal of guiding the future prevention and treatment of HFMD.MethodsSpecimens were collected from 1097 patients admitted to our hospital and diagnosed with HFMD. Enteroviruses in the specimens were identified by real-time polymerase chain reaction and epidemiological patterns were analyzed with the clinical data.ResultsAmong the 1097 clinically diagnosed HFMD cases, 916 cases were confirmed by laboratory tests. The results showed that the main infectious virus was coxsackievirus A6 (CVA6) (41.75%), followed by enterovirus 71 (EV71) (27.48%), coxsackievirus A16 (7.43%), coxsackievirus A10 (6.84%), and others (16.51%). Further investigation indicated that CVA6 caused mild cases of HFMD, while EV71 caused severe cases. More enterovirus positive cases were reported from rural areas than from urban areas.ConclusionsCA6 and EV71 were the chief pathogenic viruses of HFMD cases in the present study. Schools, childcare centers, and families from rural areas should be the major targets for prevention and awareness of HFMD. This study will provide information useful in the prevention and management of HFMD and the development of relevant vaccines for HFMD in the future. (Disaster Med Public Health Preparedness. 2019;13:740–744).

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“…In Suzhou, EV71 was the most frequently detected serotype, followed by CA16 in the period from January 2008 to December 2013. [ 25 ] From May 2010 to April 2011 in Shanghai, EV71 was predominant, followed by CA10, CA6, and CA16 in admitted patients with HFMD. [ 26 ] In Beijing, the most commonly detected serotype from hospitalized children was CA6, followed by EV71 in 2013.…”

Section: Discussionmentioning

confidence: 99%

Molecular characteristics of hand, foot, and mouth disease for hospitalized pediatric patients in Yunnan, China

et al. 2018

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Hand, foot, and mouth disease (HFMD) is a common infectious disease caused by multiple enteroviruses (EVs) in China. To better define the etiologic agents and clinical characteristics of HFMD, we conducted this study in Yunnan, China.In this study, 1280 stool specimens were collected from pediatric patients hospitalized for treatment of HFMD in 2010. EV was detected with nested reverse transcription polymerase chain reaction and directly genotyped by gene sequencing of the viral protein 1 (VP1) region. Phylogenetic analysis was performed based on the VP1 partial gene and the clinical characteristics were analyzed using SPSS Software.Of 1280 specimens, 1115 (87.1%) tested positive for EV. Seventeen different EV serotypes were detected. Coxsackievirus A16 (CA16) was the most frequently detected serotype (615/1115 cases, 55.1%), followed by enterovirus 71 (EV71; 392/1115, 35.2%), CA10 (45/1115, 4.0%), and CA4 (23/1115, 2.1%). Among the 709 severe cases, CA16, EV71, CA10, and CA4 accounted for 48.0%, 42.0%, 3.5%, and 2.3%, respectively. Of the 26 critical cases, 13 were caused by EV71, 9 by CA16, 2 by CA4, and 1 each were the result of CA10 and E9, respectively. All EV71, CA16, CA10, and CA4 isolates were highly homologous to the strains isolated from mainland China, and belonged to the C4a, B1a, G, and C genotypes, respectively.Our study showed that EV71 and CA16 were the main causative agents for severe and critical HFMD, but other serotypes can also cause severe and critical cases.

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Epidemiological profiles of hand, foot, and mouth disease, including meteorological factors, in Suzhou, China

Cited by 24 publications

References 20 publications

Time series analysis of reported cases of hand, foot, and mouth disease from 2010 to 2013 in Wuhan, China

Time series analysis of reported cases of hand, foot, and mouth disease from 2010 to 2013 in Wuhan, China

Profiles of Human Enteroviruses Associated with Hand, Foot, and Mouth Disease in Nanjing, China

Molecular characteristics of hand, foot, and mouth disease for hospitalized pediatric patients in Yunnan, China

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