The main serotypes that cause HFMD are Enterovirus71 (EV71) and Coxsackievirus A16 (Cox A16). The causative agents of HFMD are associated with the Enterovirus (EV) A species in the Enterovirus genus, which consists of 25 serotypes at present. In 2019, the number of HFMD cases was 1.91 million, which was the second highest number of notifiable infectious diseases in mainland China. In some Asian countries, millions of HFMD patients have caused 96,900 age-weighted disability-adjusted life-years (DALYs) per annum. HFMD seriously threatens the health of children because of its high transmissibility, complicated transmission route, and high epidemic intensity. Hand, foot and mouth disease (HFMD) is one of the most common infectious diseases among children, which has been reported in most regions around the world. Our findings could provide valuable information for improving the regional surveillance, prevention and control strategies of HFMD.

Cox A16 and Cox A6 became the dominant serotypes and they alternated or were co-epidemic. Regions with high risk are mainly concentrated in the areas surrounding central urban areas. ConclusionsĬhildren under 7 years old are at higher risk of mild HFMD. During 2010–2016, Enterovirus 71 (EV71), Coxsackievirus A16 (Cox A16), and other non-EV71/Cox A16 EVs, accounted for 29.1%, 34.6%, 36.3% of all the enterovirus test positive cases, respectively. The annual distribution of enterovirus serotypes showed a significant difference. Based on the cumulative reported cases, the most likely cluster was detected, including Yuhuatai District, Jiangning District, Jiangbei new Area, and Pukou District. The average annual incidence was higher in males (5,040 cases/100,000) than females (3,755 cases/100,000). Mild cases showed semi-annual peaks of activity, including a major peak (April to July) and a minor peak (September to November). There was a higher average annual incidence of mild HFMD in children aged < 7 years (4,428 cases/100,000) compared with children aged ≥ 7 years (14 cases/100,000, P < 0.001), and especially children aged 1-year-old (7,908 cases/100,000).

ResultsĪ total of 175,339 mild cases aged < 7 years were reported, accounting for 94.4% of all mild cases. Flexible spatial scan statistic was used to detect spatial clusters of mild cases.

Descriptive analysis was used to summarize epidemiological and etiological characteristics of mild cases. This study mainly focused on mild cases aged < 7 years. Methodsĭata on mild HFMD cases, during 2010–2019 in Nanjing, were collected from the China Information System for Disease Control and Prevention. This study aimed to investigate the epidemiological and etiological characteristics of mild HFMD in Nanjing. Mild hand, foot and mouth disease (HFMD) cases make up a relatively high proportion of HFMD while have often been overlooked.

Nan jing pdf