Key result
Enterovirus genotype frequencies of CAV16 and EV71 were negatively associated with HFMD case numbers (RR 0.725 and RR 0.421, respectively; both p<0.001).
Why the study?
The role of different enteroviruses during hand, foot, and mouth disease epidemics and the major contributing factors remained unknown.
Observational
Enterovirus genotype frequencies causing HFMD in Guangzhou are associated with climate factors and EV71 vaccination rates, with EV71 decreasing and CVA16 increasing annually.
Climate-linked genotype shifts may inform local HFMD surveillance; leaves open causal pathways and intervention targets.
(1) Background: Assignment of pathogens to the correct genus, species, and type is vital for controlling infectious epidemics. However, the role of different enteroviruses during hand, foot, and mouth disease (HFMD) epidemics and the major contributing factors remain unknown. (2) Methods: HFMD cases from 2016 to 2018 in Guangzhou, China were collected. The relationship between HFMD cases and genotype frequency, as well as the association between genotype frequency and climate factors, were studied using general linear models. We transformed the genotype frequency to the isometric log-ratio (ILR) components included in the model. Additionally, vaccination rates were adjusted in the climate-driven models. (3) Results: We observed seasonal trends in HFMD cases, genotype frequency, and climate factors. The model regressing case numbers on genotype frequency revealed negative associations with both the ILRs of CAV16 (RR = 0.725, p < 0.001) and EV71 (RR = 0.421, p < 0.001). The model regressing genotype frequency on driven factors showed that the trends for EV71 proportions were inversely related to vaccination rate (%, β = −0.152, p = 0.098) and temperature (°C, β = −0.065, p = 0.004). Additionally, the trends for CVA16 proportions were inversely related to vaccination rate (%, β = −0.461, p = 0.004) and temperature (°C, β = −0.068, p = 0.031). The overall trends for genotype frequency showed that EV71 decreased significantly, while the trends for CVA16 increased annually. (4) Conclusions: Our findings suggest a potential pathway for climate factors, genotype frequency, and HFMD cases. Our study is practical and useful for targeted prevention and control, and provides environmental-based evidence.
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Du et al. (2021) conducted an observational in Hand, foot, and mouth disease (HFMD). Enterovirus genotype frequency (CAV16 and EV71) was evaluated on HFMD case numbers (RR 0.421, p=<0.001). Enterovirus genotype frequencies of CAV16 and EV71 were negatively associated with HFMD case numbers (RR 0.725 and RR 0.421, respectively; both p<0.001).
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