Key result
The dominant serotypes of hand, foot, and mouth disease in Sichuan Province shifted from EV-A71 and Cox A16 to other enteroviruses since 2013, with spatio-temporal clusters increasingly concentrated in Chengdu.
Why the study?
Variations in the epidemiological characteristics and pathogen spectrum of HFMD were poorly understood in Sichuan Province, China, particularly after the introduction of the EV-A71 vaccine.
Observational (n=449,485)
The dominant serotypes of HFMD in Sichuan Province have shifted to non-EV-A71/Cox A16 enteroviruses, highlighting the need for updated pathogen surveillance and vaccination strategies.
May warrant broader enterovirus surveillance focused on Chengdu; leaves open generalizability and implications for multivalent vaccines.
Hand, foot, and mouth disease (HFMD) remains a threat to the Asia-Pacific region. The epidemiological characteristics and pathogen spectrum of HFMD vary with space and time. These variations are crucial for HFMD interventions but poorly understood in Sichuan Province, China, particularly after the introduction of the EV-A71 vaccine. Using descriptive methods, regression analyses, spatial autocorrelation analysis, and space-time scan statistics, we analysed the epidemiological and aetiological characteristics of HFMD surveillance data in Sichuan Province between 2011 and 2017 to identify spatio-temporal variations. The dominant serotypes of HFMD have changed from enterovirus 71 and coxsackievirus A16 to other enteroviruses since 2013. The seasonal pattern of HFMD showed two peaks generally occurring from April to July and November to December; however, the seasonal pattern varied by prefecture and enterovirus serotype. From 2011 to 2017, spatio-temporal clusters were increasingly concentrated in Chengdu, with several small clusters in northeast Sichuan. The clusters observed in southern Sichuan from 2011 to 2015 disappeared in 2016-2017. These findings highlight the importance of pathogen surveillance and vaccination strategies for HFMD interventions; future prevention and control of HFMD should focus on Chengdu and its vicinity.
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Peng et al. (2020) conducted an observational in Hand, foot, and mouth disease (HFMD) (n=449,485). Time and geographic location (Sichuan Province, 2011-2017) was evaluated on Incidence and spatio-temporal distribution of HFMD. The dominant serotypes of hand, foot, and mouth disease in Sichuan Province shifted from EV-A71 and Cox A16 to other enteroviruses since 2013, with spatio-temporal clusters increasingly concentrated in Chengdu.
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