Key result
Other enteroviruses replace EV-A71 as the leading cause of severe HFMD, driving ~71% of cases.
Observational
Yes
In 2018, non-EV-A71 and non-CV-A16 enterovirus serotypes became the predominant cause of severe HFMD in China, highlighting the need for multivalent vaccines.
Shifting HFMD serotypes may support multivalent vaccine development; leaves open adequacy of current monovalent strategies.
WHAT IS ALREADY KNOWN ABOUT THIS TOPIC?: Enterovirus 71 (EV-A71) is the main causative pathogen for severe and fatal patients with Hand, Foot, and Mouth Disease (HFMD) in mainland China from 2008 to 2017. Non-EV-A71 and non-CV-A16 (other enterovirus) serotypes were the major causative-serotypes for mild HFMD in years of 2013, 2015, and 2017. WHAT IS ADDED BY THIS REPORT?: In 2018, other enterovirus serotypes replaced EV-A71 for the first time as the major cause of severe HFMD with a proportion of 70.7%. However, at the national level, only a small proportion of the other enterovirus serotypes were further identified as CV-A6 and CV-A10. WHAT ARE THE LIMITATIONS FOR PUBLIC HEALTH PRACTICE?: Further identification of other enterovirus serotypes is highly recommended for provincial CDCs, especially for severe HFMD. Studies contributing to a multivalent vaccine for HFMD should be prioritized.
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Liu et al. (2020) conducted an observational in Hand, Foot, and Mouth Disease (HFMD). Other enterovirus serotypes (non-EV-A71 and non-CV-A16) vs. EV-A71 was evaluated on Proportion of severe HFMD cases. In 2018, other enterovirus serotypes replaced EV-A71 as the major cause of severe Hand, Foot, and Mouth Disease in China, accounting for 70.7% of cases.
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