What is the clinical evidence from this study?

Study design: Observational. Population: Hand, foot, and mouth disease (HFMD) (n=400264). Intervention: Enterovirus infection (EV71, CA16). Primary outcome: Incidence and etiological characteristics of HFMD.

March 10, 2015Open Access

Epidemiological and Etiological Characteristics of Hand, Foot and Mouth Disease in Henan, China, 2008–2013

XHXueyong HuangNanchang University HWHaiyan WeiChinese PLA General Hospital SWShuyu WuNanjing Agricultural University

Key Result

From 2008 to 2013, 400,264 cases of HFMD were reported in Henan, China, with an annual average incidence of 70.87 per 100,000, predominantly affecting children under 5 years old and primarily caused by EV71.

Study Design

Type

Observational (n=400,264)

Multicenter

Yes

Structured PICO

Population

400,264 reported cases of hand, foot, and mouth disease in Henan, China, from 2008 to 2013, predominantly affecting children under 5 years of age.

Outcome

Epidemiological and etiological characteristics (time, region, population distribution, and pathogen genotypes)

HFMD in Henan is primarily caused by EV71 and CA16, with children under five most affected, supporting the need for EV71 vaccination.

Limitations

Patients with milder or atypical symptoms were likely not included in the study.
Only a small proportion of reported HFMD cases were confirmed by laboratory testing, meaning some clinically diagnosed cases may have had other illnesses.
Laboratory testing may have preferentially been ordered for more severe cases, potentially biasing findings of etiologic agents.

Abstract

Hand, foot, and mouth disease (HFMD) is a common childhood illness caused by enteroviruses. HFMD outbreaks and reported cases have sharply increased in China since 2008. Epidemiological and clinical data of HFMD cases reported in Henan Province were collected from 2008 to 2013. Clinical specimens were obtained from a subset of these cases. Descriptive epidemiological methods were used to analyze the time, region and population distribution. The VP1 gene from EV71 and CA16 isolates was amplified, and the sequences were analyzed. 400,264 cases of HFMD were reported in this study, including 22,309 severe and 141 fatal cases. Incidence peaked between April and May. Laboratory confirmation was obtained for 27,692 (6.9%) cases; EV71, CA16, and other enteroviruses accounted for 59.5%, 14.1%, 26.4%, respectively. Phylogenetic analysis revealed that EV71 belonged to the C4a evolution branch of C4 sub-genotype and CA16 belonged to subtype B1a or B1b. The occurrence of HFMD in Henan was closely related to season, age and region distribution. Children under five were the most affected population. The major pathogens causing HFMD and their genotypes have not notably changed in Henan. The data strongly support the importance of EV71 vaccination in a high population density area such as Henan, China.

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Cite This Study

Huang et al. (Tue,) conducted a observational in Hand, foot, and mouth disease (HFMD) (n=400,264). Enterovirus infection (EV71, CA16) was evaluated on Incidence and etiological characteristics of HFMD. From 2008 to 2013, 400,264 cases of HFMD were reported in Henan, China, with an annual average incidence of 70.87 per 100,000, predominantly affecting children under 5 years old and primarily caused by EV71.

synapsesocial.com/papers/6a64d1fe9aeeefc9b8ef4756 https://doi.org/https://doi.org/10.1038/srep08904

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