Objective To analyze the epidemiological characteristics of hand foot mouth disease deaths in Hubei Province to provide a reference basis for preventing and reducing the death cases.
Methods Case information of hand foot mouth disease in Hubei Province from 2008 to 2021 was collected, and the epidemiology, medical institution and etiology were analyzed by descriptive methods.
Results Hubei province reported 981 315 cases and 112 deaths from 2008 to 2021, case fatality rate was 0.0114%. The peak of disease is distributed in April to June, and the death cases are mainly concentrated in April to July. The deaths were distributed in 40 (38.83%) districts and counties of the the province. The male to female ratio was 2.03∶1, the median age was 1 year, 98.21% (110/112) were under 5 years old, and 91.07% (102/112) were scattered children. The etiology examination results were mainly EV71 (95.65%, 88 / 92).
Conclusion The overall death of HFMD shows a downward trend, however the epidemiological investigation and etiology detection of severe death cases should be strengthened and improve the timeliness of diagnosis and treatment to avoid death.
1.崔金朝, 聂陶然, 任敏睿, 等. 2008-2018年中国5岁及以下儿童手足口病死亡病例流行病学特征[J]. 中华流行病学杂志, 2020, 41(7): 1041-1046. [Cui JZ, Nie TR, Ren MR, et al. Epidemiological characteristics of fatal cases of hand, foot, and mouth disease in children under 5 years old in China, 2008-2018[J]. Chinese Journal of Epidemiology, 2020, 41(7): 1041-1046.]. DOI: 10.3760/cma.j.cn112338-20200114-00031.
2.Zheng ZM, He PJ, Caueffield D, et al. Enterovirus 71 isolated from China is serologically similar to the prototype E71 BrCr strain but differs in the 5'-noncoding region[J]. J Med Virol, 1995, 47(2): 161-167. DOI: 10.1002/jmv.1890470209.
3.邵惠训. 手足口病的现状与展望[J]. 国际病毒学杂志, 2010, 17(3): 74-78. [Shao HX. Status and prospect of hand, foot and mouth disease[J]. International Journal of Virology, 2010, 17(3): 74-78.] DOI: 10.3760/cma.j.issn.1673-4092.2010.03.003.
4.McMinn PC. An overview of the evolution of enterovirus 71 and its clinical and public health significance[J]. FEMS Microbiol Rev, 2002, 26(1): 91-107. DOI: 10.1111/j.1574-6976.2002.tb00601.x.
5.Cheng H, Zeng JJ, Li HJ, et al. Neuroimaging of HFMD infected by EV71[J]. Radiology of Infectious Diseases, 2015, 1(2): 103-108. DOI: 10.1016/j.jrid.2015.02.006.
6.国家卫生健康委员会. 手足口病诊疗指南(2018年版)[J]. 传染病信息, 2018, 31(3): 193-198. [National Health Commission. Guidelines for the diagnosis and treatment of hand, foot and mouth disease (2018 edition)[J]. Infectious Disease Information, 2018, 31(3): 193-198.] DOI: 10.3969/j.issn.1007-8134.2018.03.001.
7.中华人民共和国国家卫生和计划生育委员会. WS 588-2018手足口病诊断[J]. 中国病毒病杂志, 2018, 8(6): 427-433. [National Health and Family Planning Commission of the People's Republic of China. WS 588-2018 diagnosis for hand, foot and mouth disease[J]. Chinese Journal of Viral Diseases, 2018, 8(6): 427-433.] DOI: CNKI:SUN:ZRYX.0.2018-06-001.
8.洪洁, 赵峥, 苏晴, 等.手足口病传播动力学模型的研究进展[J]. 中华流行病学杂志, 2022, 43(6): 966-973. [Hong J, Zhao Z, Su Q, et al. Research advances in transmission dynamic models on hand, foot, and mouth disease[J]. Chinese Journal of Epidemiology, 2022, 43(6): 966-973.] DOI: 10.3760/cma.j.cn112338-20211221-01006.
9.胡兢晶, 郭梦杰, 王波, 等. 111例广东省重症手足口病死亡病例流行病学分析[J]. 热带医学杂志, 2019, 19(2): 233-235, 239. [Hu JJ, Guo MJ, Wang B, et al. Epidemiology of 111 hand foot mouth disease death cases in Guangdong province[J]. Journal of Tropical Medicine, 2019, 19(2): 233-235, 239.] DOI: 10.3969/j.issn.1672- 3619.2019.02.027.
10.孙倩莱, 高立冬, 胡世雄, 等. 2009-2015年湖南省手足口病死亡病例临床与流行病学特征分析[J]. 实用预防医学, 2017, 24(2): 148-151. [Sun QL, Gao LD, Hu SX, et al. Clinical and epidemiological characteristics of death cases of hand, foot and mouth disease in Hunan Province, 2009-2015[J]. Practical Preventive Medicine, 2017, 24(2): 148-151.] DOI: 10.3969/j.issn.1006-3110.2017.02.006.
11.张静, 李秀惠, 李丽, 等 . 手足口病病原学和流行病学研究进展[J]. 中华流行病学杂志, 2022 , 43(5): 771-783. [Zhang J, Li XH, Li L, et al. Etiology and epidemiology of hand, foot and mouth disease in China[J]. Chinese Journal of Epidemiology, 2022, 43(5): 771-783.] DOI: 10.3760 /cma.j.cn112338-20211012-00788.
12.于秋丽, 刘莹莹, 赵文娜, 等. 河北省2013-2017年其他肠道病毒手足口病重症和死亡病例流行病学和病原特征分析[J]. 中华流行病学杂志, 2020, 41(7): 1054-1057. [Yu QL, Liu YY, Zhao WN, et al. Epidemiological and pathogenic characteristics of cases with severe and fatal hand, foot, and mouth disease caused by other enterovirus in Hebei province, 2013-2017[J]. Chinese Journal of Epidemiology, 2020, 41(7): 1054-1057.] DOI:10.3760/cma.j.cn112338-20190802-00575.
13.吴亦栋, 尚世强, 陈志敏, 等. 手足口病病原体流行特征分析及临床意义[J]. 中华儿科杂志, 2010, 48(7): 535-539. [Wu YD, Shang SQ, Chen ZM, et al. Analysis of the epidemic characteristics of the etiological agents in children with hand, foot and mouth disease and its clinical significance[J]. Chinese Journal of Pediatrics, 2010, 48(7): 535-539.] DOI: 10.3760/cma.j.issn.0578-1310.2010.07.012.
14.常昭瑞, 张静, 孙军玲, 等. 中国2008-2009年手足口病报告病例流行病学特征分析[J]. 中华流行病学杂志, 2011, 32(7): 676-680. [Chang ZR, Zhang J, Sun JL. Epidemiological features of hand, foot and mouth disease in China, 2008-2009[J]. Chinese Journal of Epidemiology, 2011, 32(7): 676-680. ] DOI: 10.3760/cma.j.issn.0254-6450.2011.07.009.
15.Koh WM, Bogich T, Siegel K, et al. The epidemiology of hand, foot and mouth disease in Asia:a systematic review and analysis[J]. Pediatr Infect Dis J, 2016, 35(10): e285-300. DOI: 10.1097/INF.0000000000001242.
16.Chang LY, Hsiung CA, Lu CY, et al. Status of cellular rather than humoral immunity is corclated with clinical outcome of enterovirus 71[J]. Pediatr Res, 2006, 60(4): 466-471. DOl: 10.1203/01.pdr.0000238247.86041.19.
17.Yang BY, Wu P, Wu JT, et al. Seroprevalence of enterovirus 71 antibody among children in China: a systematic review and Meta-analysis[J]. Pediatr Infect Dis J, 2015, 34(12): 1399-1406. DOI: 10.1097/INF.0000000000000900.
18.Solomon T, Lewthwaite P, Perera D, et al. Virology, epidemiology, pathogenesis, and control of enterovirus 71[J]. Lancet Infect Dis, 2010, 10(11): 778-790. DOI: 10.1016/S1473-3099(10)70194-8.
19.Hsu CH, Lu CY, Shao PL, et al. Epidemiologic and clinical features of non-polio enteroviral infections in northern Taiwan in 2008[J]. J Microbiol Immunol Infect, 2011, 44(4): 265-273. DOI: 10.1016/j.jmii.2011.01.029.
20.Wu CY, Wang HC, Wang KT, et al. Neutralization of five subgenotypes of enterovirus 71 by Taiwanese human plasma and Taiwanese plasma derived intravenous immunoglobulin[J]. Biologicals, 2013, 41(3): 154-157. DOI: 10.1016/j.biologicals.2013.02.002.
21.Li R, Liu L, Mo Z, et al. An inactivated enterovirus 71 vaccine in healthy children[J]. N Engl J Med, 2014, 370(9): 829-837. DOI: 10.1056/NEJMoa1303224.
22.Zhu FC, Xu WB, Xia JL, et al. Efficacy, safety, and immunogenicity of an enterovirus 71 vaccine in China[J]. N Engl J Med, 2014, 370(9): 818-828. DOI: 10.1056/NEJMoa1304923.
23.Zhu FC, Meng FY, Li JX, et al. Efficacy, safety, and immunology of an inactivated alum-adjuvant enterovirus 71 vaccine in children in China: a multicentre, randomised, double-blind, placebo-controlled, phase 3 trial[J]. Lancet, 2013, 381(9882): 2024-2032. DOI: 10.1016/S0140-6736(13)61049-1.
24.张静. 2008-2017年中国手足口病流行趋势和病原变化动态数列分析[J]. 中华流行病学杂志, 2019, 40(2): 147-154. [Zhang J. Trend of epidemics and variation of pathogens of hand, foot and mouth disease in China: a dynamic series analysis, 2008-2017[J]. Chinese Journal of Epidemiology, 2019, 40(2): 147-154.]DOI: 10.3760/cma.j.issn.0254-6450.2019.02.005.