Epidemiology of hand, foot and mouth disease in China, 2008 to 2015 prior to the introduction of EV-A71 vaccine.
Epidemiology of hand, foot and mouth disease in China, 2008 to 2015 prior to the introduction of EV-A71 vaccine.
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DOI：
10.2807/1560-7917.es.2017.22.50.16-00824
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发表时间：
2017-12
期刊：
影响因子：
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通讯作者：
Yu H
中科院分区：
文献类型：
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作者：
Yang B;Liu F;Liao Q;Wu P;Chang Z;Huang J;Long L;Luo L;Li Y;Leung GM;Cowling BJ;Yu H
手足口病(HFMD)通常由人类肠道病毒A型的几种血清型引起，包括肠道病毒71型(EV-A71)和柯萨奇病毒A16(CV-A16)。两种单价EV-A71灭活疫苗近日已在中国获得许可，单价CV-A16疫苗和双价EV-A71和CV-A16疫苗正在研发中。方法：利用国家监测系统的通知，我们描述了2008年至2015年在引入EV-A71疫苗之前该国手足口病的流行病学和动态。结果：实验室确定的血清型类别，即CV-A16、EV-A71和其他肠道病毒，每年都在传播。EV-A71仍然是毒力最强的血清型，是历年死亡病例(范围：88.5-95.4%)和重症病例(范围：：50.7-82.3%)的主要血清型。除了2013年和2015年在轻度手足口病中发现其他肠道病毒的频率较高(48.8%和52.5%)外，在研究涵盖的其余年份中，从轻度病例中发现EV-A71的频率较高(范围：339.4-52.6%)。与所有血清类型相关的手足口病发病率和严重风险在1岁及以下儿童中最高，并随着年龄的增长而下降。讨论/结论：这项研究为评估疫苗的影响和潜在的血清型替代提供了基线流行病学。
Hand, foot and mouth disease (HFMD) is usually caused by several serotypes from human enterovirus A species, including enterovirus 71 (EV-A71) and coxsackievirus A16 (CV-A16). Two inactivated monovalent EV-A71 vaccines have been recently licensed in China and monovalent CV-A16 vaccine and bivalent EV-A71 and CV-A16 vaccine are under development. Methods: Using notifications from the national surveillance system, we describe the epidemiology and dynamics of HFMD in the country, before the introduction of EV-A71 vaccination, from 2008 through 2015. Results: Laboratory-identified serotype categories, i.e. CV-A16, EV-A71 and other enteroviruses, circulated annually. EV-A71 remained the most virulent serotype and was the major serotype for fatal cases (range: 88.5–95.4%) and severe cases (range: 50.7–82.3%) across years. Except for 2013 and 2015, when other enteroviruses were more frequently found in mild HFMD (48.8% and 52.5%), EV-A71 was more frequently detected from mild cases in the rest of the years covered by the study (range: 39.4–52.6%). The incidence rates and severity risks of HFMD associated with all serotype categories were the highest for children aged 1 year and younger, and decreased with increasing age. Discussion/conclusion: This study provides baseline epidemiology for evaluation of vaccine impact and potential serotype replacement.