Epidemiological Characteristics and Spatial-Temporal Clusters of Hand, Foot, and Mouth Disease in Zhejiang Province, China, 2008-2012

摘要: Hand, foot and mouth disease (HFMD) is one of the major public health concerns in China. Being province with high incidence rates HFMD, epidemiological features spatial-temporal patterns Zhejiang Province were still unknown. The objective this study was to investigate characteristics high-incidence clusters, as well explore some potential risk factors. surveillance data HFMD during 2008–2012 collected from communicable network system Provincial Center for Disease Control Prevention. distributions age, gender, occupation, season, region, pathogen’s serotype severity analyzed describe Province. Seroprevalence survey human enterovirus 71 (EV71) 549 healthy children also performed, 27 seroprevalence publications between 1997 2015 summarized. methods performed clusters at county level. Furthermore, pathogens’ serotypes such EV71 coxsackievirus A16 (Cox A16) meteorological factors associated clusters. A total 454,339 cases reported 2008–2012, including 1688 (0.37%) severe cases. annual average rate 172.98 per 100,000 (ranged 72.61 270.04). male-to-female ratio mild around 1.64:1, up 1.87:1 Of cases, aged under three years old five accounted almost 60% 90%, respectively. Among all enteroviruses, predominant (49.70%), followed by Cox (26.05%) other enteroviruses (24.24%) In (82.85%) causative agent. confirmed that occult infection common children. literature summary 26 studies 1997–2015 0–5 group showed lowest level (29.1% on average) compared elder (6–10 group: 54.6%; 11–20 61.8%). Global positive spatial autocorrelation (Moran’s Is>0.25, P<0.05) discovered not only but local revealed counties eastern coastal southern regions. retrospective space-time cluster analysis these patterns. Risk analyses implied more less sunshine Our highly epidemic provinces China similar provinces. Occult adults important reasons why most under-five. Combining results analysis, distribution could be for, serve an early warning of, outbreak