Objective  To describe the epidemiological characteristics of hand foot and mouth disease (HFMD) in Jingzhou, Hubei Province, from 2011 to 2021, analyze the risk factors for severe cases, and provide scientific evidence for the prevention and control of HFMD in Jingzhou.

  Methods  The incidence data, etiological surveillance results and epidemic data of HFMD in Jingzhou during this period were collected from “China Disease Prevention and Control Information System” for a descriptive epidemiological analysis, and the incidence rate, severe case rate or proportion, positive rate of sample detection and subtype proportion were calculated. Logistic regression analysis was used to identify the risk factors for severe HFMD.

  Results  From 2011 to 2021, a total of 62 521 cases of HFMD were reported in Jingzhou, with an average annual incidence rate of 100.87/100 000. In these cases, 146 were severe ones, with a severe case rate of 0.23%, 5 were death ones, the case fatality rate was 0.80/10 000, and severe case mortality rate was 3.42%. There was no significant difference in the annual incidence rate ( r_\rms =−0.21, P=0.539). The severe case rate showed a downward trend with year ( r_\rms =−0.66, P=0.031). Two annual incidence peaks of HFMD were observed (April-June and November-December). The incidence of HFMD in counties in Jingzhou (districts) ranged from 51.85/100 000 to 140.23/100 000, and the areas with high-incidences changed with year. The cases were mainly children living scatteredly (69.58%) and children attending child care settings (28.18%), and the incidence rate in boys (59.01/100 000) was higher than that in girls (41.66/100000, RR=1.42, 95%CI: 1.39–1.44). Most HFMD cases were children under 5 years old (96.08%). Severe cases were more likely to occur in boys, young children, children living in area on south bank of the Yangtze River and children with longer interval between onset and medical treatment and in epidemic season (OR>1, P<0.05). EV71 was the main pathogen of severe cases (53.57%) and death cases (80.00%). A total of 89 case clusters and 5 outbreaks were reported, mainly in child care settings (87, 92.55%). The positive rate of pathogen detection was 70.88% (3 488/4 921). The pathogens detected included EV71 (16.66%), Cox A16 (27.24%) and other enteroviruses (56.10%). The proportion of other enteroviruses showed an upward trend with year ( r_\rms =0.75, P=0.007).

  Conclusion  The incidence of HFMD in Jingzhou remained at a high level. In recent years, the incidence rate of severe HFMD dropped significantly. HFMD had obvious spatiotemporal heterogeneity and other enteroviruses had become the main pathogens of HFMD in Jingzhou.