Epidemiology of hand foot and mouth disease caused by enterovirus 71 in Jinan,2010-2013

Objective To understand the epidemiological characteristics of enterovirus 71(EV71) caused hand foot and mouth disease (HFMD) in Jinan from 2010 to 2013,and provide scientific evidence for prevention and control of HFMD. Methods Stool samples and pharynx swabs were collected from clinically diagnosed HFMD cases in Jinan from 2010 to 2013,and reverse transcriptas-polymerase chain reaction (RT-PCR) was conducted with universal primers within 5'untranslated region of enterovirus and VP1 region of Coxsackievirus A16 (Cox A16) and EV71 for etiological identification. Results Among the 3351 HFMD cases surveyed in Jinan during 2010-2013,including 114 severe cases, 2548 were enterovirus positive (76.04%). Of the 2548 cases, 1001 (39.29%) were EV71 positive. The annual EV71 positive rate was 23.51%, 39.95%, 22.12%, and 33.84%, respectively.The difference in EV71 positive rate was significant between severe cases (80.70%) and mild cases (28.08%) (2=131.9135, P0.01); Of the 114 severe cases, the positive rate of EV71 was significantly higher than those of other enteroviruses (2=245.24, P0.01). Among the 1001 EV71 caused HFMD cases, the male to female ratio was 1.60:1, and the age of most affected children was under 4 years (84.42%), and those aged 1-3 years accounted for 48.65%. Most severe cases (89.13%) were children aged3 years, and the male to female ratio of the severe cases was 2.83:1. The 2 fatal cases were all under 1 year old. Conclusion The circulating strength and trend of EV71 varied with year during 2010-2013; EV71 was major pathogen of severe or fatal HFMD cases.