Clinical, aetiological, and epidemiological studies of outpatient cases of hand, foot, and mouth disease in Chengdu, China, from 2019 to 2022: a retrospective study

Abstract Background The introduction of the Enterovirus A71 (EV-A71) vaccine in China in 2016 has led to a considerable decline in severe hand, foot, and mouth disease (HFMD) cases, with mild outpatient instances now representing the majority of HFMD cases in the country. Nevertheless, epidemiologic...

Full description

Saved in:
Bibliographic Details
Main Authors: Maoyao Xia, Yu Zhu, Juan Liao, Shirong Zhang, Denghui Yang, Peng Gong, Shihang Zhang, Guiyu Jiang, Yue Cheng, Jiantong Meng, Zhenhua Chen, Ye Liao, Xiaojing Li, Yilan Zeng, Chaoyong Zhang, Lu Long
Format: Article
Language:English
Published: BMC 2024-12-01
Series:BMC Public Health
Subjects:
Online Access:https://doi.org/10.1186/s12889-024-20909-8
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850100465483644928
author Maoyao Xia
Yu Zhu
Juan Liao
Shirong Zhang
Denghui Yang
Peng Gong
Shihang Zhang
Guiyu Jiang
Yue Cheng
Jiantong Meng
Zhenhua Chen
Ye Liao
Xiaojing Li
Yilan Zeng
Chaoyong Zhang
Lu Long
author_facet Maoyao Xia
Yu Zhu
Juan Liao
Shirong Zhang
Denghui Yang
Peng Gong
Shihang Zhang
Guiyu Jiang
Yue Cheng
Jiantong Meng
Zhenhua Chen
Ye Liao
Xiaojing Li
Yilan Zeng
Chaoyong Zhang
Lu Long
author_sort Maoyao Xia
collection DOAJ
description Abstract Background The introduction of the Enterovirus A71 (EV-A71) vaccine in China in 2016 has led to a considerable decline in severe hand, foot, and mouth disease (HFMD) cases, with mild outpatient instances now representing the majority of HFMD cases in the country. Nevertheless, epidemiological investigations concerning mild outpatient cases remain scarce, resulting in inadequate descriptions of their clinical, etiological, and epidemiological characteristics. Our study aimed to analyze the clinical, etiological, and epidemiological characteristics of HFMD outpatients in Chengdu from 2019 to 2022 while identifying potential risk factors associated with the progression of outpatients requiring hospitalization. Methods A retrospective study was conducted to summarize the clinical, etiological, and epidemiological characteristics of outpatient HFMD cases in Chengdu from 2019 to 2022. Risk factors associated with progression to hospitalization of HFMD outpatients were evaluated using binomial logistic regression analysis. Results The study included 1,073 coxsackievirus A6 (CVA6), coxsackievirus A10 (CVA10), and coxsackievirus A16 (CVA16) HFMD nucleic acid test-positive outpatients. Among these, only 45 outpatients (4.19%) progressed to hospitalization. The median ages for CVA6, CVA10, and CVA16 infections were 25.23, 28.13, and 38.45 months, respectively (P < 0.001). CVA6 (76.51%, 821/1,073) has become the main serotype among outpatients in Chengdu, with the proportions from the second half of 2019 to 2022 being 45.59%, 95.17%, 77.67% and 80.71% respectively. EV-A71 cases even disappeared. Patients infected with CVA10 had a significantly higher likelihood of hospitalization (P < 0.05), while the presence of oral rash served as a protective factor (P < 0.05). Conclusions Our study highlights the critical need for enhanced surveillance of multiple HFMD pathogens, predominantly caused by the prevalent serotype CVA6. Clinically, enhanced surveillance of CVA10 is imperative to mitigate the hospitalization rate associated with HFMD.
format Article
id doaj-art-737801b6593e42158cd199a35a98a484
institution DOAJ
issn 1471-2458
language English
publishDate 2024-12-01
publisher BMC
record_format Article
series BMC Public Health
spelling doaj-art-737801b6593e42158cd199a35a98a4842025-08-20T02:40:18ZengBMCBMC Public Health1471-24582024-12-0124111010.1186/s12889-024-20909-8Clinical, aetiological, and epidemiological studies of outpatient cases of hand, foot, and mouth disease in Chengdu, China, from 2019 to 2022: a retrospective studyMaoyao Xia0Yu Zhu1Juan Liao2Shirong Zhang3Denghui Yang4Peng Gong5Shihang Zhang6Guiyu Jiang7Yue Cheng8Jiantong Meng9Zhenhua Chen10Ye Liao11Xiaojing Li12Yilan Zeng13Chaoyong Zhang14Lu Long15Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan UniversityWest China Second University Hospital, Sichuan UniversityDepartment of Gastroenterology Institution, West China School of Public Health and West China Fourth Hospital, Sichuan UniversityDepartment of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan UniversityDepartment of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan UniversityDepartment of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan UniversitySchool of Mathematics, Sichuan UniversityDepartment of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan UniversityChengdu Center for Disease Control and PreventionChengdu Center for Disease Control and PreventionChengdu Center for Disease Control and PreventionDepartment of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan UniversityChengdu Jinjiang Center for Disease Control and PreventionPublic Health Clinical Center of ChengduPublic Health Clinical Center of ChengduDepartment of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan UniversityAbstract Background The introduction of the Enterovirus A71 (EV-A71) vaccine in China in 2016 has led to a considerable decline in severe hand, foot, and mouth disease (HFMD) cases, with mild outpatient instances now representing the majority of HFMD cases in the country. Nevertheless, epidemiological investigations concerning mild outpatient cases remain scarce, resulting in inadequate descriptions of their clinical, etiological, and epidemiological characteristics. Our study aimed to analyze the clinical, etiological, and epidemiological characteristics of HFMD outpatients in Chengdu from 2019 to 2022 while identifying potential risk factors associated with the progression of outpatients requiring hospitalization. Methods A retrospective study was conducted to summarize the clinical, etiological, and epidemiological characteristics of outpatient HFMD cases in Chengdu from 2019 to 2022. Risk factors associated with progression to hospitalization of HFMD outpatients were evaluated using binomial logistic regression analysis. Results The study included 1,073 coxsackievirus A6 (CVA6), coxsackievirus A10 (CVA10), and coxsackievirus A16 (CVA16) HFMD nucleic acid test-positive outpatients. Among these, only 45 outpatients (4.19%) progressed to hospitalization. The median ages for CVA6, CVA10, and CVA16 infections were 25.23, 28.13, and 38.45 months, respectively (P < 0.001). CVA6 (76.51%, 821/1,073) has become the main serotype among outpatients in Chengdu, with the proportions from the second half of 2019 to 2022 being 45.59%, 95.17%, 77.67% and 80.71% respectively. EV-A71 cases even disappeared. Patients infected with CVA10 had a significantly higher likelihood of hospitalization (P < 0.05), while the presence of oral rash served as a protective factor (P < 0.05). Conclusions Our study highlights the critical need for enhanced surveillance of multiple HFMD pathogens, predominantly caused by the prevalent serotype CVA6. Clinically, enhanced surveillance of CVA10 is imperative to mitigate the hospitalization rate associated with HFMD.https://doi.org/10.1186/s12889-024-20909-8Hand, foot, and mouth diseaseOutpatientsCoxsackievirusEpidemiologyRisk factors
spellingShingle Maoyao Xia
Yu Zhu
Juan Liao
Shirong Zhang
Denghui Yang
Peng Gong
Shihang Zhang
Guiyu Jiang
Yue Cheng
Jiantong Meng
Zhenhua Chen
Ye Liao
Xiaojing Li
Yilan Zeng
Chaoyong Zhang
Lu Long
Clinical, aetiological, and epidemiological studies of outpatient cases of hand, foot, and mouth disease in Chengdu, China, from 2019 to 2022: a retrospective study
BMC Public Health
Hand, foot, and mouth disease
Outpatients
Coxsackievirus
Epidemiology
Risk factors
title Clinical, aetiological, and epidemiological studies of outpatient cases of hand, foot, and mouth disease in Chengdu, China, from 2019 to 2022: a retrospective study
title_full Clinical, aetiological, and epidemiological studies of outpatient cases of hand, foot, and mouth disease in Chengdu, China, from 2019 to 2022: a retrospective study
title_fullStr Clinical, aetiological, and epidemiological studies of outpatient cases of hand, foot, and mouth disease in Chengdu, China, from 2019 to 2022: a retrospective study
title_full_unstemmed Clinical, aetiological, and epidemiological studies of outpatient cases of hand, foot, and mouth disease in Chengdu, China, from 2019 to 2022: a retrospective study
title_short Clinical, aetiological, and epidemiological studies of outpatient cases of hand, foot, and mouth disease in Chengdu, China, from 2019 to 2022: a retrospective study
title_sort clinical aetiological and epidemiological studies of outpatient cases of hand foot and mouth disease in chengdu china from 2019 to 2022 a retrospective study
topic Hand, foot, and mouth disease
Outpatients
Coxsackievirus
Epidemiology
Risk factors
url https://doi.org/10.1186/s12889-024-20909-8
work_keys_str_mv AT maoyaoxia clinicalaetiologicalandepidemiologicalstudiesofoutpatientcasesofhandfootandmouthdiseaseinchengduchinafrom2019to2022aretrospectivestudy
AT yuzhu clinicalaetiologicalandepidemiologicalstudiesofoutpatientcasesofhandfootandmouthdiseaseinchengduchinafrom2019to2022aretrospectivestudy
AT juanliao clinicalaetiologicalandepidemiologicalstudiesofoutpatientcasesofhandfootandmouthdiseaseinchengduchinafrom2019to2022aretrospectivestudy
AT shirongzhang clinicalaetiologicalandepidemiologicalstudiesofoutpatientcasesofhandfootandmouthdiseaseinchengduchinafrom2019to2022aretrospectivestudy
AT denghuiyang clinicalaetiologicalandepidemiologicalstudiesofoutpatientcasesofhandfootandmouthdiseaseinchengduchinafrom2019to2022aretrospectivestudy
AT penggong clinicalaetiologicalandepidemiologicalstudiesofoutpatientcasesofhandfootandmouthdiseaseinchengduchinafrom2019to2022aretrospectivestudy
AT shihangzhang clinicalaetiologicalandepidemiologicalstudiesofoutpatientcasesofhandfootandmouthdiseaseinchengduchinafrom2019to2022aretrospectivestudy
AT guiyujiang clinicalaetiologicalandepidemiologicalstudiesofoutpatientcasesofhandfootandmouthdiseaseinchengduchinafrom2019to2022aretrospectivestudy
AT yuecheng clinicalaetiologicalandepidemiologicalstudiesofoutpatientcasesofhandfootandmouthdiseaseinchengduchinafrom2019to2022aretrospectivestudy
AT jiantongmeng clinicalaetiologicalandepidemiologicalstudiesofoutpatientcasesofhandfootandmouthdiseaseinchengduchinafrom2019to2022aretrospectivestudy
AT zhenhuachen clinicalaetiologicalandepidemiologicalstudiesofoutpatientcasesofhandfootandmouthdiseaseinchengduchinafrom2019to2022aretrospectivestudy
AT yeliao clinicalaetiologicalandepidemiologicalstudiesofoutpatientcasesofhandfootandmouthdiseaseinchengduchinafrom2019to2022aretrospectivestudy
AT xiaojingli clinicalaetiologicalandepidemiologicalstudiesofoutpatientcasesofhandfootandmouthdiseaseinchengduchinafrom2019to2022aretrospectivestudy
AT yilanzeng clinicalaetiologicalandepidemiologicalstudiesofoutpatientcasesofhandfootandmouthdiseaseinchengduchinafrom2019to2022aretrospectivestudy
AT chaoyongzhang clinicalaetiologicalandepidemiologicalstudiesofoutpatientcasesofhandfootandmouthdiseaseinchengduchinafrom2019to2022aretrospectivestudy
AT lulong clinicalaetiologicalandepidemiologicalstudiesofoutpatientcasesofhandfootandmouthdiseaseinchengduchinafrom2019to2022aretrospectivestudy