Wang Zhifang, Lv Huakun, Zhu Wenming, Mo Zhe, Mao Guangming, Wang Xiaofeng, Lou Xiaoming, Chen Yongdi
Department of Immunization Programme, Zhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Hangzhou 310051, China.
Department of Environmental and Occupational Health, Zhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Hangzhou 310051, China.
Int J Environ Res Public Health. 2016 Dec 30;14(1):33. doi: 10.3390/ijerph14010033.
Enterovirus 71 (EV71) usually causes hand-foot-and-mouth disease (HFMD) with severe clinical symptoms and even deaths in China. There is no efficient antiviral drug to protect against severe EV71-associated HFMD, making the development of EV71 vaccines therefore a priority. However, the potential target subject population(s) to be immunized with EV71 vaccine are not well understood. In this study, we characterized the epidemiology regarding EV71-associated HFMD on the basis of provincial-level surveillance. We extracted data on EV71-associated HFMD from the National Notifiable Disease Reporting System in Zhejiang Province, China between 1 January 2009 and 31 December 2013 ( = 7650). The higher incidence rate of EV71 cases occurred in those children aged 12-23 months, with boys being predominant. Interestingly, different peaks activities of EV71 infection was observed in different calendar year, with one peak in 2009 and 2013 and two peaks in 2010-2012. However, EV71 infection seemed to predominately occur in warm season and a distinguished cyclic peak that seemed to be of about 12 months. Children aged 12-23 months are thus identified as an important target population for public health intervention, for example, it is recommended that these key subjects immunized with EV71 vaccine. In addition, an enhanced surveillance system for EV71-associated with HFMD needs to focus on generic and phylogenetic analysis.
肠道病毒71型（EV71）在中国通常会引发手足口病（HFMD），伴有严重的临床症状甚至导致死亡。目前尚无有效的抗病毒药物来预防与EV71相关的重症手足口病，因此开发EV71疫苗成为当务之急。然而，EV71疫苗潜在的目标接种人群尚未得到充分了解。在本研究中，我们基于省级监测对与EV71相关的手足口病的流行病学特征进行了描述。我们从中国浙江省国家法定传染病报告系统中提取了2009年1月1日至2013年12月31日期间与EV71相关的手足口病数据（n = 7650）。EV71病例发病率较高的是12至23个月大的儿童，且以男孩为主。有趣的是，在不同年份观察到EV71感染的不同高峰活动，2009年和2013年有一个高峰，2010 - 2012年有两个高峰。然而，EV71感染似乎主要发生在温暖季节，且有一个约12个月的明显周期性高峰。因此，12至23个月大的儿童被确定为公共卫生干预的重要目标人群，例如，建议对这些关键对象接种EV71疫苗。此外，针对与手足口病相关的EV71的强化监测系统需要关注基因和系统发育分析。
