Epidemiological characteristics and trend of mortality on hand, foot and mouth disease in China, 2008-2022
10.3760/cma.j.cn112338-20231125-00317
- VernacularTitle:2008-2022年中国手足口病死亡病例流行特征和变化趋势
- Author:
Feng GAO
1
;
Bicheng TANG
;
Xinli JIANG
;
Siyu YIN
;
Zhaorui CHANG
;
Ying QIN
;
Yu LI
;
Zhongjie LI
Author Information
1. 中国疾病预防控制中心传染病管理处/传染病溯源预警与智能决策全国重点实验室，北京 102206
- Keywords:
Hand, foot and mouth disease;
Mortality;
Epidemiology characteristics;
Epidemic trend
- From:
Chinese Journal of Epidemiology
2024;45(12):1626-1632
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the nationwide epidemiological characteristics and trend of hand, foot and mouth disease (HFMD) fatal cases from 2008 to 2022 and provide evidence for the prevention and control of HFMD.Methods:The information on HFMD fatal cases during 2008 to 2022 was collected from the National Notifiable Disease Surveillance Reporting System of China. Data of the epidemiological characteristics was analyzed by R 4.2.2 software and the changing trends for the case fatality rates, mortality rates and their age-adjusted rates were analyzed by Joinpoint 4.9.10 software.Results:From 2008 to 2022, a total of 3 704 fatal HFMD cases were reported in China. The fatal cases were primarily observed in children aged <3 years (83.42%, 3 090/3 704). The male and female gender ratio was 1.82 ∶1 (2 389 ∶1 315). Regarding the age-adjusted case fatality rates over time, there was a rapid increase from 2008 to 2010 [annual percentage change (APC) =41.97%, P<0.05]. From 2010 to 2016, a steady decline was observed (APC=-28.57%, P<0.05), and the decline accelerated (APC=-39.66%, P<0.05) from 2016 to 2022. Since 2020, less than 10 fatal cases were reported annually nationwide. Among the 2 566 laboratory-confirmed deaths from 2008 to 2022, Enterovirus A71 (EV71) was the predominant pathogen (91.62%,2 351/2 566). There have been noticeable changes in the pathogen composition since 2017, decreasing in EV71 and increasing in the proportion of fatalities caused by Coxsackievirus A16 (CV-A16) and other enteroviruses. Conclusions:From 2008 to 2022, the HFMD case fatality rates and mortality rates continuously declined, peaked in 2010. Since 2017, the decline of HFMD case fatality rates has been noticeably accelerated. Along with the decrease in the proportion of EV71 in HFMD fatal cases, the proportion of other enteroviruses appeared increasing. It is essential to continuously monitor the etiological spectrum of the fatal cases.
