Molecular epidemiology and clinical features of hand, foot and mouth disease requiring hospitalization after the use of enterovirus A71 inactivated vaccine in chengdu, China, 2017-2022: a descriptive study.

Publisher: Taylor & Francis Country of Publication: United States NLM ID: 101594885 Publication Model: Print Cited Medium: Internet ISSN: 2222-1751 (Electronic) Linking ISSN: 22221751 NLM ISO Abbreviation: Emerg Microbes Infect Subsets: MEDLINE

Publication: 2019- : [Philadelphia, PA] : Taylor & Francis
Original Publication: New York : NPG, 2012-2018.

Enterovirus*/genetics ; Hand, Foot and Mouth Disease*/epidemiology ; Hand, Foot and Mouth Disease*/prevention & control ; Hand, Foot and Mouth Disease*/complications ; AIDS Vaccines* ; Influenza Vaccines* ; Respiratory Syncytial Virus Vaccines* ; SAIDS Vaccines* ; Enterovirus Infections*/epidemiology ; Enterovirus Infections*/prevention & control ; Enterovirus Infections*/diagnosis ; Papillomavirus Vaccines* ; Enterovirus A, Human*/genetics; Child ; Humans ; Male ; Female ; Diphtheria-Tetanus-Pertussis Vaccine ; Molecular Epidemiology ; BCG Vaccine ; Measles-Mumps-Rubella Vaccine ; China/epidemiology ; Vaccines, Inactivated ; Antigens, Viral ; Hospitalization

Three inactivated enterovirus A71 (EV-A71) vaccines have been widely vaccinated among children in the targeted age group in mainland China since mid-2016. However, comprehensive virological surveillance of hand, foot and mouth disease (HFMD) over multiple years after the use of EV-A71 vaccines has rarely been conducted. Using long-term data extracted from the Public Health and Clinical Center of Chengdu, we described the clinical, aetiological, and epidemiological characteristics of HFMD inpatients after the use of EV-A71 vaccines from 2017 through 2022. A total of 5115 patients were selected for analysis with a male-to-female ratio of 1.63:1 and were mostly under 5 years of age (97.6%). Among these cases, 4.3% presented with severe symptoms, and 4.1% of severe cases experienced significant complications. EV-A71 was no longer the major serotype for laboratory-confirmed HFMD, responsible for 15.6% of severe cases and 1.2% of mild cases. A significant downwards trend of EV-A71 infections was observed after the use of EV-A71 vaccines (P for trend < 0.001). Coxsackievirus A6 was the predominant pathogen, accounting for 63.5% of mild cases and 36.2% of severe cases. Coxsackievirus A10 (CV-A10) and A16 were sporadically detected, and an upwards trend was observed in the proportion of CV-A10 infections. This study provides baseline molecular epidemiology for the evaluation of EV-A71 vaccination impact and potential serotype replacement based on HFMD inpatients. Additional nationwide and population-based epidemiologic and serologic studies are essential to elucidate HFMD dynamics after the use of EV-A71 vaccines, and to inform public health authorities to introduce optimized intervention strategies.

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Keywords: EV-A71 vaccine; Hand foot and mouth disease; clinical features; enterovirus; molecular epidemiology

0 (Diphtheria-Tetanus-Pertussis Vaccine)
16VY3TM7ZO (antineoplaston A10)
0 (AIDS Vaccines)
0 (BCG Vaccine)
0 (Influenza Vaccines)
0 (Measles-Mumps-Rubella Vaccine)
0 (Respiratory Syncytial Virus Vaccines)
0 (SAIDS Vaccines)
0 (Vaccines, Inactivated)
0 (Antigens, Viral)
0 (Papillomavirus Vaccines)

Date Created: 20220914 Date Completed: 20221028 Latest Revision: 20221102

20240829

PMC9621254

10.1080/22221751.2022.2125346

36103331