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Shen L, Sun M, Wei M, Hu Q, Bai Y, Shao Z, Liu K. The non-stationary and spatially varying associations between hand, foot and mouth disease and multiple environmental factors: A Bayesian spatiotemporal mapping model study. Infect Dis Model 2024; 9:373-386. [PMID: 38385017 PMCID: PMC10879665 DOI: 10.1016/j.idm.2024.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 01/29/2024] [Accepted: 02/04/2024] [Indexed: 02/23/2024] Open
Abstract
The transmission and prevalence of Hand, Foot and Mouth Disease (HFMD) are affected by a variety of natural and socio-economic environmental factors. This study aims to quantitatively investigate the non-stationary and spatially varying associations between various environmental factors and HFMD risk. We collected HFMD surveillance cases and a series of relevant environmental data from 2013 to 2021 in Xi'an, Northwest China. By controlling the spatial and temporal mixture effects of HFMD, we constructed a Bayesian spatiotemporal mapping model and characterized the impacts of different driving factors into global linear, non-stationary and spatially varying effects. The results showed that the impact of meteorological conditions on HFMD risk varies in both type and magnitude above certain thresholds (temperature: 30 °C, precipitation: 70 mm, solar radiation: 13000 kJ/m2, pressure: 945 hPa, humidity: 69%). Air pollutants (PM2.5, PM10, NO2) showed an inverted U-shaped relationship with the risk of HFMD, while other air pollutants (O3, SO2) showed nonlinear fluctuations. Moreover, the driving effect of increasing temperature on HFMD was significant in the 3-year period, while the inhibitory effect of increasing precipitation appeared evident in the 5-year period. In addition, the proportion of urban/suburban/rural area had a strong influence on HFMD, indicating that the incidence of HFMD firstly increased and then decreased during the rapid urbanization process. The influence of population density on HFMD was not only limited by spatial location, but also varied between high and low intervals. Higher road density inhibited the risk of HFMD, but higher night light index promoted the occurrence of HFMD. Our findings further demonstrated that both ecological and socioeconomic environmental factors can pose multiple driving effects on increasing the spatiotemporal risk of HFMD, which is of great significance for effectively responding to the changes in HFMD epidemic outbreaks.
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Affiliation(s)
- Li Shen
- School of Remote Sensing and Information Engineering, Wuhan University, Wuhan, Hubei Province, China
| | - Minghao Sun
- School of Remote Sensing and Information Engineering, Wuhan University, Wuhan, Hubei Province, China
| | - Mengna Wei
- School of Remote Sensing and Information Engineering, Wuhan University, Wuhan, Hubei Province, China
| | - Qingwu Hu
- School of Remote Sensing and Information Engineering, Wuhan University, Wuhan, Hubei Province, China
| | - Yao Bai
- Department of Infection Disease Control and Prevention, Xi'an Center for Disease Control and Prevention, Xi'an, Shaanxi, China
| | - Zhongjun Shao
- Department of Epidemiology, Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, School of Public Health, Air Force Medical University, Xi'an, Shaanxi Province, China
| | - Kun Liu
- Department of Epidemiology, Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, School of Public Health, Air Force Medical University, Xi'an, Shaanxi Province, China
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Wang J, Wu W, Wang W, Zhang J, Xiao J, Cai M, Guo J, Li R, Zhu S, Zhang W, Chen M, Teng Z. Seroprevalence of neutralizing antibodies against HFMD associated enteroviruses among healthy individuals in Shanghai, China, 2022. Virol Sin 2024:S1995-820X(24)00077-4. [PMID: 38801978 DOI: 10.1016/j.virs.2024.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 05/20/2024] [Indexed: 05/29/2024] Open
Affiliation(s)
- Jiayu Wang
- Microbiology Department, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, 200336, China
| | - Wencheng Wu
- Microbiology Department, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, 200336, China
| | - Wei Wang
- Microbiology Department, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, 200336, China
| | - Jingyi Zhang
- Microbiology Department, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, 200336, China
| | - Jianwei Xiao
- Microbiology Department, Yangpu Municipal Center for Disease Control and Prevention, Shanghai, 200090, China
| | - Mingyi Cai
- Microbiology Department, Jing'an Municipal Center for Disease Control and Prevention, Shanghai, 200070, China
| | - Jiaying Guo
- Microbiology Department, Changning Municipal Center for Disease Control and Prevention, Shanghai, 200050, China
| | - Run Li
- Microbiology Department, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, 200336, China
| | - Shuangli Zhu
- WHO WPRO Regional Polio Reference Laboratory, NHC Key Laboratory for Biosafety, NHC Key Laboratory for Medical Virology, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, China
| | - Wanju Zhang
- Microbiology Department, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, 200336, China
| | - Min Chen
- Microbiology Department, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, 200336, China
| | - Zheng Teng
- Microbiology Department, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, 200336, China.
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Jia W, Zhang X, Sun R, Li P, Song C. Impact of the COVID-19 outbreak and interventions on hand, foot and mouth disease in Zhengzhou, China, 2014-2022: a retrospective study. BMC Infect Dis 2024; 24:386. [PMID: 38594638 PMCID: PMC11005130 DOI: 10.1186/s12879-024-09244-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 03/21/2024] [Indexed: 04/11/2024] Open
Abstract
BACKGROUND Since December 2019, COVID-19 has spread rapidly around the world, and studies have shown that measures to prevent COVID-19 can largely reduce the spread of other infectious diseases. This study explored the impact of the COVID-19 outbreak and interventions on the incidence of HFMD. METHODS We gathered data on the prevalence of HFMD from the Children's Hospital Affiliated to Zhengzhou University. An autoregressive integrated moving average model was constructed using HFMD incidence data from 2014 to 2019, the number of cases predicted from 2020 to 2022 was predicted, and the predicted values were compared with the actual measurements. RESULTS From January 2014 to October 2022, the Children's Hospital of Zhengzhou University admitted 103,995 children with HFMD. The average number of cases of HFMD from 2020 to 2022 was 4,946, a significant decrease from 14,859 cases from 2014 to 2019. We confirmed the best ARIMA (2,0,0) (1,1,0)12 model. From 2020 to 2022, the yearly number of cases decreased by 46.58%, 75.54%, and 66.16%, respectively, compared with the forecasted incidence. Trends in incidence across sexes and ages displayed patterns similar to those overall. CONCLUSIONS The COVID-19 outbreak and interventions reduced the incidence of HFMD compared to that before the outbreak. Strengthening public health interventions remains a priority in the prevention of HFMD.
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Affiliation(s)
- Wanyu Jia
- Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, No. 1, South University Road, Erqi District, 450018, Zhengzhou, China
| | - Xue Zhang
- Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, No. 1, South University Road, Erqi District, 450018, Zhengzhou, China
| | - Ruiyang Sun
- Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, No. 1, South University Road, Erqi District, 450018, Zhengzhou, China
| | - Peng Li
- Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, No. 1, South University Road, Erqi District, 450018, Zhengzhou, China
| | - Chunlan Song
- Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, No. 1, South University Road, Erqi District, 450018, Zhengzhou, China.
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Zhang L, Yang F, Zhu Z, Zeng W, Rong Z, Hu J, Li X, Zhao J, Zeng B, Li Y, Quan Y, Zhang Q, Huang Z, Li Y, Huang X, Zheng W, Xu J, Li Y, Chen Q, Xiao J, Zhang M. Assessing the impact of COVID-19 interventions on the hand, foot and mouth disease in Guangdong Province, China: a Bayesian modeling study. Front Public Health 2024; 11:1307321. [PMID: 38348379 PMCID: PMC10860754 DOI: 10.3389/fpubh.2023.1307321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 12/26/2023] [Indexed: 02/15/2024] Open
Abstract
Background The non-pharmaceutical interventions (NPIs) against COVID-19 may have affected the transmission of hand, foot and mouth disease (HFMD). We aimed to assess the impact of the NPIs on HFMD in the high epidemic area of HFMD, Guangdong Province. Methods The data of HFMD cases, etiological information, and meteorological factors in Guangdong from January 1, 2012, to December 31, 2021, were collected. Using a Bayesian structural time series (BSTS) model integrated counterfactual framework, we assessed the effect of NPIs on HFMD by different intervention periods, populations (gender, age, occupation), and cities. We further explored the correlation between the reduction of HFMD and socioeconomic factors in 21 cities. Results A total of 351,217 HFMD cases were reported and 455,327 cases were averted in Guangdong Province during 2020-2021 with a reduction of 84.94% (95%CI: 81.63-87.22%) in 2020 and 29.49% (95%CI: 15.26-39.54%) in 2021. The impact of NPIs on HFMD differed by age and gender. The effects of NPIs were more remarkable for children aged 0-2 years and scattered children. We found that the relative reductions in 21 cities were related to the composition ratio of children and COVID-19 incidence. Conclusion The reduction of HFMD incidence was significantly associated with COVID-19 NPIs, and school closure was an effective intervention to prevent HFMD outbreaks. Our findings will contribute to the development of HFMD prevention and control measures.
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Affiliation(s)
- Li Zhang
- School of Public Health, Southern Medical University, Guangzhou, China
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Fen Yang
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
- Guangdong Workstation for Emerging Infectious Disease Control and Prevention, Guangzhou, China
| | - Zhihua Zhu
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Weilin Zeng
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Zuhua Rong
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Jianxiong Hu
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Xing Li
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Jianguo Zhao
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Biao Zeng
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
- Guangdong Workstation for Emerging Infectious Disease Control and Prevention, Guangzhou, China
| | - Yihan Li
- School of Public Health, Southern Medical University, Guangzhou, China
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Yi Quan
- School of Public Health, Southern Medical University, Guangzhou, China
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Qian Zhang
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Zitong Huang
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
- School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Yuye Li
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Xing Huang
- School of Public Health, Southern Medical University, Guangzhou, China
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Wenyuan Zheng
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
- School of Medicine, Jinan University, Guangzhou, China
| | - Jiaqing Xu
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Yan Li
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
- Guangdong Workstation for Emerging Infectious Disease Control and Prevention, Guangzhou, China
| | - Qing Chen
- School of Public Health, Southern Medical University, Guangzhou, China
| | - Jianpeng Xiao
- School of Public Health, Southern Medical University, Guangzhou, China
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Meng Zhang
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
- Guangdong Workstation for Emerging Infectious Disease Control and Prevention, Guangzhou, China
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Zhou X, Qian K, Zhu C, Yi L, Tu J, Yang S, Zhang Y, Zhang Y, Xia W, Ni X, Xu T, He F, Li H. Surveillance, epidemiology, and impact of the coronavirus disease 2019 interventions on the incidence of enterovirus infections in Nanchang, China, 2010-2022. Front Microbiol 2023; 14:1251683. [PMID: 37920267 PMCID: PMC10618362 DOI: 10.3389/fmicb.2023.1251683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 09/27/2023] [Indexed: 11/04/2023] Open
Abstract
Introduction Pathogen spectrum of Hand, foot and mouth disease (HFMD) has substantially changed in the past decade in China. Growing evidence has indicated that anti-COVID-19 nonpharmaceutical interventions (NPIs) can support control of various infectious diseases, including intestinal diseases. Methods In this study, HFMD cases were enrolled from sentinel hospitals of Nanchang, Jiangxi province, and enteroviruses were genotyped using specific real time RT-PCR. We systematically characterized the epidemiology of HFMD based on the continuous molecular surveillance and estimated the impact of COVID-19 intervention on HFMD incidence using seasonal autoregressive integrated moving average (ARIMA) models. Results A total of 10247 HFMD cases were included during 2010-2022, of which 6121 enterovirus (EV)-positive cases (59.7%) were identified by real-time RT-PCR. Over 80% cases were associated with EV-A71 and coxsackievirus A16 (CVA16) during 2010-2012, while the type distribution significantly changed as CVA6 emerged to be dominant, accounting for 22.6%-59.6% during 2013-2022. It was observed that the prevalence patterns of EV-A71 and CVA16 were similar and both of them peaked in the second quarter and then leveled off. However, CVA6 was generally prevalent around the fourth quarter, demonstrating a staggered prevalence during 2010-2019. During the COVID-19 epidemic, the seasonal HFMD epidemic peak was restrained, and the ARIMA analysis indicated that the COVID-19 intervention had mitigated EV transmission during the first COVID-19 outbreak in early 2020. In addition, bivariate Spearman's cross-correlation coefficients were estimated for the major types CVA6, CVA16 and EV-A71. Our analyses indicated the possible existence of correlations among CVA6, CVA16 and EV-A71 prevalence in the epidemiological level. Discussion Taken together, the type distribution of HFMD has substantially changed over the last decade and CVA6 and CVA16 are currently the most predominant types co-circulating in Nanchang. The anti-COVID-19 NPIs significantly reduced the incidence of EV infections.
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Affiliation(s)
- Xianfeng Zhou
- Cancer Research Center, Jiangxi University of Chinese Medicine, Nanchang, China
- Jiangxi Provincial Health Commission Key Laboratory of Pathogenic Diagnosis and Genomics of Emerging Infectious Diseases, Nanchang Center for Disease Control and Prevention, Nanchang, China
| | - Ke Qian
- Jiangxi Provincial Health Commission Key Laboratory of Pathogenic Diagnosis and Genomics of Emerging Infectious Diseases, Nanchang Center for Disease Control and Prevention, Nanchang, China
| | - Chunlong Zhu
- Clinical Laboratory, Third Hospital of Nanchang, Nanchang, China
| | - Liu Yi
- Jiangxi Provincial Health Commission Key Laboratory of Pathogenic Diagnosis and Genomics of Emerging Infectious Diseases, Nanchang Center for Disease Control and Prevention, Nanchang, China
| | - Junling Tu
- Jiangxi Provincial Health Commission Key Laboratory of Pathogenic Diagnosis and Genomics of Emerging Infectious Diseases, Nanchang Center for Disease Control and Prevention, Nanchang, China
| | - Shu Yang
- Jiangxi Provincial Health Commission Key Laboratory of Pathogenic Diagnosis and Genomics of Emerging Infectious Diseases, Nanchang Center for Disease Control and Prevention, Nanchang, China
| | - Yanxia Zhang
- Jiangxi Provincial Health Commission Key Laboratory of Pathogenic Diagnosis and Genomics of Emerging Infectious Diseases, Nanchang Center for Disease Control and Prevention, Nanchang, China
| | - Yanglin Zhang
- Clinical Laboratory, Third Hospital of Nanchang, Nanchang, China
| | - Wen Xia
- Jiangxi Provincial Health Commission Key Laboratory of Pathogenic Diagnosis and Genomics of Emerging Infectious Diseases, Nanchang Center for Disease Control and Prevention, Nanchang, China
| | - Xiansheng Ni
- Jiangxi Provincial Health Commission Key Laboratory of Pathogenic Diagnosis and Genomics of Emerging Infectious Diseases, Nanchang Center for Disease Control and Prevention, Nanchang, China
| | - Tielong Xu
- School of Life Science, Jiangxi University of Chinese Medicine, Nanchang, China
| | - Fenglan He
- Jiangxi Provincial Health Commission Key Laboratory of Pathogenic Diagnosis and Genomics of Emerging Infectious Diseases, Nanchang Center for Disease Control and Prevention, Nanchang, China
| | - Hui Li
- Jiangxi Provincial Health Commission Key Laboratory of Pathogenic Diagnosis and Genomics of Emerging Infectious Diseases, Nanchang Center for Disease Control and Prevention, Nanchang, China
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Bai Y, Shen L, Sun M, Yang Z, Chen Z, Zhai J, Xue M, Shao Z, Liu K, Zheng C. The short and long-term impact of nonpharmaceutical interventions on the prevalence of varicella in Xi'an during the COVID-19 pandemic. J Med Virol 2023; 95:e29020. [PMID: 37548166 DOI: 10.1002/jmv.29020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 07/20/2023] [Accepted: 07/24/2023] [Indexed: 08/08/2023]
Abstract
Varicella is a highly prevalent infectious disease with a similar transmission pathway to coronavirus disease 2019 (COVID-19). In the context of the COVID-19 pandemic, anti-COVID-19 nonpharmaceutical interventions (NPIs) have been implemented to prevent the spread of the infection. This study aims to analyze varicella's epidemiological characteristics and further investigate the effect of anti-COVID-19 NPIs on varicella in Xi'an, northwestern China. Based on the varicella surveillance data, search engine indices, meteorological factors from 2011 to 2021 in Xi'an, and different levels of emergency response to COVID-19 during the pandemic, we applied Bayesian Structural Time Series models and interrupted time series analysis to predict the counterfactual incidence of varicella and quantify the impact of varying NPIs intensities on varicella. From 2011 to 2021, varicella incidence increased, especially in 2019, with a high incidence of 111.69/100 000. However, there was a sharp decrease of 43.18% in 2020 compared with 2019, and the peak of varicella incidence in 2020 was lower than in previous years from the 21st to the 25th week. In 2021, the seasonality of varicella incidence gradually returned to a seasonal pattern in 2011-2019. The results suggest that anti-COVID-19 NPIs effectively reduce the incidence of varicella, and the reduction has spatiotemporal heterogeneity.
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Affiliation(s)
- Yao Bai
- Department of Infection Disease Control and Prevention, Xi'an Center for Disease Control and Prevention, Xi'an, Shaanxi Province, People's Republic of China
- Department of Epidemiology, The Fourth Military Medical University, Xi'an, Shaanxi Province, People's Republic of China
| | - Li Shen
- School of Remote Sensing and Information Engineering, Wuhan University, Wuhan, Hubei Province, People's Republic of China
| | - Minghao Sun
- School of Remote Sensing and Information Engineering, Wuhan University, Wuhan, Hubei Province, People's Republic of China
| | - Zurong Yang
- Department of Epidemiology, The Fourth Military Medical University, Xi'an, Shaanxi Province, People's Republic of China
| | - Zhijun Chen
- Department of Infection Disease Control and Prevention, Xi'an Center for Disease Control and Prevention, Xi'an, Shaanxi Province, People's Republic of China
| | - Jingbo Zhai
- Key Laboratory of Zoonose Prevention and Control at Universities of Inner Mongolia Autonomous Region, Medical College, Inner Mongolia Minzu University, Tongliao, China
| | - Mengzhou Xue
- Department of Cerebrovascular Diseases, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Zhongjun Shao
- Department of Epidemiology, The Fourth Military Medical University, Xi'an, Shaanxi Province, People's Republic of China
| | - Kun Liu
- Department of Epidemiology, The Fourth Military Medical University, Xi'an, Shaanxi Province, People's Republic of China
| | - Chunfu Zheng
- Department of Microbiology, Immunology and Infectious Diseases, University of Calgary, Calgary, Alberta, Canada
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Zhu P, Ji W, Li D, Li Z, Chen Y, Dai B, Han S, Chen S, Jin Y, Duan G. Current status of hand-foot-and-mouth disease. J Biomed Sci 2023; 30:15. [PMID: 36829162 PMCID: PMC9951172 DOI: 10.1186/s12929-023-00908-4] [Citation(s) in RCA: 31] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 02/16/2023] [Indexed: 02/26/2023] Open
Abstract
Hand-foot-and-mouth disease (HFMD) is a viral illness commonly seen in young children under 5 years of age, characterized by typical manifestations such as oral herpes and rashes on the hands and feet. These symptoms typically resolve spontaneously within a few days without complications. Over the past two decades, our understanding of HFMD has greatly improved and it has received significant attention. A variety of research studies, including epidemiological, animal, and in vitro studies, suggest that the disease may be associated with potentially fatal neurological complications. These findings reveal clinical, epidemiological, pathological, and etiological characteristics that are quite different from initial understandings of the illness. It is important to note that HFMD has been linked to severe cardiopulmonary complications, as well as severe neurological sequelae that can be observed during follow-up. At present, there is no specific pharmaceutical intervention for HFMD. An inactivated Enterovirus A71 (EV-A71) vaccine that has been approved by the China Food and Drug Administration (CFDA) has been shown to provide a high level of protection against EV-A71-related HFMD. However, the simultaneous circulation of multiple pathogens and the evolution of the molecular epidemiology of infectious agents make interventions based solely on a single agent comparatively inadequate. Enteroviruses are highly contagious and have a predilection for the nervous system, particularly in child populations, which contributes to the ongoing outbreak. Given the substantial impact of HFMD around the world, this Review synthesizes the current knowledge of the virology, epidemiology, pathogenesis, therapy, sequelae, and vaccine development of HFMD to improve clinical practices and public health efforts.
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Affiliation(s)
- Peiyu Zhu
- grid.207374.50000 0001 2189 3846Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, 450001 China
| | - Wangquan Ji
- grid.207374.50000 0001 2189 3846Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, 450001 China
| | - Dong Li
- grid.207374.50000 0001 2189 3846Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, 450001 China
| | - Zijie Li
- grid.207374.50000 0001 2189 3846Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, 450001 China
| | - Yu Chen
- grid.207374.50000 0001 2189 3846Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, 450001 China
| | - Bowen Dai
- grid.207374.50000 0001 2189 3846Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, 450001 China
| | - Shujie Han
- grid.207374.50000 0001 2189 3846Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, 450001 China
| | - Shuaiyin Chen
- grid.207374.50000 0001 2189 3846Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, 450001 China
| | - Yuefei Jin
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, 450001, China.
| | - Guangcai Duan
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, 450001, China. .,Academy of Medical Science, Zhengzhou University, Zhengzhou, 450001, Henan, China.
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8
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Wu K, Ma X, Liu H, Zheng J, Zhou R, Yuan Z, Huang Z, Zhong Q, Huang Y, Zhang Z, Wu X. Effects of different levels of non-pharmaceutical interventions on hand, foot and mouth disease in Guangzhou, China. BMC Public Health 2022; 22:2398. [PMID: 36539790 PMCID: PMC9767397 DOI: 10.1186/s12889-022-14850-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 12/09/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Non-pharmaceutical interventions (NPIs) against coronavirus disease 2019 (COVID-19) may have suppressed the transmission of other infectious diseases. This study aimed to evaluate the impact of different degrees of NPIs during the COVID-19 pandemic on hand, foot and mouth disease (HFMD) in Guangzhou, China. METHODS Weekly reported HFMD cases and pathogens information during 2015-2021 in Guangzhou were collected from the China National Notifiable Disease Reporting System. The observed number of HFMD cases in 2020 and 2021 was compared to the average level in the same period during 2015-2019. Then, an interrupted time-series segmented regression analysis was applied to estimate the impact of NPIs on HFMD, such as social distancing, suspension of schools, community management and mask wearing. The effects across different subgroups stratified by gender, children groups and enterovirus subtype of HFMD were also examined. RESULTS A total of 13,224 and 36,353 HFMD cases were reported in 2020 and 2021, which decreased by 80.80% and 15.06% respectively compared with the average number of cases in the same period during 2015-2019. A significant drop in the number of HFMD cases during time when strict NPIs were applied (relative change: 69.07% [95% confidence interval (CI): 68.84%-69.30%]). The HFMD incidence rebounded to historical levels in 2021 as the lockdown eased. The slightest reduction of HFMD cases was found among children at kindergartens or childcare centres among the three children groups (children at kindergartens or childcare centres: 55.50% [95% CI: 54.96%-56.03%]; children living at home: 72.64% [95% CI: 72.38%-72.89%]; others: 74.06% [95% CI: 73.19%-74.91%]). CONCLUSIONS The strong NPIs during the COVID-19 epidemic may have a significant beneficial effect on mitigating HFMD. However, the incidence of HFMD rebounded as the NPIs became less stringent. Authorities should consider applying these NPIs during HFMD outbreaks and strengthening personal hygiene in routine prevention.
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Affiliation(s)
- Keyi Wu
- grid.284723.80000 0000 8877 7471Department of Epidemiology, School of Public Health, Guangdong Provincial Key Laboratory of Tropical Disease Research), Southern Medical University, Baiyun District, Nos.1023–1063, Shatai South Road, Guangzhou, 510515 China
| | - Xiaowei Ma
- grid.508371.80000 0004 1774 3337Guangzhou Center for Disease Control and Prevention, Guangzhou City, 510440 Guangdong China
| | - Huamin Liu
- grid.284723.80000 0000 8877 7471Department of Epidemiology, School of Public Health, Guangdong Provincial Key Laboratory of Tropical Disease Research), Southern Medical University, Baiyun District, Nos.1023–1063, Shatai South Road, Guangzhou, 510515 China
| | - Jiazhen Zheng
- grid.284723.80000 0000 8877 7471Department of Epidemiology, School of Public Health, Guangdong Provincial Key Laboratory of Tropical Disease Research), Southern Medical University, Baiyun District, Nos.1023–1063, Shatai South Road, Guangzhou, 510515 China
| | - Rui Zhou
- grid.284723.80000 0000 8877 7471Department of Epidemiology, School of Public Health, Guangdong Provincial Key Laboratory of Tropical Disease Research), Southern Medical University, Baiyun District, Nos.1023–1063, Shatai South Road, Guangzhou, 510515 China
| | - Zelin Yuan
- grid.284723.80000 0000 8877 7471Department of Epidemiology, School of Public Health, Guangdong Provincial Key Laboratory of Tropical Disease Research), Southern Medical University, Baiyun District, Nos.1023–1063, Shatai South Road, Guangzhou, 510515 China
| | - Zhiwei Huang
- grid.284723.80000 0000 8877 7471Department of Epidemiology, School of Public Health, Guangdong Provincial Key Laboratory of Tropical Disease Research), Southern Medical University, Baiyun District, Nos.1023–1063, Shatai South Road, Guangzhou, 510515 China
| | - Qi Zhong
- grid.284723.80000 0000 8877 7471Department of Epidemiology, School of Public Health, Guangdong Provincial Key Laboratory of Tropical Disease Research), Southern Medical University, Baiyun District, Nos.1023–1063, Shatai South Road, Guangzhou, 510515 China
| | - Yining Huang
- grid.284723.80000 0000 8877 7471Department of Epidemiology, School of Public Health, Guangdong Provincial Key Laboratory of Tropical Disease Research), Southern Medical University, Baiyun District, Nos.1023–1063, Shatai South Road, Guangzhou, 510515 China
| | - Zhoubin Zhang
- grid.508371.80000 0004 1774 3337Guangzhou Center for Disease Control and Prevention, Guangzhou City, 510440 Guangdong China
| | - Xianbo Wu
- grid.284723.80000 0000 8877 7471Department of Epidemiology, School of Public Health, Guangdong Provincial Key Laboratory of Tropical Disease Research), Southern Medical University, Baiyun District, Nos.1023–1063, Shatai South Road, Guangzhou, 510515 China
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9
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Prognosis of Myocarditis Developing After mRNA COVID-19 Vaccination Compared With Viral Myocarditis. J Am Coll Cardiol 2022; 80:2255-2265. [PMID: 36480967 PMCID: PMC9721305 DOI: 10.1016/j.jacc.2022.09.049] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 09/23/2022] [Accepted: 09/30/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Association between messenger RNA (mRNA) COVID-19 vaccines and myocarditis has aroused public concern over vaccine safety. OBJECTIVES The goal of this study was to compare the prognosis of this condition with viral infection-related myocarditis over 180 days. METHODS A territory-wide electronic public health care database in Hong Kong linked with population-based vaccination records was used to conduct a retrospective cohort study. Since the roll-out of BNT162b2 (Pfizer-BioNTech), patients aged ≥12 years hospitalized with myocarditis within 28 days after BNT162b2 vaccination were compared against viral infection-related myocarditis recorded before the pandemic (2000-2019), over a 180-day follow-up period (starting from diagnosis of myocarditis). All-cause mortality, heart failure, dilated cardiomyopathy, heart transplant, and postdischarge health care utilization were examined with Cox proportional hazards models. RESULTS A total of 866 patients were included for analysis. Over the follow-up period, 1 death (1.0%) of 104 patients with postvaccination myocarditis and 84 deaths (11.0%) of 762 patients with viral infection-related myocarditis were identified. One case (1.0%) of dilated cardiomyopathy and 2 cases (1.9%) of heart failure were identified in the postvaccination group, compared with 28 (3.7%) and 93 (12.2%) in the viral infection-related myocarditis group, respectively. Adjusted analysis showed that the postvaccination myocarditis group had a 92% lower mortality risk (adjusted HR: 0.08; 95% CI: 0.01-0.57). No significant differences in other prognostic outcomes were seen. CONCLUSIONS This study found a significantly lower rate of mortality among individuals with myocarditis after mRNA vaccination compared with those with viral infection-related myocarditis. Prognosis of this iatrogenic condition may be less severe than naturally acquired viral infection-related myocarditis.
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10
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Salvo M, Azambuya J, Baccardatz N, Moriondo A, Blanco R, Martinez M, Direnna M, Bertolini G, Gamazo P, Colina R, Alvareda E, Victoria M. One-Year Surveillance of SARS-CoV-2 and Rotavirus in Water Matrices from a Hot Spring Area. FOOD AND ENVIRONMENTAL VIROLOGY 2022; 14:401-409. [PMID: 36181654 PMCID: PMC9525940 DOI: 10.1007/s12560-022-09537-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 09/18/2022] [Indexed: 06/16/2023]
Abstract
The pandemic of Coronavirus Disease 2019 (COVID-19) caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is still impacting not only on human health but also all economic activities, especially in those related to tourism. In this study, in order to characterize the presence of SARS-CoV-2 in a hot spring park in Uruguay, swimming pools water, wastewater, and surface water from this area were analyzed by quantitative PCR. Wastewater from Salto city located next to the hydrothermal spring area was also evaluated as well as the presence of Rotavirus (RV). Overall, SARS-CoV-2 was detected in 13% (13/102) of the analyzed samples. Moreover, this virus was not detected in any of the samples from the swimming pools water and was present in 18% (3/17) of wastewater samples from the hotels area showing the same trend between the titer of SARS-CoV-2 and the number of infected people in Salto city. SARS-CoV-2 was also detected in wastewater samples (32% (11/34)) from Salto city, detecting the first positive sample when 105 persons were positive for SARS-CoV-2. Rotavirus was detected only in 10% (2/24) of the wastewater samples analyzed in months when partial lockdown measures were taken, however, this virus was detected in nearly all wastewater samples analyzed when social distancing measures and partial lockdown were relaxed. Wastewater results confirmed the advantages of using the detection and quantification of viruses in this matrix in order to evaluate the presence of these viruses in the population, highlighting the usefulness of this approach to define and apply social distancing. This study suggests that waters from swimming pools are not a source of infection for SARS-CoV-2, although more studies are needed including infectivity assays in order to confirm this statement.
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Affiliation(s)
- M Salvo
- Water Department, Centro Universitario Regional Litoral Norte, Universidad de La República, Rivera 1350, 50000, Salto, CP, Uruguay
| | - J Azambuya
- Administración de Las Obras Sanitarias del Estado, Salto, Uruguay
| | - N Baccardatz
- Administración de Las Obras Sanitarias del Estado, Salto, Uruguay
| | - A Moriondo
- Ministry of Public Health, Salto, Uruguay
| | - R Blanco
- Ministry of Public Health, Salto, Uruguay
| | | | - M Direnna
- Intendencia de Salto, Salto, Uruguay
| | | | - P Gamazo
- Water Department, Centro Universitario Regional Litoral Norte, Universidad de La República, Rivera 1350, 50000, Salto, CP, Uruguay
| | - R Colina
- Laboratory of Molecular Virology, Centro Universitario Regional Litoral Norte, Universidad de la República, Rivera 1350, 50000, Salto, CP, Uruguay
| | - E Alvareda
- Water Department, Centro Universitario Regional Litoral Norte, Universidad de La República, Rivera 1350, 50000, Salto, CP, Uruguay.
| | - M Victoria
- Laboratory of Molecular Virology, Centro Universitario Regional Litoral Norte, Universidad de la República, Rivera 1350, 50000, Salto, CP, Uruguay.
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11
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Zhang H, Shen L, Sun M, Zhao C, Li Q, Yang Z, Liu J, Liu K, Xiao B. Spatiotemporal impact of non-pharmaceutical interventions against COVID-19 on the incidence of infectious diarrhea in Xi'an, China. Front Public Health 2022; 10:1011592. [PMID: 36518571 PMCID: PMC9742410 DOI: 10.3389/fpubh.2022.1011592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 11/08/2022] [Indexed: 11/29/2022] Open
Abstract
Background Non-pharmaceutical interventions (NPIs) against COVID-19 may prevent the spread of other infectious diseases. Our purpose was to assess the effects of NPIs against COVID-19 on infectious diarrhea in Xi'an, China. Methods Based on the surveillance data of infectious diarrhea, and the different periods of emergence responses for COVID-19 in Xi'an from 2011 to 2021, we applied Bayesian structural time series model and interrupted time series model to evaluate the effects of NPIs against COVID-19 on the epidemiological characteristics and the causative pathogens of infectious diarrhea. Findings A total of 102,051 cases of infectious diarrhea were reported in Xi'an from 2011 to 2021. The Bayesian structural time series model results demonstrated that the cases of infectious diarrhea during the emergency response period was 40.38% lower than predicted, corresponding to 3,211 fewer cases, during the COVID-19 epidemic period of 2020-2021. The reduction exhibited significant variations in the demography, temporal and geographical distribution. The decline in incidence was especially evident in children under 5-years-old, with decreases of 34.09% in 2020 and 33.99% in 2021, relative to the 2017-2019 average. Meanwhile, the incidence decreased more significantly in industrial areas. Interpretation NPIs against COVID-19 were associated with short- and long-term reductions in the incidence of infectious diarrhea, and this effect exhibited significant variations in epidemiological characteristics.
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Affiliation(s)
- Hui Zhang
- Department of Prevention of Infectious Diseases, Xi'an Center for Disease Control and Prevention, Xi'an, Shaanxi, China
| | - Li Shen
- School of Remote Sensing and Information Engineering, Wuhan University, Wuhan, China
| | - Minghao Sun
- School of Remote Sensing and Information Engineering, Wuhan University, Wuhan, China
| | - Chenxi Zhao
- Department of Epidemiology, Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, School of Public Health, Air Force Medical University, Xi'an, China
| | - Qian Li
- Department of Prevention of Infectious Diseases, Xi'an Center for Disease Control and Prevention, Xi'an, Shaanxi, China
| | - Zurong Yang
- Department of Epidemiology, Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, School of Public Health, Air Force Medical University, Xi'an, China
| | - Jifeng Liu
- Department of Prevention of Infectious Diseases, Xi'an Center for Disease Control and Prevention, Xi'an, Shaanxi, China
| | - Kun Liu
- Department of Epidemiology, Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, School of Public Health, Air Force Medical University, Xi'an, China,Kun Liu
| | - Bo Xiao
- Department of Plastic Surgery, Xijing Hospital, Air Force Medical University, Xi'an, China,*Correspondence: Bo Xiao
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12
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Sun J, Li Y, Yang Z, Fang Q, Chen B. Effect of enterovirus 71 vaccination on the epidemiological characteristics and etiology in hospitalized children with hand-foot-and-mouth disease: A retrospective study from a tertiary children's hospital. Medicine (Baltimore) 2022; 101:e30356. [PMID: 36123878 PMCID: PMC9478296 DOI: 10.1097/md.0000000000030356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Enterovirus 71 (EV71) vaccine for hand-foot-and-mouth disease (HFMD) prevention has been available for several years. However, as a new vaccine, the impact of EV71 vaccination on the epidemiology and etiology of HFMD is currently unclear. The purpose of this study was to compare and analyze the changes of epidemiological characteristics and etiology of HFMD patients after the introduction of EV71 vaccine. The data of hospitalized children with HFMD from 2014 to 2020 were collected from the case record department of a tertiary children hospital of Anhui Province. The changes of epidemiological characteristics, time distribution, disease severity and enterovirus serotypes in hospitalized children were analyzed. A total of 7373 cases of HFMD were reported during 2014 to 2020, including 634 (8.6%) severe cases. The number of cases reached the peak in 2016 (n = 1783) and decreased gradually after EV71 vaccination. The results of etiological test showed the positive rate was 80.5%, in which EV71 accounted for 1599 (21.7%) and CV-A16 accounted for 1028 (13.9%) respectively. The number of patients showed a bimodal distribution throughout the year, which were April to June and October to November. The age distribution changed significantly following the introduction of EV71 vaccine. The proportion of 1-year-old group of post-vaccination was significantly higher than that of pre-vaccination (61.9% vs 50.8%, P < .001). The proportion of HFMD caused by EV71 and severe cases decreased significantly after the vaccination (P < .001 for both). While the comparison of epidemiological characteristics and enterovirus serotypes between unvaccinated and vaccinated cases during 2017 to 2020 showed no significant difference. The dominant enterovirus serotypes of hospitalized HFMD changed significantly after the introduction of EV71 vaccine. The proportion of severe cases decreased significantly after the vaccination, but EV71 was still a major pathogen in patients with severe HFMD. More age-appropriate children are recommended to get vaccinated to establish stronger herd immunity in the population.
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Affiliation(s)
- Jing Sun
- Department of Infectious Diseases, Anhui Provincial Children’s Hospital, Hefei, China
| | - Yuanyuan Li
- Department of Infectious Diseases, Anhui Provincial Children’s Hospital, Hefei, China
| | - Zhi Yang
- Department of Infectious Diseases, Anhui Provincial Children’s Hospital, Hefei, China
| | - Qingfeng Fang
- Department of Infectious Diseases, Anhui Provincial Children’s Hospital, Hefei, China
| | - Biquan Chen
- Department of Infectious Diseases, Anhui Provincial Children’s Hospital, Hefei, China
- *Correspondence: Biquan Chen, Department of Infectious Diseases, Anhui Provincial Children’s Hospital, Hefei, China (e-mail: )
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