Volume 24, Number 3—March 2018
CME ACTIVITY - Synopsis
Epidemiology of Recurrent Hand, Foot and Mouth Disease, China, 2008–2015
, and Sheng Wei2
Table 1
Demographic characteristics of patients with recurrent probable and laboratory-confirmed HFMD in 29 provinces of China, 2008–2015*
| Characteristic |
Patients with recurrent probable HFMD, N = 396,243 |
Cases of recurrent laboratory-confirmed HFMD, N = 1,814† | Patients with recurrent laboratory-confirmed HFMD, N = 1,767 |
|||||
|---|---|---|---|---|---|---|---|---|
| Reinfection after EV-A71 with EV-A71, n = 99 |
Reinfection after CV-A16 with CV-A16, n = 45 |
Reinfection after other EVs with other EVs, n = 364 |
Reinfection after EV-A71 with CV-A16 or after CV-A61 with EV-A71, n = 383 |
Reinfection after EV-A71 with other EVs or after other EVs with EV-A71, n = 469 |
Reinfection after CV-A16 with other EVs or after other EVs with CV-A16, n = 454 |
|||
| Age at first episode | ||||||||
| Age, mo, median (IQR) | 20.8 (12.2–31.4) | 24.2 (15.6–36.5) | 27.1 (20.9–39.4) | 18.8 (12.2–31.4) | 26.3 (17.7–36.8) | 22.6 (14.5–34.4) | 22.8 (14.2–32.8) | 22.6 (14.2–34.0) |
| Age group | ||||||||
| <6 mo | 7,279 (2) | 1 (1) | 0 | 10 (3) | 1 (0.3) | 4 (1) | 7 (2) | 23 (1) |
| 6–11 mo | 80,982 (20) | 10 (12) | 7 (16) | 77 (21) | 39 (10) | 76 (16) | 72 (16) | 283 (16) |
| 12–23 mo | 155,973 (39) | 46 (46) | 14 (31) | 144 (40) | 132 (35) | 181 (39) | 176 (38) | 696 (39) |
| 24–59 mo | 145,289 (37) | 39 (39) | 22 (49) | 129 (35) | 203 (53) | 204 (43) | 192 (42) | 738 (42) |
| 5–9 y | 6,526 (2) | 2 (2) | 2 (4) | 4 (1) | 8 (2) | 4 (1) | 7 (2) | 26 (2) |
| 10–14 y | 158 (0.04) | 1 (1) | 0 | 0 | 0 | 0 | 0 | 1 (0.05) |
| >15 y |
36 (0.01) |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
| Age at second episode | ||||||||
| Age, mo, median (IQR) | 36.4 (24.3–48.5) | 40.0 (27.4–50.2) | 40.7 (25.7–55.8) | 34.7 (24.2–45.9) | 42.3 (32.5–53.2) | 37.1 (26.8–49.4) | 36.8 (26.8–49.2) | 36.5 (25.7–48.7) |
| Age group | ||||||||
| <6 mo | 236 (0.06) | 0 | 0 | 1 (0.3) | 0 | 0 | 0 | 1 (0.05) |
| 6–11 mo | 14,239 (4) | 2 (2) | 0 | 12 (3) | 3 (1) | 14 (3) | 13 (3) | 47 (3) |
| 12–23 mo | 83,568 (21) | 17 (17) | 8 (18) | 89 (25) | 35 (9) | 73 (16) | 73 (16) | 309 (17) |
| 24–59 mo | 257,729 (65) | 69 (70) | 29 (64) | 232 (64) | 298 (78) | 335 (71) | 315 (69) | 1,234 (70) |
| 5–9 y | 39,786 (10) | 10 (10) | 7 (16) | 29 (8) | 47 (12) | 45 (10) | 52 (12) | 170 (10) |
| 10–14 y | 640 (0.16) | 1 (1) | 1 (2) | 1 (0.3) | 0 | 2 (0.4) | 1 (0.2) | 6 (0.33) |
| >15 y |
45 (0.01) |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
| Male sex | 259,028 (65) | 74 (75) | 31 (69) | 247 (68) | 270 (70) | 326 (70) | 291 (64) | 1,208 (68) |
| Rural residence |
186,700 (47) |
49 (49) |
19 (42) |
115 (32) |
187 (49) |
190 (41) |
167 (37) |
716 (41) |
| Frequency of episodes | ||||||||
| 2 | 373,745 (95) | 91 (92) | 41 (91) | 303 (83) | 356 (93) | 404 (86) | 400 (88) | 1,595 (90) |
| 3 | 21,023 (5) | 7 (7) | 4 (9) | 54 (15) | 22 (6) | 59 (13) | 49 (11) | 161 (9) |
| >4‡ |
1,475 (0.4) |
1 (1) |
0 |
7 (2) |
5 (1) |
6 (1) |
5 (1) |
11 (1) |
| Death | 20 (0.005) | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
*Data are no. (%) patients unless otherwise indicated. CV-A16, coxsackievirus A16; EV-A71, enterovirus A71; HFMD, hand, foot and mouth disease; IQR, interquartile range; other EVs, other non–EV-A71 and non–CV-A16 enteroviruses.
†For patients with laboratory-confirmed recurrence of 3 or 4 HFMD episodes, any 2 laboratory-confirmed HFMD episodes were combined to form a case of recurrence of laboratory-confirmed HFMD. For example, patients with 3 episodes were categorized as having 3 reinfections, with the first and second, first and third, and second and third infections being grouped together.
‡For patients with recurrence of laboratory-confirmed HFMD, the highest number of episodes was 4. For patients with recurrence of probable HFMD, the highest number of episodes was 8.
1These first authors contributed equally to this article.
2These senior authors contributed equally to this article.