Epidemiology and etiology of hand-foot-mouth disease in Hebei Province, 2011-2015

Objective To understand the epidemiological characteristics and pathogen patterns of hand-foot-mouth disease (HFMD) in Hebei Province during 2011-2015 and provide scientific evidence for the development of HFMD prevention and control measures. Methods The cases reported from the National Disease Surveillance Information Management System and laboratory testing results in Hebei Province from 2011-2015 were analyzed with the descriptive epidemiology. Results A total of 349 113 HFMD cases were reported from 2011 to 2015, with anannual incidence of 95.91/100 000. The incidence rate in 2012 and 2014 was significantly higher than in other years, presenting an epidemic phenomena of peaking every other year.There was an obvious temporal distribution of the cases, the main peak occurred in 5-7 months and the second peak or "tail" peak was in 10-12 months. The major cases afflicted with HFMD were children less than five years old, and especially those aged 1-3 years old.The epidemic in different regions was different, so the method of cluster analysis and assigned evaluation were conducted according to the incidence and severe rates, which were used as the classification index. The results showed that Langfang, Cangzhou, Hengshui, Shijiazhuang, Baoding and Chengde were the focus for prevention and control. The pathogen composition was slightly different during the five years. In 2013 and 2015, having superseding coxsachievirus A16(CoxA16) and enterovirus 71(EV71), other enteroviruses became the predominantly prevailing pathogens,accounting for 44.89% and 66.23%, respectively. Conclusions It showed a certain characteristics in seasonal, populational and regional distribution of HFMD in Hebei Province. We should pay more attention to the changes of pathogens and the key areas of prevention and control of HFMD should be enhanced.