Chao Shi and Juan Liu contributed equally to this work.
Hand, foot, and mouth disease (HFMD) is a viral disease caused by human enteroviruses. Although HFMD reinfection is common, studies investigating this phenomenon are insufficient.
The present study focused on HFMD reinfection in Wuxi from 2008 to 2016 using surveillance system data.
Of 107,677 cases included in the study, 6470 cases were classified as reinfections. The overall reinfection rate was 6.01% (6.37% male and 5.48% female patients), which decreased with increasing age (χ2 = 1125.477, p < 0.001). The rate was 6.17 and 5.79% in urban and rural areas, respectively, and 7.83 and 5.98% of the cases were severe and mild, respectively. Multivariate logistic regression analysis showed that male sex, younger age, residence in an urban area, and severe disease were risk factors for HFMD reinfection. The case-severity rate in secondary infection cases was lower than that in non-reinfection cases (odds ratio 0.675, 95% confidence interval 0.526–0.866).
Boys younger than 4 years of age living in urban areas were more prone to reinfection. Specific health education and intervention should be developed to protect these susceptible populations.
Lu B, Guo H, Lu H. Hand, foot, and mouth disease in mainland China. Lancet Infect Dis. 2014;14(11):1041. CrossRef
Pérezvélez CM, Anderson MS, Robinson CC, McFarland EJ, Nix WA, et al. Outbreak of neurologic enterovirus type 71 disease: a diagnostic challenge. Clin Infect Dis. 2007;45(8):950–7. CrossRef
World Health Organization. WPRO A guide to clinical management and public health response for hand, foot and mouth disease (HFMD). Geneva: WHO Press; 2011.
Liu W, Wu S, Xiong X, Li T, Wen Z, Yan N, et al. Co-circulation and genomic recombination of coxsackievirus A16 and enterovirus 71 during a large outbreak of hand, foot, and mouth disease in Central China. PLoS One. 2014;9(4):e96051. CrossRef
Hii YL, Rocklöv J, Ng N. Short term effects of weather on hand, foot and mouth disease. PLoS One. 2011;6(2):e16796. CrossRef
Michos AG, Syriopoulou VP, Hadjichristodoulou C, Daikos GL, Lagona E, Douridas P, et al. Aseptic meningitis in children: analysis of 506 cases. PLoS One. 2007;2(7):e674. CrossRef
Solomon T, Lewthwaite P, Perera D, Cardosa MJ, McMinn P, Ooi MH. Virology, epidemiology, pathogenesis, and control of enterovirus 71. Lancet Infect Dis. 2010;10(11):778–90. CrossRef
Chan LG, Parashar UD, Lye MS, Ong FG, Zaki SR, Alexander FP, et al. Deaths of children during an outbreak of hand, foot, and mouth disease in Sarawak, Malaysia: clinical and pathological characteristics of the disease. For the Outbreak Study Group. Clin Infect Dis. 2000;31(3):678–83. CrossRef
Wu TN. An epidemic of enterovirus 71 infection in Taiwan. N Engl J Med. 1999;341(13):929. CrossRef
Ang LW, Koh BK, Chan KP, Chua LT, James L, Goh KT. Epidemiology and control of hand, foot and mouth disease in Singapore, 2001-2007. Ann Acad Med Singap. 2009;38(2):106. PubMed
Zhang Y, Zhu Z, Yang W, Ren J, Tan X, Wang Y, et al. An emerging recombinant human enterovirus 71 responsible for the 2008 outbreak of hand foot and mouth disease in Fuyang city of China. Virol J. 2010;7(1):94. CrossRef
Huang EV, Huang LM, Kao VL, Lu VY, Shao PL, Cheng SL, et al. Seroprevalence of enterovirus 71 and no evidence of crossprotection of enterovirus 71 antibody against the other enteroviruses in kindergarten children in Taipei city. J Microbiol Immunol Infect. 2012;45(2):96. CrossRef
Chen GP, Wu JB, Wang JJ, Pan HF, Zhang J, Shi YL, et al. Epidemiological characteristics and influential factors of hand, foot and mouth disease (HFMD) reinfection in children in Anhui province. Epidemiol Infect. 2016;144(1):153–60. CrossRef
Xie Z, Wang L, Yan Y, Hong R, Ou J, Huang W, et al. A cohort study on the characteristics of the recurrent epidemics on hand, foot and mouth disease, in Fujian province. Zhonghua Liu Xing Bing Xue Za Zhi. 2014;35(10):1109. PubMed
Mao YJ, Sun L, Xie JG, Yau KK. Epidemiological features and spatio-temporal clusters of hand-foot-mouth disease at town level in Fuyang, Anhui Province, China (2008-2013). Epidemiol Infect. 2016;144(15):3184–97. CrossRef
Ji H, Li L, Liu Y, Ge H, Wang X, Hu J, et al. Seroepidemiology of human enterovirus71 and coxsackievirusA16 in Jiangsu province, China. Virol J. 2012;9(1):248. CrossRef
Chen C, Xiao X, Ding P. Analysis of repeated infection in hand-foot-mouth disease cases in Guangzhou from 2008 to 2011. China Trop Med. 2012;12(8):934–6.
Xie Z, Zhang Y, Yan Y, Hong R, Wang L. Preliminary study on recurrence with viruses causing hand foot and mouth disease. Dis Surveillance. 2013;28(9):735–9.
Li L, He Y, Yang H, Zhu J, Xu X, Dong J, et al. Genetic characteristics of human enterovirus 71 and coxsackievirus A16 circulating from 1999 to 2004 in Shenzhen, People's Republic of China. J Clin Microbiol. 2005;43(8):3835. CrossRef
Perera D, Yusof MA, Podin Y, Ooi MH, Thao NT, Wong KK, et al. Molecular phylogeny of modern coxsackievirus A16. Arch Virol. 2007;152(6):1201–8. CrossRef
Zhang Y, Wang D, Yan D, Zhu S, Liu J, Wang H, et al. Molecular evidence of persistent epidemic and evolution of subgenotype B1 coxsackievirus A16-associated hand, foot, and mouth disease in China. J Clin Microbiol. 2010;48(2):619–22. CrossRef
Huang ML, Chiang PS, Chia MY, Luo ST, Chang LY, Lin TY, et al. Cross-reactive neutralizing antibody responses to enterovirus 71 infections in young children: implications for vaccine development. PLoS Negl Trop Dis. 2013;7(2):e2067. CrossRef
- Epidemiological characteristics and influential factors of hand, foot, and mouth disease reinfection in Wuxi, China, 2008–2016
- BioMed Central
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