An Analysis Of Epidemiological Characteristics And Severe Risk Factors Of Hand-foot-mouth Disease In Lianyungang From 2015 To 2018

Objective:The aim of this study is to analyze the epidemiological characteristics of hand,foot and mouth disease in Lianyungang from 2015 to 2018,and to betterunderstand the epidemic law of hand,foot and mouth disease,whichmayfurther provide a theoretical basis for the establishment of scientific and effective prevention for hand,foot and mouth disease.Secondly,it is able to provide a theoretical basis for the control and preventionof hand,foot and mouth disease according totheanalysisofthe etiological characteristics and epidemiological dataof local hand,foot and mouth disease.Finally,it can be useful to develop an appropriate local prevent measure and provide theoretical basis for early clinical identification and intervention of severe hand,foot and mouth disease in terms of analysis of the protective andriskfactors of severe cases of hand,foot and mouth disease in Lianyungang.Methods:A retrospective observation study was used to analyze the secondary data of hand,foot and mouth disease,which was collected from the China Disease Prevention and Control Information System in Lianyungangfrom 2015 to 2018.The current study described the distribution characteristics of time,region,and population,and further analyzed the epidemic characteristics of hand,foot and mouth disease in Lianyungang.Moreover,the pathogenic analysis depends on the data of pharyngeal swab specimens from patients with hand,foot and mouth disease andthe detection of viral nucleic acids.68 hospitalized participants with severe hand,foot and mouth disease and 68 hospitalized participants with mild hand,foot and mouth disease were recruited in2017-2018.Therefore,a control study was carried out between the severe group and the mild group.The analysis of the risk factors and protective factors of hand,foot and mouth disease by the data from the questionnaires and consulting medical records.Results:1.The overall trend of hand,foot and mouth disease incidence in Lianyungang from 2015 to 2018was highly epidemic every other year.The incidence rate was respectively 88.62/10~5 in 2015,189.99/10~5 in 2016,79.09/10~5 in 2017,and 178.77/10~5 in 2018.2.The time distribution of hand,foot and mouth disease in Lianyungang was mainly from April to June and September to November each year.The disease has occurred in 7 counties and districts in the city.The incidence in children aged 0-5 accounted for 94.81%,and the incidence rate of scattered children and childcare children is 97.57%,and the gender distribution rate of the male and female was 1.61:1.3.The main pathogenic types of hand,foot and mouth disease in 2015 were CV-A16 and EV-71.The mainlyprevalent pathogen in 2016-2017 was EV-71.However,in 2018,the proportion of EV-71 enter viruses has declined sharply.CV-A16 virus showed a decreasing trend from 2015 to2018.4.In the study of factors related to severe hand,foot and mouth disease,Single factor analysis results show 3 years old or younger,the highest fever≥39℃,vomiting,neurological symptoms,arrhythmia,children who have been exposed to hand-foot-mouth disease in the past week,children who often bite their fingers,caregivers education level,Caregivers know that hand,foot and mouth disease,positive etiology results,infected with EV-71 enterovirus,and infected with other types of enterovirus.The two groups are different in the above aspects.The differences were statistically significant(P<0.05).In the multivariate analysis results,there were differences in the educational level of the caregiver(OR:0.166),the age of three years old and below(OR:0.888),neurological symptoms(OR:413.608),and EV-71 infection(OR:15.962)Statistical significance.Conclusions:1.From 2015 to 2018,the overall incidence of hand,foot and mouth disease in Lianyungang City was highly epidemic every other year,and the overall incidence is relatively stable,and there is no overall upward trend.2.The main pathogenic types of hand,foot and mouth disease in 2015 were CV-A16 and EV-71.The mainly prevalent pathogen in 2016-2017 was EV-71.Other enter viruses in 2018 were epidemic strains.3.The protective factors of severe hand,foot and mouth disease mainly contains caregivers’education level,age(3 years old or younger).The risk factorswerehistory of contact with hand,foot and mouth disease in the past week,frequent bites of toys,infection with EV-71,and neurological symptoms.