Epidemiological characteristics of hand,foot,and mouth disease in China before and after the application of inactivated enterovirus 71 vaccine

LI Xin; TAO XiaoE; XIE Xuan; YUAN Dan; YANG Chenxi

doi:10.3969/j.issn.1007-8134.2025.06.017

Abstract：Objective To analyze the epidemiological characteristics and spatio-temporal clustering of hand,foot and mouth disease(HFMD)in China before and after the application of inactivated enterovirus 71(EV71)vaccine,and to provide a scientific basis for optimizing the vaccination strategy and formulating precise prevention and control measures.Methods The surveillance data of HFMD in China from 2011 to 2019 were collected through the Chinese Public Health Science Data Center.Excel 2016 software and SPSS 24.0 software were used for data sorting and descriptive statistical analysis.ArcGIS 10.8 software was used for global and local autocorrelation analysis.Spatiotemporal scan analysis was performed using SaTScan 10.2.5 software to analyze the spatio-temporal clustering characteristics.Results From 2011 to 2019,the average annual reported incidence rate of HFMD in China was 154.82/105,and the standardized incidence rate was 148.94/105.The average annual reported incidence rate of the EV71 vaccine after application(148.89/105)was lower than that before(157.86/105),and the standardized incidence rates were 141.66/105 and 152.77/105.There was an obvious seasonal fluctuation of the onset,and the peak incidence was mainly concentrated in April to July.Most of the cases were reported among 0-4 years old accounting for 89.37%,and the incidence rate after application of EV71 vaccine was lower than that before with statistically significant difference(χ2=45 371.564,P=0.000).The top three annual reported incidence rates before and after the application of EV71 vaccine were Hainan,Guangxi and Guangdong,and the incidence rate after the application of EV71 vaccine in Hainan and Guangxi were lower than those prior to vaccination(χ2Hainan=6 805.520,χ2Guangxi=9 355.466,P=0.000).Spatial analysis showed that the incidence of HFMD in China from 2011 to 2019 had spatial clustering(Moran's I=0.263-0.547,P<0.05),spatio-temporal scanning analysis identified six clusters,of which the first type cluster encompassing four provinces of Guangdong,Hainan,Guangxi and Hunan,and the aggregation time was 2014-2017.Conclusion The incidence rate of HFMD in China from 2011 to 2019 fluctuated slightly within a small range,and the average annual reported incidence rate after application of the EV71 vaccine was lower than that before.Comprehensive measures should be adopted to control the epidemic trend of HFMD,including enhancing immunization strategies,strengthening surveillance and early warning systems,and deepening health education initiatives.