Investigation and analysis of persistent transmission of herpangina mixed with hand, foot and mouth disease

doi:10.19871/j.cnki.xfcrbzz.2024.03.003

Abstract

Abstract: Objective To understand the epidemiological characteristics of an outbreak of herpangina (HA) combined hand, foot and mouth disease (HFMD) in a kindergarten in Luohu District, Shenzhen, and analyze the factors of sustained transmission and provide scientific basis for formulating effective prevention and control measures. Method Field epidemiological methods were used to collate and analyze the relevant data of the epidemic. Throat swabs, anal swabs and environmental samples were collected to detect the nucleic acid and genotype of enterovirus in the stages of reporting and continuous transmission of the epidemic. Result The epidemic lasted for 42 days, 115 cases were reported, no severe cases, no hospitalization cases, no death cases. There were 86 cases of HA, 11 cases of HFMD and 18 others. The overall incidence was 20.7% (115/555), and the incidence of children on the second floor of the teaching building was 27.5% (57/207), the difference was statistically significant (RR=1.824, 95%CI:1.187-2.804). The pathogens in the two samples were different, and the sustained spread of the epidemic may be related to factors such as close community contact, misdiagnosis of the first diagnosis, irregular morning examination, and park activities. Conclusion This is an outbreak of HA mixed HFMD caused by multiple transmission sources. There is not only communication from community to kindergarten, but also communication between kindergarten classes. It is recommended to add the observation period of home isolation for the prevention and control of campus infectious diseases to prevent the continued spread of the epidemic.

Key words: Herpangina, Hand, foot and mouth disease, Enterovirus, Cluster epidemic, Kindergarten, Shenzhen

CLC Number:

R512.5

Liu Wei, Wang Yanmei, Jiang Shiqing, Zheng Sijie, Chen Zhigao, Zhang Zhen, Kuang Cuiping. Investigation and analysis of persistent transmission of herpangina mixed with hand, foot and mouth disease[J]. Electronic Journal of Emerging Infectious Diseases, 2024, 9(3): 11-15.

References

[1] 邱方洲, 沈永明. 肠道病毒感染相关疾病的流行特征研究进展[J/CD]. 新发传染病电子杂志, 2023, 8(3): 84-89.
[2] YU H, LI XW, LIU QB, et al.Diagnosis and treatment of herpangina: Chinese expert consensus[J]. World J Pediatr, 2020, 16(2): 129-134.
[3] 中华医学会儿科学分会感染学组,国家感染性疾病医疗质量控制中心. 疱疹性咽峡炎诊断及治疗专家共识(2019年版)[J]. 中华儿科杂志, 2019, 57(3): 177-180.
[4] HOFFMANN AJ, LATROUS M, LAM JM.Atypical hand-foot-and-mouth disease[J]. CMAJ, 2020, 192(3): E69.
[5] COX B, LEVENT F. Hand, Foot,Mouth Disease[J]. JAMA, 2018, 320(23): 2492.
[6] 付艺亮, 徐会, 李奇, 等. 2016-2020年我国儿童疱疹性咽峡炎住院病例流行特征及疾病负担分析[J]. 中华实验和临床病毒学杂志, 2023, 37(1): 7-12.
[7] 王明章, 尹旭, 黄蕊, 等. 感染肠道病毒71型重症手足口病以疱疹性咽峡炎起病的发病率调查[J]. 健康必读, 2021, (18): 53.
[8] 蒋荣猛. 《疱疹性咽峡炎诊断及治疗专家共识(2019版)》解读[J]. 西部医学, 2019, 31(12): 1810-1813.
[9] 潘倩瑜, 杨洪, 何雅青, 等. 2021年深圳地区疱疹性咽峡炎流行病学与病原学特征分析[J]. 热带医学杂志, 2023, 23(7): 900-903,913.
[10] 黄妙芬, 王文祥, 连宪强, 等. 深圳市大鹏新区2起儿童疱疹性咽峡炎聚集性疫情的病原鉴定与基因分型分析[J]. 上海预防医学, 2022, 34(7): 660-664.
[11] 罗淑华, 黄鹏飞, 姚炜, 等. 2017年-2021年深圳光明区手足口病流行特征及其病原学分析[J]. 中国卫生检验杂志, 2022, 32(15): 1887-1890.
[12] UJIIE M, NAKAMOTO T, IWAMOTO N, et al.Large-scale resurgence of herpangina in Japan, following the easing of COVID-19 measures[J]. IJID Reg, 2023, 10: 15-17.
[13] MIRAND A, COHEN R, BISSEUX M, et al.A large-scale outbreak of hand, foot and mouth disease, France, as at 28 September 2021[J]. Euro surveil, 2021, 26(43): 2100978.
[14] 李松, 饶睿, 鲁志力, 等. 儿童临床常见疱疹性疾病误诊及误用抗生素情况分析[J/CD]. 临床医药文献电子杂志, 2019, 6(75): 3-4.
[15] 张晓云. 手足口病32例早期误诊原因分析[J]. 医学信息, 2012, 25(5): 263.
[16] SUN Y, ZHOU J, NIE W, et al.Study on the epidemiological characteristics of enterovirus among pediatric patients in Hangzhou, China: A comparison between the pre-COVID-19, COVID-19 pandemic, and post-COVID-19 periods[J]. J Med Virol, 2024, 96(1): e29412.
[17] LEE PI, TSAI TC, HUANG YC, et al.Effectiveness of case isolation and class suspension in mitigation of enterovirus transmission in children[J]. J Infect Public Health, 2022, 15(5): 594-598.
[18] 孙秋云, 杨瑞兰. 2019-2021年天津市河东区手足口病聚集性病例流行特征分析[J]. 职业与健康, 2023, 39(4): 502-504,509.
[19] 邱方洲, 申辛欣, 颜腾飞, 等. 肠道病毒亚型在不同人群中的分布特点及致病风险分析[J/CD]. 新发传染病电子杂志, 2018, 3(1): 8-11.
[20] LI R, LIN C, DONG S, et al.Phylogenetics and phylogeographic characteristics of coxsackievirus A16 in hand foot and mouth disease and herpangina cases collected in Beijing, China from 2019 to 2021[J]. J Med Virol, 2023, 95(8): e28991.
[21] KIM MJ, LEE JE, KIM KG, et al.Long-term sentinel surveilance of enteroviruses in Gwangju, South Korea, 2011-2020[J]. Sci Rep, 2023, 13(1): 2798.
[22] 徐超, 方丽, 李冉, 等. 2008~2018年中国肠道病毒的地域性及时间性分布特征[J]. 中国生物制品学杂志, 2020, 33(7): 799-808.