Leading Enterovirus Genotypes Causing Hand, Foot, and Mouth Disease in Guangzhou, China: Relationship with Climate and Vaccination against EV71

Zhicheng Du, Yong Huang, Wayne R. Lawrence, Jianxiong Xu, Zhicong Yang, Jianyun Lu, Zhoubin Zhang and Yuantao Hao
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Zhicheng Du: Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
Yong Huang: Department of Immunization Programme Planning, Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, China
Wayne R. Lawrence: Department of Epidemiology and Biostatistics, School of Public Health, State University of New York at Albany, Albany, NY 12144, USA
Jianxiong Xu: Department of Immunization Programme Planning, Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, China
Zhicong Yang: Department of Communicable Disease Control and Prevention, Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, China
Jianyun Lu: Department of Communicable Disease Control and Prevention, Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, China
Zhoubin Zhang: Department of Communicable Disease Control and Prevention, Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, China
Yuantao Hao: Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China

IJERPH, 2021, vol. 18, issue 1, 1-10

Abstract: (1) Background: Assignment of pathogens to the correct genus, species, and type is vital for controlling infectious epidemics. However, the role of different enteroviruses during hand, foot, and mouth disease (HFMD) epidemics and the major contributing factors remain unknown. (2) Methods: HFMD cases from 2016 to 2018 in Guangzhou, China were collected. The relationship between HFMD cases and genotype frequency, as well as the association between genotype frequency and climate factors, were studied using general linear models. We transformed the genotype frequency to the isometric log-ratio (ILR) components included in the model. Additionally, vaccination rates were adjusted in the climate-driven models. (3) Results: We observed seasonal trends in HFMD cases, genotype frequency, and climate factors. The model regressing case numbers on genotype frequency revealed negative associations with both the ILRs of CAV16 (RR = 0.725, p < 0.001) and EV71 (RR = 0.421, p < 0.001). The model regressing genotype frequency on driven factors showed that the trends for EV71 proportions were inversely related to vaccination rate (%, β = −0.152, p = 0.098) and temperature (°C, β = −0.065, p = 0.004). Additionally, the trends for CVA16 proportions were inversely related to vaccination rate (%, β = −0.461, p = 0.004) and temperature (°C, β = −0.068, p = 0.031). The overall trends for genotype frequency showed that EV71 decreased significantly, while the trends for CVA16 increased annually. (4) Conclusions: Our findings suggest a potential pathway for climate factors, genotype frequency, and HFMD cases. Our study is practical and useful for targeted prevention and control, and provides environmental-based evidence.

Keywords: hand, foot, and mouth disease; genotype frequency; climate (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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