title: [Epidemiological characteristics and temporal-spatial clustering analysis on hand-foot-mouth disease in Jiangsu province, 2009 - 2011].
abstract: OBJECTIVE
  To analyze the epidemic characteristics of hand-foot-mouth disease (HFMD) in Jiangsu province.
  
  
  METHODS
  We downloaded the case-data of HFMD in Jiangsu province during 2009 - 2011 from the Chinese National Notifiable Infectious Disease Reporting System, and made a comprehensive analysis on the epidemiological features of it with descriptive epidemiological methods and retrospective space-time permutation scan statistics.
  
  
  RESULTS
  A total of 285 414 cases were reported in Jiangsu, from 2009 to 2011, with an annual incidence of 122.66 per 100 000. There were 3686 severe cases in the 3 years a cumulatively, accounting for 1.29% of the total. Proportion of the cases being 5 years old or even younger was 93.64%. Scatteredly living children accounted for 64.08% of the total cases and 78.65% of the severe cases, respectively. The epidemics of HFMD were visible in each city of Jiangsu province, with a lowest annual incidence rate of 44.02 per 100 000 and a highest one up to 202.90 per 100 000. Regions as Suzhou, Nanjing, Wuxi had the highest incidence in the province, with cases in these three areas occupying almost 40% of all. The numbers of severe cases in Suqian and in Yancheng cities increased by 339.22% and 328.33% in 2011 compared to in 2010, respectively, and the rates of increase in these two cities were much higher than those in the other regions. Two peaks of incidence were observed every year, with the highest occurring between April and June and the second occurring in November. The spatial-temporal distribution of HFMD was not random in Jiangsu province, from 2009 to 2011. Clusters for general cases in August and 7 clusters for severe cases were detected, respectively. 12 359 cases of HFMD were laboratory confirmed in the said 3 years, including 10 414 common cases and 1945 severe cases. EV71 and CoxA16 accounted for 43.49% and 37.07% of common cases, respectively. In terms of the severe cases, the ratios were 80.82% and 5.96%, respectively.
  
  
  CONCLUSIONS
  HFMD was highly endemic in Jiangsu province, and the situation of prevention and control for it is still grim. Scatteredly living children of 5 years old or younger were the major population at risk, and the epidemic in different regions and seasons was different. EV71 and CoxA16 were the major etiologic agents, but the etiologic constitute showed seasonal changes.
authors.affiliation: Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China.
authors.forename: Wen-dong
authors.initials: WD
authors.lastname: Liu
authors.forename: Ying
authors.initials: Y
authors.lastname: Wu
authors.forename: Qi
authors.initials: Q
authors.lastname: Liang
authors.forename: Jian-li
authors.initials: JL
authors.lastname: Hu
authors.forename: Qi-gang
authors.initials: QG
authors.lastname: Dai
authors.forename: Yuan
authors.initials: Y
authors.lastname: Li
authors.forename: Jing
authors.initials: J
authors.lastname: Ai
authors.forename: Fen-yang
authors.initials: FY
authors.lastname: Tang
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D016000:Cluster Analysis; D005260:Female; D006232:Hand, Foot and Mouth Disease / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D055815:Young Adult