Prevalent pathogens of hand,foot and mouth disease in Ningxia Hui Autonomous Region,2013-2014

Objective To analyze epidemiological and pathogenic characteristics of hand,foot and mouth disease(HFMD) in Ningxia Hui Autonomous Region(Ningxia) during 2013-2014 and to provide theoretical evidences for HFMD prevention and control.Methods Data on all registered HFMD cases in Ningxia during the two year period were collected;fecal or throat swab specimens were sampled from all severe and death HFMD cases and the HFMD cases visiting sentinel hospitals(5 cases/per hospital/per month);enterovirus(EV) culture and isolation were conducted for the specimens and the types of the virus isolated were identified with real-time PCR and gene sequencing technology.Descriptive epidemiological method was adopted in data analyses.Results Of 1703 EV positive specimens detected during the period,814(47.8%) were Coxsackievirus group A type 16(CAV16) positive;479(28.1%) were enterovirus 71(EV71) positive;and 410(24.1%) were other EV positive.CAV16 was the predominant pathogen of HFMD during 2013-2014;other EV were the second major pathgen in 2013 and EV71 was the second major virus in 2014.An obvious seasonality was observed in the distribution and there were statistically significant differences in spatial and temporal distribution of HFMD pathogens in Ningxia during the period.Conclusion The dominant HFMD pathogens in Ningxia are EV71,CAV16 and other EV,with an alternated prevalent trend among the viruses,and the pathogen prevalence trend should be concerned in the control of HFMD epidemic.