Epidemiological characteristics and influential factors of hand, foot, and mouth disease reinfection in Wuxi, China, 2008-2016

Abstract

Background: Hand, foot, and mouth disease (HFMD) is a viral disease caused by human enteroviruses. Although HFMD reinfection is common, studies investigating this phenomenon are insufficient.

Methods: The present study focused on HFMD reinfection in Wuxi from 2008 to 2016 using surveillance system data.

Results: Of 107,677 cases included in the study, 6470 cases were classified as reinfections. The overall reinfection rate was 6.01% (6.37% male and 5.48% female patients), which decreased with increasing age (χ² = 1125.477, p < 0.001). The rate was 6.17 and 5.79% in urban and rural areas, respectively, and 7.83 and 5.98% of the cases were severe and mild, respectively. Multivariate logistic regression analysis showed that male sex, younger age, residence in an urban area, and severe disease were risk factors for HFMD reinfection. The case-severity rate in secondary infection cases was lower than that in non-reinfection cases (odds ratio 0.675, 95% confidence interval 0.526-0.866).

Conclusions: Boys younger than 4 years of age living in urban areas were more prone to reinfection. Specific health education and intervention should be developed to protect these susceptible populations.

Keywords: And mouth disease; Epidemiology; Foot; Hand; Reinfection.

Fig. 1

Seasonal distributions of the primary and secondary infections and non-reinfection

Fig. 2

Time intervals between primary and secondary infections in different age groups