Open AccessInteraction analysis on transmissibility of main pathogens of hand, foot, and mouth disease
Author(s) -
Kaiwei Luo,
Jia Rui,
Shixiong Hu,
Qingqing Hu,
Dong Yang,
Shan Xiao,
Zeyu Zhao,
Yao Wang,
Xingchun Liu,
Lili Pan,
Ran An,
Dongbei Guo,
Yanhua Su,
Bin Zhao,
Lidong Gao,
Tianmu Chen
Publication year - 2020
Publication title -
medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.59
H-Index - 148
eISSN - 1536-5964
pISSN - 0025-7974
DOI - 10.1097/md.0000000000019286
Subject(s) - medicine , hand foot and mouth disease , enterovirus 71 , etiology , case fatality rate , foot and mouth disease , foot (prosody) , transmissibility (structural dynamics) , disease , enterovirus , confidence interval , epidemiology , virology , outbreak , virus , linguistics , philosophy , physics , vibration isolation , quantum mechanics , vibration
Hand, foot, and mouth disease (HFMD) has spread widely and led to high disease burden in many countries. In this study, we aimed to analyze the interaction of the main pathogens of HFMD using a mathematical model. A dataset on reported HFMD cases was collected from April, 2009 to December, 2017 in Changsha City. A long-term etiological surveillance was conducted focusing on the pathogens of the disease including enterovirus A71 (EV71), coxsachievirus A16 (CA16), and other enteroviruses. A susceptible-infectious-recovered model was adopted to calculate the reproduction number during the ascending period of reported cases (defined as R asc ) and the descending period (defined as R des ). About 214,178 HFMD cases (including clinically diagnosed cases and confirmed cases) were reported in Changsha City, among which 31 were death cases with a fatality of 0.01%. The number of reported HFMD cases increased yearly with a Linear model of “ f ( t ) = 18542.68 + 1628.91 t ” where f ( t ) and t referred to number of reported cases and sequence of year, respectively. The fatality of the disease decreased yearly with a linear model of “ f ( t ) = – 0.012 + 0.083/ t ”. About 5319 stool or anal swab specimens were collected from the reported cases. Among them, 1201 were tested EV71 positive, 836 were CA16 positive, and 1680 were other enteroviruses positive. R asc and R des of HFMD was 1.34 (95% confidence interval [CI]: 1.28–1.40) and 0.73 (95% CI: 0.69–0.76), respectively. EV71 and CA16 interacted with each other, and the interaction between EV71 and other enteroviruses and the interaction between CA16 and other enteroviruses were both directional. However, during the reported cases decreasing period, interactions only occurred between EV71 and other enteroviruses and between CA16 and other enteroviruses. These interactions all decreased R asc but increased R des of affected pathogens. The interactions of the pathogens exist in Changsha City. The effective reproduction number of the affected pathogen is adjusted and verges to 1 by the interaction.