Pathogen Spectrum of Hand, Foot, and Mouth Disease Based on Laboratory Surveillance - China, 2018.

WHAT IS ALREADY KNOWN ABOUT THIS TOPIC?: Enterovirus 71 (EV-A71) is the main causative pathogen for severe and fatal patients with Hand, Foot, and Mouth Disease (HFMD) in mainland China from 2008 to 2017. Non-EV-A71 and non-CV-A16 (other enterovirus) serotypes were the major causative-serotypes for mild HFMD in years of 2013, 2015, and 2017.

WHAT IS ADDED BY THIS REPORT?: In 2018, other enterovirus serotypes replaced EV-A71 for the first time as the major cause of severe HFMD with a proportion of 70.7%. However, at the national level, only a small proportion of the other enterovirus serotypes were further identified as CV-A6 and CV-A10.

WHAT ARE THE LIMITATIONS FOR PUBLIC HEALTH PRACTICE?: Further identification of other enterovirus serotypes is highly recommended for provincial CDCs, especially for severe HFMD. Studies contributing to a multivalent vaccine for HFMD should be prioritized.