Effect of meteorological variables on the incidence of hand, foot, and mouth disease in children: a time-series analysis in Guangzhou, China

Abstract

BackgroundOver the last decade, major outbreaks of hand, foot, and mouth disease (HFMD) have been reported in Asian countries, resulting in thousands of deaths among children. However, less is known regarding the effect of meteorological variables on the incidence of HFMD in children. This study aims at quantifying the relationship between meteorological variables and the incidence of HFMD among children in Guangzhou, China.MethodsThe association between weekly HFMD cases in children aged <15 years and meteorological variables in Guangzhou from 2008 to 2011 were analyzed using the generalized additive model (GAM) and time-series method, after controlling for long-term trend and seasonality, holiday effects, influenza period and delayed effects.ResultsTemperature and relative humidity with one week lag were significantly associated with HFMD infection among children. We found that a 1°C increase in temperature led to an increase of 1.86% (95% CI: 0.92, 2.81%) in the weekly number of cases in the 0–14 years age group. A one percent increase in relative humidity may lead to an increase of 1.42% (95% CI: 0.97, 1.87%) in the weekly number of cases in the 0–14 years age group.ConclusionsThis study provides quantitative evidence that the incidence of HFMD in children was associated with high average temperature and high relative humidity. The one-week delay in the effects of temperature and relative humidity on HFMD is consistent with the enterovirus incubation period and the potential time lag between onset of children’s sickness and parental awareness and response.

Impact of meteorological changes on the incidence of scarlet fever in Hefei City, China

“…Rainfall and relative humidity had high correlation (r s = 0.573, p < 0.001) and may had similar effect on incidence as it was reported in other studies (Huang et al 2013). It might not influence incidence directly but through change of relative humidity and human activities (Dangi et al 2014).…”

Detecting the association between meteorological factors and hand, foot, and mouth disease using spatial panel data models

“…26 A positive relationship between temperature and HFMD incidence was observed, as well as between relative humidity and HFMD incidence, which is consistent with the findings of other recent studies. [27][28][29] The vapor pressure and wind speed were negatively correlated with HFMD. A laboratory-based study suggested that enteroviruses are resilient to the environmental conditions of the gastrointestinal tract, and that their stability in external environmental conditions is dependent on temperature and humidity.…”

“…[7][8][9] The relationship between meteorological factors and HFMD has been investigated in a number of studies. [10][11][12][13][14] For instance, Hu et al 10 found that climate factors were potential determinants of the incidence of HFMD in most areas in China, using geographically weighted regression. A study by Huang et al 12 provided evidence that the incidence of HFMD in children was associated with the high average temperature and high relative humidity in Guangzhou.…”

The Association between Ambient Temperature and Childhood Hand, Foot and Mouth Disease in Chengdu, China: A Distributed Lag Non-linear Analysis

“…On one side, previous studies have provided evidence of the nonlinear relationship between temperature and HFMD1314. On the other side, some time series studies have reported the delayed effect of temperature exposure on HFMD1112.…”