Meteorological factors affect the hand, foot, and mouth disease epidemic in Qingdao, China, 2007–2014

Abstract

Hand, foot, and mouth disease (HFMD) has caused public health concerns worldwide. We aimed to investigate the effect of meteorological factors on the HFMD epidemic in Qingdao, a port city in China. A total of 78641 cases were reported in Qingdao between January 2007 and December 2014. Of those, 71084 (90·39%) occurred in children aged 0-5 years, with an incidence of 1691·2/100000. The incidence increased from early spring, peaked between spring and summer, and decreased in late summer. Aetiological agents in all severe cases and selected mild cases were characterized by examining throat swabs. Except for enterovirus 71 (EV71) and coxsackievirus A16 (CA16), other EVs caused >50% of the HFMD cases between 2011 and 2014. EV71 was more frequent in the off-peak months than in the peak months and prone to causing more severe cases compared to CA16 (χ 2 = 46·3, P < 0·001). CA10 caused more severe HFMD than did CA6 (χ 2 = 20·49, P < 0·001) and all non-CA10 EVs (χ 2 = 41·01, P < 0·001). Community-derived HFMD cases accounted for 65·11%. Spearman rank correlation analysis showed that HFMD incidence in children aged 0-5 years was positively correlated with atmospheric temperature (r s = 0·77, P < 0·001), relative humidity (r s = 0·507, P < 0·001), and precipitation (r s = 0·328, P < 0·001). Climate changes and CA10 surveillance in communities should be integrated into the current prophylactic programme.

Associations between Meteorological Factors and Aseptic Meningitis in Six Metropolitan Provinces of the Republic of Korea

“…Previous studies from temperate regions of China, Taiwan, and Japan also reported a similar effect of temperature on EV diseases [32,37,38]. An increase in the weekly lags of rainfall had a positive effect on AM cases.…”

“…Although several studies have found the effect of meteorological factors on the burden of hand-foot-and-mouth disease (HFMD) [32,33,37,38], and other infectious and non-infectious diseases [13,20,21], their effects on the development of AM remain obscure. We used a generalized linear quasi-Poisson model to estimate the lagged effects of diverse meteorological factors on AM cases in Korea using weekly data.…”

“…We also found significantly higher positive associations between Nino3 and AM during outbreak years. In Korea, several studies have reported the effects of ENSO on variations in local temperature, rainfall, and precipitation [17,18], and these factors also influence the distribution of EV diseases in different countries [32,33,38]. …”

“…Climate variability was not great across the metropolitan provinces across the four distinct seasons. Several ecological studies have found associations between meteorological factors and enteroviral diseases with different lags [19,32,33]. Therefore, we designed the length of lag time in weeks after reviewing the incubation period of EVs [3] and other possible effects of host and environment on disease development.…”

The effect of temperature on childhood hand, foot and mouth disease in Guangdong Province, China, 2010-2013: A multicity study

“…Some basic information about cases, such as current address, age, gender, the onset data and daily counts of cases in each city were also collected. In this study, we mainly focus on children 0-5 years old because they are more sensitive to disease and majority of reported cases were in this age group [1].…”