Seasonal modeling of hand, foot, and mouth disease as a function of meteorological variations in Chongqing, China

Abstract

Hand, foot, and mouth disease (HFMD) is an enterovirus-induced infectious disease, mainly affecting children under 5 years old. Outbreaks of HFMD in recent years indicate the disease interacts with both the weather and season. This study aimed to investigate the seasonal association between HFMD and weather variation in Chongqing, China. Generalized additive models and distributed lag non-linear models based on a maximum lag of 14 days, with negative binomial distribution assumed to account for overdispersion, were constructed to model the association between reporting HFMD cases from 2009 to 2014 and daily mean temperature, relative humidity, total rainfall and sun duration, adjusting for trend, season, and day of the week. The year-round temperature and relative humidity, rainfall in summer, and sun duration in winter were all significantly associated with HFMD. An inverted-U relationship was found between mean temperature and HFMD above 19 °C in summer, with a maximum morbidity at 27 °C, while the risk increased linearly with the temperature in winter. A hockey-stick association was found for relative humidity in summer with increasing risks over 60%. Heavy rainfall, relative to no rain, was found to be associated with reduced HFMD risk in summer and 2 h of sunshine could decrease the risk by 21% in winter. The present study showed meteorological variables were differentially associated with HFMD incidence in two seasons. Short-term weather variation surveillance and forecasting could be employed as an early indicator for potential HFMD outbreaks.

Hand, Foot, and Mouth Disease Caused by Coxsackievirus A6: A Preliminary Report from Istanbul

“…The frequency of HFMD emergences peak twice in a year in countries with a tropical climate; however, it can be observed throughout the year. It exhibits a single annual rise in summer or fall in countries located at higher latitudes (Blomqvist et al 2010;Huang et al 2015;Wang et al 2017). In Turkey, individual studies showed that the frequency of HFMD rises during summer (Topkarcı 2013; Uğraş et al 2014;Yorulmaz and Onat 2017).…”

Forecasting hand, foot, and mouth disease in Shenzhen based on daily level clinical data and multiple environmental factors

“…Chongqing adopted multiple meteorological parameters to quantify the association of daily weather variation with HFMD incidence (9). Besides the meteorological parameters, studies from the Central South University also explored the relationship between HFMD and fine particulate matter less than 10 (PM 10 ) (10).…”

Clinical Significance and Prognostic Effect of Serum 25-hydroxyvitamin D Concentrations in Critical and Severe Hand, Foot and Mouth Disease

“…Studies suggest that may result from a combination of pathological immune responses and direct viral effects, but no effective treatment is currently available and no biomarker that can be used as an early warning for critical HFMD. Chongqing (southwest of China) is a high incidence area of severe and critical HFMD [3], but also a high incidence of vitamin D (VitD) deficiency and insufficiency [4]. Studies have already suggested that the deficiency of (VitD) was found in some critical and severe disease [5], and in our clinical practice, we also found some critical HFMD children with a very low serum concentration of 25-hydroxyvitamin D [25(OH)D].…”