Transmission of Hand, Foot and Mouth Disease and Its Potential Driving Factors in Hong Kong

Yang, Bingyi; Lau, Eric H. Y.; Wu, Peng; Cowling, Benjamin J.

doi:10.1038/srep27500

Cited by 24 publications

(23 citation statements)

References 36 publications

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“…The range of R eff in previous studies was obviously disparate because of different experimental designs. Such as 1.14-1.24 by Yang et al [31], which was slightly lower than this study, it might be influenced by its focus that placed more emphasis on community. The range of R eff was between 2.5 to 5.5 from two studies in Hong Kong and Singapore [32,33], which was approximately consistent with this study.…”

Section: Assessment Of Transmissibility Of Hfmdcontrasting

confidence: 68%

Seasonality of the transmissibility of hand, foot and mouth disease: a modelling study in Xiamen City, China

Huang

Wang²,

Qiu

et al. 2019

Epidemiol. Infect.

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This study attempts to figure out the seasonality of the transmissibility of hand, foot and mouth disease (HFMD). A mathematical model was established to calculate the transmissibility based on the reported data for HFMD in Xiamen City, China from 2014 to 2018. The transmissibility was measured by effective reproduction number (Reff) in order to evaluate the seasonal characteristics of HFMD. A total of 43 659 HFMD cases were reported in Xiamen, for the period 2014 to 2018. The median of annual incidence was 221.87 per 100 000 persons (range: 167.98/100,000–283.34/100 000). The reported data had a great fitting effect with the model (R2 = 0.9212, P < 0.0001), it has been shown that there are two epidemic peaks of HFMD in Xiamen every year. Both incidence and effective reproduction number had seasonal characteristics. The peak of incidence, 1–2 months later than the effective reproduction number, occurred in Summer and Autumn, that is, June and October each year. Both the incidence and transmissibility of HFMD have obvious seasonal characteristics, and two annual epidemic peaks as well. The peak of incidence is 1–2 months later than Reff.

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Section: Assessment Of Transmissibility Of Hfmdcontrasting

confidence: 68%

Seasonality of the transmissibility of hand, foot and mouth disease: a modelling study in Xiamen City, China

Huang

Wang²,

Qiu

et al. 2019

Epidemiol. Infect.

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“…School terms did not significantly affect HFMD transmission rate. This is consistent with conclusions obtained from other studies for HFMD in Hong Kong and Singapore [39,40]: closing schools was found having a positive effect on reducing the spread of HFMD, but the impact was small. The average age of HFMD infection in China is around 3 years old, with a little younger age in provinces in the tropical and subtropical zones, and a little older in provinces in the north [2].…”

Section: Discussionsupporting

confidence: 92%

The transmission of Hand, Foot, and Mouth Disease in East and Southeast Asia

Zhao

Wang

2019

Preprint

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Hand Foot and Mouth Disease (HFMD) is in endemic in many countries in East and Southeast Asia, including those in the tropical or subtropical climate zones. To substantially reduce HFMD, it is necessary to design effective control measures, which is based on a deep understanding of the disease transmission. However, the transmission mechanism of HFMD was rarely studied. The cyclic pattern of HFMD incidence is believed to be related to climatic factors, rather than school terms as observed from childhood infectious diseases in developed countries in the prevaccination era. Furthermore, the association of incidence and climatic factors in different locales in China are inconsistent and even contradictory. Here we selected countries or regions in typical climatic zones in East and Southeast Asia to study the transmission rate and its seasonality for HFMD. Countries or regions selected representing temperate, subtropical and tropical zones are Japan, Hong Kong SAR, Macau SAR and Singapore. Comparatively, we chose provinces in mainland China in three climate zones and contrast them with above selected regions or countries. We used Time Series Susceptible Infected Recovered (TSIR) model to estimate the HFMD transmission rate. The parameters in the TSIR model were estimated by Markov Chain Monte Carlo (MCMC). We then used a linear regression model to analyze the effects of climate factors, seasonal contact rate in children (and seasonal contact rate in population for provinces in China) on the transmission rate of HFMD in selected regions. We found that: 1) transmission rate of HFMD is highly seasonal in the studied countries, SARs and provinces of mainland China, except Singapore; 2) the HFMD transmission rate can be affected by the climatic factors as well as the seasonal contact rate of population, depending on which factor is dominant; 3) The transmission rate in provinces in China increased dramatically during the time period of Chinese Spring Travel Rush that has higher population contact; 4) transmission rate seasonality in Japan, Hong Kong SAR and Macau SAR is affected by climatic factors. Author SummaryHand, Foot and Mouth Disease (HFME) is endemic in East and Southeast Asia with reported cases of more than two million every year. The epidemic patterns such as annual cyclic pattern of reported HFMD cases have been observed and studied for the purpose of understanding the disease. The mechanisms that describe how a disease is transmitted cannot be observed, however they lead to the observed epidemic patterns of the disease. We analyzed the transmission rate (that help to understand the transmission mechanism) of HFMD in selected countries or regions that represent territories in tropical, subtropical and temperate climatic zones in East and Southeast Asia and compared the HFMD transmission in these regions. We also analyzed the possible driving factors of the seasonal transmission of HFMD. The transmission of HFMD can be affected by both social behavior and climatic factors, however either of them can dominant t...

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“…23,24 There is, however, a lack of empirical evidence on the effect of school closure on HFMD transmission: one exception is a review of HFMD in Hong Kong that revealed fewer HFMD consultations than expected during the 2003 severe acute respiratory syndrome and the 2009 influenza pandemic, which was attributed to various control measures including school closure. 25,26 This article aimed to assess the effect of school closure on HFMD transmission. In Singapore, HFMD is endemic with year-round transmission and is legally notifiable by physicians and childcare teachers, as well as actively screened for in preschool-aged children.…”

Section: Introductionmentioning

confidence: 99%

The Effect of School Closure on Hand, Foot, and Mouth Disease Transmission in Singapore: A Modeling Approach

Chen

Badaruddin

Lee

et al. 2018

The American Journal of Tropical Medicine and Hygiene

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Abstract.Singapore implements a school closure policy for institutional hand, foot, and mouth disease (HFMD) outbreaks, but there is a lack of empirical evidence on the effect of closure on HFMD transmission. We conducted a retrospective analysis of 197,207 cases of HFMD over the period 2003–2012 at the national level and of 57,502 cases in 10,080 institutional outbreaks over the period 2011–2016 in Singapore. The effects of school closure due to 1) institutional outbreaks, 2) public holidays, and 3) school vacations were assessed using a Bayesian time series modeling approach. School closure was associated with a reduction in HFMD transmission rate. During public holidays, average numbers of secondary cases having onset the week after dropped by 53% (95% credible interval 44–62%), and during school vacations, the number of secondary cases dropped by 7% (95% credible interval 3–10%). Schools being temporarily closed in response to an institutional outbreak reduced the average number of new cases by 1,204 (95% credible interval 1,140–1,297). Despite the positive effect in reducing transmission, the effect of school closure is relatively small and may not justify the routine use of this measure.

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Transmission of Hand, Foot and Mouth Disease and Its Potential Driving Factors in Hong Kong

Cited by 24 publications

References 36 publications

Seasonality of the transmissibility of hand, foot and mouth disease: a modelling study in Xiamen City, China

Seasonality of the transmissibility of hand, foot and mouth disease: a modelling study in Xiamen City, China

The transmission of Hand, Foot, and Mouth Disease in East and Southeast Asia

The Effect of School Closure on Hand, Foot, and Mouth Disease Transmission in Singapore: A Modeling Approach

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