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.
Highlights
Over 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
Hand, foot, and mouth disease (HFMD) is an infectious gastrointestinal disease commonly caused by enterovirus 71 (EV71) and coxsackievirus A16 (Cox A16) and occurring mainly in children under 5 years old [1,2]
The weekly HFMD cases were positively correlated with temperature, relative humidity, rainfall and wind speed, except that wind speed were not significantly correlated with HFMD cases in the
Summary
Major outbreaks of hand, foot, and mouth disease (HFMD) have been reported in Asian countries, resulting in thousands of deaths among children. 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. Seasonality in the incidence of HFMD has been seen in a number of countries. In Japan, a seasonal peak was detected during the summer months [6,7], while in Finland most HFMD cases were reported in autumn [8]. The seasonality of HFMD suggests that meteorological variables might be influential in the spread of the disease
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