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

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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.

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Acknowledgements

We thank the Chongqing Center for Disease Control and Prevention for the provision of disease data and the China Meteorological Administration for the provision of weather data.

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Authors and Affiliations

  1. School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China

    Pin Wang & William B. Goggins

  2. Chongqing Center for Disease Control and Prevention, Chongqing, China

    Han Zhao

  3. Chongqing Jiangbei District Center for Disease Control and Prevention, Chongqing, China

    Fangxin You & Hailong Zhou

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  1. Pin Wang
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  2. Han Zhao
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  3. Fangxin You
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  4. Hailong Zhou
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  5. William B. Goggins
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Corresponding author

Correspondence to William B. Goggins.

Ethics declarations

This study involves human participants but is not a survey or observation of human behavior. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required. This study complies with the current laws in China.

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The authors declare that they have no conflict of interest.

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Wang, P., Zhao, H., You, F. et al. Seasonal modeling of hand, foot, and mouth disease as a function of meteorological variations in Chongqing, China. Int J Biometeorol 61, 1411–1419 (2017). https://doi.org/10.1007/s00484-017-1318-0

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  • DOI: https://doi.org/10.1007/s00484-017-1318-0

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