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. 2016 Aug 17;11(8):e0161006.
doi: 10.1371/journal.pone.0161006. eCollection 2016.

Hand, Foot and Mouth Disease in Hong Kong: A Time-Series Analysis on Its Relationship with Weather

Pin Wang  1 , William B Goggins  1 , Emily Y Y Chan  2
Affiliations

Hand, Foot and Mouth Disease in Hong Kong: A Time-Series Analysis on Its Relationship with Weather

Pin Wang et al. PLoS One. .

Abstract

Background: Hand, foot and mouth disease (HFMD) is an emerging enterovirus-induced infectious disease for which the environmental risk factors promoting disease circulation remain inconclusive. This study aims to quantify the association of daily weather variation with hospitalizations for HFMD in Hong Kong, a subtropical city in China.

Methods: A time series of daily counts of HFMD public hospital admissions from 2008 through 2011 in Hong Kong was regressed on daily mean temperature, relative humidity, wind speed, solar radiation and total rainfall, using a combination of negative binomial generalized additive models and distributed lag non-linear models, adjusting for trend, season, and day of week.

Results: There was a positive association between temperature and HFMD, with increasing trends from 8 to 20°C and above 25°C with a plateau in between. A hockey-stick relationship of relative humidity with HFMD was found, with markedly increasing risks over 80%. Moderate rainfall and stronger wind and solar radiation were also found to be associated with more admissions.

Conclusions: The present study provides quantitative evidence that short-term meteorological variations could be used as early indicators for potential HFMD outbreaks. Climate change is likely to lead to a substantial increase in severe HFMD cases in this subtropical city in the absence of further interventions.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Seasonal variation in daily hand, foot and mouth disease cases and meteorological variables in Hong Kong, 2008–2011.
Fig 2
Fig 2. Three-dimensional plots of relative risks along daily mean temperature (A), relative humidity (B), square root of wind speed (C) and total daily solar radiation (D) and their corresponding lags.
Fig 3
Fig 3. Cumulative relative risks of hand, foot and mouth disease hospitalization as a function of meteorological variables for a time lag of 1 week (mean temperature (A) and relative humidity (B)) and 2 weeks (square root of wind speed (C) and total solar radiation (D)).
Fig 4
Fig 4. Lag-response association specific to rainfall category 2(0 mm
See this image and copyright information in PMC

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References

    1. Duff MF. Hand-foot-and-mouth syndrome in humans: coxackie A10 infections in New Zealand. Br Med J. 1968;2(5606):661–4. - PMC - PubMed
    1. Chen KT, Chang HL, Wang ST, Cheng YT, Yang JY. Epidemiologic features of hand-foot-mouth disease and herpangina caused by enterovirus 71 in Taiwan, 1998–2005. Pediatrics. 2007;120(2):e244–52. - PubMed
    1. Ma E, Lam T, Chan KC, Wong C, Chuang SK. Changing epidemiology of hand, foot, and mouth disease in Hong Kong, 2001–2009. Jpn J Infect Dis. 2010;63(6):422–6. - PubMed
    1. Ang LW, Koh BK, Chan KP, Chua LT, James L, Goh KT. Epidemiology and control of hand, foot and mouth disease in Singapore, 2001–2007. Ann Acad Med Singapore. 2009;38(2):106–12. - PubMed
    1. Nguyen NT, Pham HV, Hoang CQ, Nguyen TM, Nguyen LT, Phan HC, et al. Epidemiological and clinical characteristics of children who died from hand, foot and mouth disease in Vietnam, 2011. BMC Infect Dis. 2014;14:341 10.1186/1471-2334-14-341 - DOI - PMC - PubMed

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