ArticlePLoS neglected tropical diseases2025
Effects of temperature and environmental covariates on the dynamic transmission of hand, foot, and mouth disease in Zhejiang, China.
Article in PLoS neglected tropical diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Modelling the impacts of meteorological factors on herpangina: a Bayesian spatiotemporal analysis.Tropical medicine and health · 2026Article
- Interactive and joint effects of multiple meteorological and air pollution exposures on hand, foot and mouth disease risk in western China: a time-series analysis.BMJ public health · 2026Article
- Unraveling meteorologically influenced recurrence and sequential infection risks among influenza, mumps, scarlet fever, and hand-foot-and-mouth disease: evidence from Shenzhen, China.Frontiers in public health · 2026Article
- Quantifying the temperature-related fraction of hand, foot, and mouth disease using distributed lag non-linear models: lessons from the COVID-19 pandemic period.Frontiers in public health · 2026Article
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9 authors.
Funding
Abstract
backgroundStudies have documented the impact of temperature on the incidence of hand, foot, and mouth disease (HFMD); however, no study has examined its impact on the transmissibility.
methodsThe longitudinal surveillance data of HFMD in Zhejiang Province during 2013-2019 were collected from National Notifiable Infectious Diseases Reporting Information System. The incidence of HFMD was represented by daily case counts, and the transmissibility was quantified as the instantaneous reproductive number ([Formula: see text]). The case time series design was applied to investigate the association between temperature and HFMD incidence at small-scale spatial patterns (i.e., townships). General additive model was further employed to analyze the effects of temperature and other driving factors on the transmissibility of HFMD. Separate models were also conducted for each city, along with seasonal and spatial stratified analysis.
resultsWe observed an inverted V-shaped association between temperature and HFMD incidence, with the highest cumulative relative risk (RR: 3.81, 95% CI: 3.75-3.86) at 28°C compared to the reference temperature. Notably, we discovered that HFMD transmissibility exhibited a similar but more pronounced sensitivity to temperature changes, peaking at a lower temperature of 19.69°C. City-specific and stratified results were aligned with the overall provincial pattern. Additionally, other significant driving factors of HFMD transmissibility included the depletion of susceptible individuals, school holidays, vaccination program, relative humidity, and the Normalized Difference Vegetation Index.
conclusionNonlinear associations between temperature and HFMD incidence, as well as transmissibility, are observed. Other driving factors potentially contribute to changes in HFMD dynamic transmission. These findings underscore the importance of implementing targeted policies aimed at early intervention, particularly when HFMD transmissibility begins to reach its peak.
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