What is the clinical evidence from this study?

Study design: Observational. Population: Hand, foot, and mouth disease (HFMD). Intervention: COVID-19 control measures vs. Historical incidence (2015-2019). Primary outcome: Total attack rate (TAR) of HFMD (RD 36.35-98.41%).

June 1, 2021Journal of Safety Science and Resilience15 citationsOpen Access

Control measures during the COVID-19 outbreak reduced the transmission of hand, foot, and mouth disease

YNYan NiuChinese Center For Disease Control and Prevention LLLi LuoPeking University JRJia RuiJiangnan University

Key Result

COVID-19 control measures significantly reduced the transmission of hand, foot, and mouth disease, with the relative difference in total attack rate ranging from 36.35% to 98.41% compared to the median of previous years in five of six cities.

Study Design

Type

Observational

Multicenter

Yes

Structured PICO

Do COVID-19 preventive and control measures reduce the transmission of hand, foot, and mouth disease in mainland China?

Population

Reported cases of hand, foot, and mouth disease across six cities in mainland China from 2015 to 2020, analyzed to evaluate the impact of COVID-19 control measures.

Exposure

COVID-19 preventive and control measures (e.g., suspension of classes, home isolation, closing leisure places, wearing masks)

Comparator

Pre-COVID-19 period (2015-2019) without these measures

Outcome

Incidence, effective reproduction number (Reff), and total attack rate (TAR) of hand, foot, and mouth disease (HFMD)

COVID-19 preventive and control measures significantly contributed to the containment of hand, foot, and mouth disease transmission in China.

Main Result

Effect estimate: RD 36.35-98.41%

Limitations

The regions selected for the study did not involve cities located in western China, limiting generalizability to those areas.
The cut-off period of the study is 2020, leaving it unknown how long the rebound effect observed in the second half of 2020 will last.

Abstract

Control measures during the coronavirus disease 2019 (COVID-19) outbreak may have limited the spread of infectious diseases. This study aimed to analyze the impact of COVID-19 on the spread of hand, foot, and mouth disease (HFMD) in China. A mathematical model was established to fit the reported data of HFMD in six selected cities in mainland China from 2015 to 2020. The absolute difference (AD) and relative difference (RD) between the reported incidence in 2020, and simulated maximum, minimum, or median incidence of HFMD in 2015–2019 were calculated. The incidence and Reff of HFMD have decreased in six selected cities since the outbreak of COVID-19, and in the second half of 2020, the incidence and Reff of HFMD have rebounded. The results show that the total attack rate (TAR) in 2020 was lower than the maximum, minimum, and median TAR fitted in previous years in six selected cities (except Changsha City). For the maximum, median, minimum fitted TAR, the range of RD (%) is 42·20–99·20%, 36·35–98·41% 48·35–96·23% (except Changsha City) respectively. The preventive and control measures of COVID-19 have significantly contributed to the containment of HFMD transmission.

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