Effects of the non-pharmaceutical interventions during the COVID-19 epidemic on hand, foot and mouth disease in Qingdao, China

Xueling Xin; Dapeng Sun; Qing Liu; Cun Wang; Yan Liu; Jing Jia

doi:10.1186/s12879-025-11838-x

November 4, 2025BMC Infectious DiseasesOpen Access

Effects of the non-pharmaceutical interventions during the COVID-19 epidemic on hand, foot and mouth disease in Qingdao, China

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Why the study?

Non-pharmaceutical interventions against COVID-19 have shown co-benefits for preventing other infectious diseases, but their impact on hand, foot and mouth disease in Qingdao, China, required evaluation.

Do non-pharmaceutical interventions during the COVID-19 epidemic reduce the incidence of hand, foot and mouth disease in Qingdao, China?

Structured PICO

Do non-pharmaceutical interventions during the COVID-19 epidemic reduce the incidence of hand, foot and mouth disease in Qingdao, China?

P

Population

Monthly reported hand, foot and mouth disease (HFMD) cases and pathogens information during 2010-2023 in Qingdao, China

I

Intervention

Non-pharmaceutical interventions (NPIs) implemented during the COVID-19 epidemic

C

Comparator

Predicted HFMD cases based on historical data using a seasonal autoregressive integrated moving average (SARIMA) model

O

Outcome

Monthly HFMD cases

Non-pharmaceutical interventions implemented during the COVID-19 pandemic significantly reduced the spread of hand, foot, and mouth disease.

Implication

Should not yet change HFMD control practice; leaves open causality and generalizability beyond this single-city ecological analysis.

Abstract

BACKGROUND: Since December 2019, COVID-19 has spread rapidly, leading to a global epidemic. The non-pharmaceutical interventions (NPIs) were implemented to control the transmission of COVID-19. Previous studies have shown that NPIs have co-benefits for the prevention of other infectious diseases. This study aimed to explore the impact of the NPIs on Hand, foot and mouth disease (HFMD) in Qingdao, China. METHODS: Monthly reported HFMD cases and pathogens information during 2010-2023 in Qingdao were collected from the China Notifiable Disease Surveillance System. Descriptive epidemiology method was adopted to describe the epidemic trend of HFMD. The seasonal autoregressive integrated moving average (SARIMA) model was used to estimate the monthly HFMD cases during the COVID-19 period, and assessed the effect of NPIs on HFMD by different years and response levels. The effects across different subgroups stratified by gender and ages were also explored. RESULTS: model. Model prediction showed that the actual value from 2020 to 2022 decreased by 73.32% compared to the predicted values (38,127cases). The greatest relative reduction was in 2020 and the level 1 response period. As the NPIs eased, the HFMD incidence rebounded to historical levels in 2023. The stratified analysis showed the same patterns as the overall trends. CONCLUSIONS: The implementations of NPIs during the COVID-19 pandemic effectively reduced the spread of HFMD. Hence, strengthening public health intervention remains a priority measure for preventing HFMD.