Why the study?
Although the spatio-temporal dynamics of HFMD have been studied, inter-regional transmission patterns remain underexplored.
HFMD transmission in Guangdong is primarily driven by autoregressive components, with temperature influencing different transmission components, suggesting the need for localized and season-specific preventive measures.
Local HFMD control may be most efficient in urban clusters; leaves open meteorological causality and broader applicability.
BACKGROUND: Hand, foot, and mouth disease (HFMD) is a significant public health challenge, particularly in Guangdong Province, China. Although spatio-temporal dynamics of HFMD have been studied, inter-regional transmission patterns remain underexplored. This study investigates these patterns and the influence of meteorological factors to provide insights for more effective prevention strategies in the context of environmental factors. METHODS: We collected HFMD cases surveillance, population, and meteorological data from 21 cities in Guangdong from 2009 to 2017. Endemic-epidemic multivariate time-series model was used to analyze the case data, decomposing the HFMD risk into endemic, autoregressive, and spatio-temporal components, and investigating the influence of temperature and relative humidity on these components. RESULTS: HFMD in Guangdong shows distinct seasonal peaks in the second and fourth quarters, with regional clusters in Guangzhou, Shenzhen, Foshan, and Dongguan. The endemic-epidemic model indicates that 86.57% (95%CI: 77.17%-97.08%) of infection risk is due to autoregressive transmission, 9.50% (95%CI: 8.46%-10.65%) to spatio-temporal transmission, and 3.94% (95%CI: 3.33%-4.60%) to endemic factors. Shenzhen, Foshan, Meizhou, and Zhanjiang have autoregressive transmission rates of 89%-94.08%, while Yunfu, Jiangmen, Zhaoqing, and Shantou have import rates of 12.27%-21.44%. HFMD risk is positively correlated with temperatures below 25 °C for the endemic component and above 25 °C for the autoregressive and spatio-temporal components. CONCLUSION: HFMD transmission in Guangdong is primarily driven by the autoregressive component, with temperature influencing different transmission components. Health authorities should enhance local preventive measures during high-risk seasons and adjust control strategies based on various transmission components to mitigate HFMD spread.
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Tang et al. (2025) studied this question.
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