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February 23, 2026EpidemicsOpen Access

COVID-19 NPIs linked to up to ~20% reduced transmission of HFMD enteroviruses.

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Why the study?

A decline in HFMD incidence during the COVID-19 pandemic suggested altered enterovirus transmission dynamics, prompting evaluation of the impact of non-pharmaceutical interventions in Japan.

Do COVID-19 non-pharmaceutical interventions reduce the transmission rate of HFMD-associated enteroviruses in Japan?

Population

Surveillance cases of HFMD EV-A71, CVA16, and CVA6 in Japan from January 2005 to December 2024

Comparison

COVID-19 pandemic period vs pre-pandemic levels

Design

Stochastic transmission modelling study using sentinel surveillance data

Key result

COVID-19 NPIs reduced transmission of HFMD enteroviruses in Japan by 7.86% for EV-A71, 12.0% for CVA16, and 20.1% for CVA6 from 2020-2022.

Authors

XYXuemei YanNGNicholas C GrasslyMPMargarita Pons-Salort

Discussion

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Member takes

Overview

NPIs may curb HFMD transmission; leaves open generalizability and need for prospective trials.

Key Points

  • This study aims to estimate how COVID-19 non-pharmaceutical interventions affected the transmission of enteroviruses causing hand, foot, and mouth disease in Japan.
  • Fitted a susceptible-infected-recovered stochastic transmission model to surveillance data
  • Analyzed weekly reported cases of EV-A71, CVA16, and CVA6 from 2005 to 2024
  • Used the COVID-19 Stringency Index to correlate with transmission rates
  • Transmission rates decreased by 7.86% for EV-A71, 12.0% for CVA16, and 20.1% for CVA6 from January 2020 to December 2022
  • 49.3%, 19.9%, and 25.5% of the reduction for each serotype was explained by the Stringency Index
  • Higher transmissibility enterovirus serotypes showed greater reductions during COVID-19 containment measures

Structured PICO

Do COVID-19 non-pharmaceutical interventions reduce the transmission rate of HFMD-associated enteroviruses in Japan?

P
Population
Surveillance data of hand, foot, and mouth disease (HFMD) enterovirus A71 (EV-A71), coxsackievirus A16 (CVA16), and CVA6 cases in Japan from January 2005 to December 2024
I
Intervention
COVID-19 non-pharmaceutical interventions (NPIs)
C
Comparator
Pre-pandemic levels
O
Outcome
Transmission rate of EV-A71, CVA16, and CVA6

COVID-19 non-pharmaceutical interventions significantly reduced the transmission of HFMD-related enteroviruses in Japan, with greater reductions seen in serotypes with higher transmissibility.

Cite This Study

Yan et al. (2026) studied this question. COVID-19 NPIs reduced transmission of HFMD enteroviruses in Japan by 7.86% for EV-A71, 12.0% for CVA16, and 20.1% for CVA6 from 2020-2022.

synapsesocial.com/papers/699bee551c6c6bad5397ff24https://doi.org/10.1016/j.epidem.2026.100899
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