Spatial dynamic patterns of hand-foot-mouth disease in the People's Republic of China

Hand-foot-mouth disease (HFMD) is the most common and widespread infectious disease in the People's Republic of China. Although there has been a substantial increase of HFMD in many parts of the country in recent years, its spatial dynamics and determinants remain unclear. When we collected and analysed weekly data on HFMD cases from 1,456 counties and the corresponding meteorological factors from 1 May 2008 to 27 March 2009, it was found that HFMD was spatially dispersed across the country in the summer and winter, while clustered in the spring and autumn. The spatial variation of HFMD was found to be affected by a combination of climate variables, while its spatio-temporal transmission was largely driven by temperature variations with a 7-week lag implying that (i) the dispersal of the disease can be anticipated based on the variation of the temperature and other climate variables; and (ii) the spatial dynamics of HFMD can be robustly predicted 7 weeks ahead of time using temperature data only. The findings reported allow prompt preparation and implementation of appropriate public health interventions to control and prevent disease outbreaks.