Assessing the impact of humidex on HFMD in Guangdong Province and its variability across social-economic status and age groups

Humidex is a meteorological index that combines the impacts of temperature and humidity, and is directly comparable with dry temperature in degrees Celsius. However, to date, no research has focused on the effect of humidex on hand, foot and mouth disease (HFMD). The current study was designed to address this research need. Case-based HFMD surveillance data and daily meteorological data collected between 2010 and 2012 was obtained from the China CDC and the National Meteorological Information Center, respectively. Distributed lag nonlinear models were applied to assess the impact of humidex on HFMD among children under 15 years oldin Guangdong, and its variability across social-economic status and age groups. We found that relative risk (RR) largely increased with humidex. Lag-specific and cumulative humidex-RR curves for children from the Pearl-River Delta Region as well as older children were more likely to show two-peak distribution patterns. One RR peak occurred at a humidex of between 15 and 20, and the other occurred between 30 and 35. This study provides a comprehensive picture of the impact of humidex on HFMD incidence in Guangdong Province. Results from the present study should be important in the development of area-and-age-targeted control programs.

[1]  Zhicong Yang,et al.  HAND-FOOT-AND-MOUTH DISEASE EPIDEMIOLOGICAL STATUS AND RELATIONSHIP WITH METEOROLOGICAL VARIABLES IN GUANGZHOU, SOUTHERN CHINA, 2008-2012 , 2014, Revista do Instituto de Medicina Tropical de Sao Paulo.

[2]  Fateh Chebana,et al.  A general and flexible methodology to define thresholds for heat health watch and warning systems, applied to the province of Québec (Canada) , 2013, International Journal of Biometeorology.

[3]  H. Sutton.  AN EPIDEMIOLOGICAL STUDY , 1937 .

[4]  Antonio Gasparrini,et al.  Distributed Lag Linear and Non-Linear Models in R: The Package dlnm. , 2011, Journal of statistical software.

[5]  Qiyong Liu,et al.  The Effect of Meteorological Variables on the Transmission of Hand, Foot and Mouth Disease in Four Major Cities of Shanxi Province, China: A Time Series Data Analysis (2009-2013) , 2015, PLoS neglected tropical diseases.

[6]  Yanchen Bo,et al.  Using an autologistic regression model to identify spatial risk factors and spatial risk patterns of hand, foot and mouth disease (HFMD) in Mainland China , 2014, BMC Public Health.

[7]  Y. Tsai,et al.  Enterovirus 71 Virion-Associated Galectin-1 Facilitates Viral Replication and Stability , 2015, PloS one.

[8]  A Gasparrini,et al.  Distributed lag non-linear models , 2010, Statistics in medicine.

[9]  D. Easterling,et al.  Spatial variation in hyperthermia emergency department visits among those with employer-based insurance in the United States – a case-crossover analysis , 2015, Environmental Health.

[10]  Y. Hao,et al.  Spatial-Temporal Clusters and Risk Factors of Hand, Foot, and Mouth Disease at the District Level in Guangdong Province, China , 2013, PloS one.

[11]  Scott C. Sheridan,et al.  Assessing Variability in the Impacts of Heat on Health Outcomes in New York City Over Time, Season, and Heat-Wave Duration , 2014, EcoHealth.

[12]  Jiaqi Ma,et al.  Surveillance of hand, foot, and mouth disease in mainland China (2008-2009). , 2011, Biomedical and environmental sciences : BES.

[13]  J. Rocklöv,et al.  Short Term Effects of Weather on Hand, Foot and Mouth Disease , 2011, PloS one.

[14]  C. Pantea,et al.  Cold Spells and the Risk of Hospitalization for Asthma: New York, USA 1991–2006 , 2014, Lung.

[15]  M. Hashizume,et al.  The influence of temperature and humidity on the incidence of hand, foot, and mouth disease in Japan. , 2011, The Science of the total environment.

[16]  Hualiang Lin,et al.  The effect of meteorological factors on adolescent hand, foot, and mouth disease and associated effect modifiers , 2014, Global health action.

[17]  H. Lei,et al.  Reemerging of enterovirus 71 in Taiwan: the age impact on disease severity , 2011, European Journal of Clinical Microbiology & Infectious Diseases.

[18]  Y. Hao,et al.  Effect of meteorological variables on the incidence of hand, foot, and mouth disease in children: a time-series analysis in Guangzhou, China , 2013, BMC Infectious Diseases.

[19]  Hualiang Lin,et al.  Short-Term Effect of El Niño-Southern Oscillation on Pediatric Hand, Foot and Mouth Disease in Shenzhen, China , 2013, PloS one.

[20]  Jian Cheng,et al.  Associations between extreme precipitation and childhood hand, foot and mouth disease in urban and rural areas in Hefei, China. , 2014, The Science of the total environment.

[21]  R. Dales,et al.  Air Pollution and Mortality in Chile: Susceptibility among the Elderly , 2007, Environmental health perspectives.

[22]  Ming Wang,et al.  Hand-foot-and-mouth disease and weather factors in Guangzhou, southern China , 2013, Epidemiology and Infection.

[23]  Cécile Viboud,et al.  Hand, foot, and mouth disease in China, 2008-12: an epidemiological study. , 2014, The Lancet. Infectious diseases.

[24]  Distributed lag linear and non-linear models for time series data , 2013 .

[25]  Y. Liao,et al.  Determinants of the Incidence of Hand, Foot and Mouth Disease in China Using Geographically Weighted Regression Models , 2012, PloS one.

[26]  Hualiang Lin,et al.  Short-term effects of meteorological factors on children hand, foot and mouth disease in Guangzhou, China , 2014, International Journal of Biometeorology.