Abstract：Objective To examine the impact of temperature on the incidence of hand-foot-mouth disease (HFMD), so as to provide a basis for research on the impact of climate on HFMD. Methods HFMD incidence data in Huzhou City, Zhejiang Province from 2010 to 2022 were collected from the Infectious Disease Surveillance System of Chinese Disease Prevention and Control Information System. Concurrent meteorological data were obtained from the Huzhou Meteorological Bureau. A distributed lag non-linear model (DLNM) was employed to analyze the impact of temperature on HFMD incidence. Results A total of 65 059 cases of HFMD were reported in Huzhou City from 2010 to 2022, with incidence peaks occurring from April to July and from October to November. The 5th, 25th, 50th, 75th, and 95th percentiles (P5, P25, P50, P75, and P95) of daily average temperature were 2.5, 9.4, 17.8, 24.7, and 30.6 ℃, respectively. The results from the DLNM analysis revealed a non-linear relationship between daily average temperature and HFMD incidence, which exhibited an irregular "M" shape. The incidence peaks were observed at 6.5 ℃ (RR=1.596, 95%CI: 1.154-2.207) and 25.7 ℃ (RR=3.257, 95%CI: 2.614-4.058), respectively. The maximum single-day effect was observed at a daily average temperature of -6.2 ℃ at lag 0 day (RR=1.250, 95%CI: 1.100-1.420), while the minimum single-day effect was observed at a daily average temperature of 34.6 ℃ at lag 0 day (RR=0.881, 95%CI: 0.826-0.940). The impact of daily average temperature at P5 on the incidence of HFMD showed RR values greater than 1 at lag 0, 3, 27, and 30 days, but less than 1 at lag 9 and 12 days, with no significant cumulative lag effect. In contrast, for the daily average temperature at P95, the RR values less than 1 at lag 15, 18, and 21 days, with significant cumulative lag effects identified. Conclusions The incidence of HFMD in Huzhou City peaks from April to July and again from October to November. There exists a nonlinear relationship and lag effect between temperature and HFMD incidence, with particular attention drawn to the impact of extreme temperatures on the disease's onset.
孙秀秀, 沈建勇, 杨中荣, 罗小福, 张子喆. 气温对手足口病发病的影响研究[J]. 预防医学, 2025, 37(11): 1160-1164.
SUN Xiuxiu, SHEN Jianyong, YANG Zhongrong, LUO Xiaofu, ZHAGN Zizhe. Impact of temperature on the incidence of hand-foot-mouth disease. Preventive Medicine, 2025, 37(11): 1160-1164.
[1] 中华人民共和国卫生部.手足口病预防控制指南(2009版)[J].全科医学临床与教育,2010,8(2):125-127,133. National Health Commission of the People's Republic of China.Guidelines for prevention and control of hand,foot and mouth disease (2009 edition)[J].Clin Educ Gen Pract,2010,8(2):125-127,133.(in Chinese) [2] 梁小洁,张智芳,王晓欢.中国大陆手足口病流行特征及空间聚集性分析[J].中国人兽共患病学报,2023,39(10):1009-1016. LIANG X J,ZHANG Z F,WANG X H.Spatio-temporal distribution of hand,foot and mouth disease in mainland China[J].Chin J Zoonoses,2023,39(10):1009-1016.(in Chinese) [3] 石佳琪,龚旻炜,吴健.手足口病流行与气象因素关系的研究进展[J].预防医学论坛,2024,30(5):397-400. SHI J Q,GONG M W,WU J.Research progress on meteorological factors affecting hand-foot-mouth disease[J].Prev Med Tribune,2024,30(5):397-400.(in Chinese) [4] 李建兵,王玉明,李世雄,等.嘉峪关市气温和相对湿度对儿童手足口病的影响及其交互作用分析[J].中国公共卫生管理,2022,38(6):852-855,859. LI J B,WANG Y M,LI S X,et al.Influence and interactive effects of air temperature and humidity on hand,foot and mouth disease of children in Jiayuguan City[J].Chin J P H M,2022,38(6):852-855,859.(in Chinese) [5] CHEN C,JIANG Q Q,SONG Z Z,et al.Influence of temperature and humidity on hand,foot,and mouth disease in Guangzhou,2013-2017[J/OL].J Int Med Res,2020,48(6)[2025-08-27].https://doi.org/10.1177/0300060520929895. [6] HUANG S J,WANG H,LI Z,et al.Risk effects of meteorological factors on human brucellosis in Jilin Province,China,2005-2019[J/OL].Heliyon,2024,10(8)[2025-08-27].https://doi.org/10.1016/j.heliyon.2024.e29611. [7] 何晓庆,罗进斌,王小红,等.金华市大气污染物短期暴露对居民死亡和寿命损失年的影响[J].预防医学,2024,36(5):383-387. HE X Q,LUO J B,WANG X H,et al.Effects of short-term exposure to air pollutants on death and years of life lost in Jinhua City[J].China Prev Med J,2024,36(5):383-387.(in Chinese) [8] 李晨晨. 河北省某市气象因素对手足口病发病影响的研究[D].保定:河北大学,2023. LI C C.Study on the influence of meteorological factors on the incidence of foot and mouth disease in a city in Hebei Province[D].Baoding:Hebei University,2023.(in Chinese) [9] 庞孟涛,李傅冬,林君芬,等.2016—2019年浙江省手足口病流行特征[J].预防医学,2022,34(3):307-310. PANG M T,LI F D,LIN J F,et al.Epidemiological characteristics of hand,foot and mouth disease in Zhejiang Province from 2016 to 2019[J].China Prev Med J,2022,34(3):307-310.(in Chinese) [10] 文艳,杨小蓉,陈华,等.2012—2021年绵阳市手足口流行病学及病原学特征分析[J].医学动物防制,2023,39(4):371-374,378. WEN Y,YANG X R,CHEN H,et al.Analysis of epidemiological and etiological characteristics of hand-foot-mouth disease in Mianyang from 2012 to 2021[J].J Med Pest Control,2023,39(4):371-374,378.(in Chinese) [11] GAO Q,LIU Z D,XIANG J J,et al.Forecast and early warning of hand,foot,and mouth disease based on meteorological factors:Evidence from a multicity study of 11 meteorological geographical divisions in mainland China[J/OL].Environ Res,2021,192[2025-08-27].https://doi.org/10.1016/j.envres.2020.110301. [12] 梁东旭,康强,曾毅,等.基于分布滞后非线性模型探讨南宁市手足口病的发病与气象因素的关联[J].中华疾病控制杂志,2023,27(11):1254-1261. LIANG D X,KANG Q,ZENG Y,et al.Study on the relationship between the incidence of hand-foot-mouth disease and meteorological factors in Nanning City based on the distribution lag nonlinear model[J].Chin J Dis Control Prev,2023,27(11):1254-1261.(in Chinese) [13] XU J W,YANG M,ZHAO Z Y,et al.Meteorological factors and the transmissibility of hand,foot,and mouth disease in Xiamen City,China[J/OL].Front Med(Lausanne),2021,7[2025-08-27].https://doi.org/10.3389/fmed.2020.597375. [14] 高子庆,高秀静,宋传清,等.濮阳市气象因素与手足口病发病的相关性[J].河南医学研究,2023,32(16):2904-2908. GAO Z Q,GAO X J,SONG C Q,et al.Correlation between meteorological factors and incidence of hand-foot-mouth disease in Puyang City[J].Henan Med Res,2023,32(16):2904-2908.(in Chinese) [15] 纪学悦,费春楠,宋佳,等.2014—2018年天津市气温对儿童手足口病发病的短期效应研究[J].华南预防医学,2021,47(11):1366-1370. JI X Y,FEI C N,SONG J,et al.Short-term effect of air temperature on the incidence of hand-foot-mouth disease in children in Tianjin,2014-2018[J].South China J Prev Med,2021,47(11):1366-1370.(in Chinese) [16] 杨亚,费洁,杨怡玮,等.手足口病发病与气象因素的关联研究[J].预防医学,2025,37(4):346-349,355. YANG Y,FEI J,YANG Y W,et al.Association between incidence of hand-foot-mouth disease and meteorological factors[J].China Prev Med J,2025,37(4):346-349,355.(in Chinese) [17] BAKER R E,YANG W C,VECCHI G A,et al.Increasing intensity of enterovirus outbreaks projected with climate change[J/OL].Nat Commun,2024,15(1)[2025-08-27].https://doi.org/10.1038/s41467-024-50936-3. [18] 李昆,武泽昊,刘国涛,等.北京市手足口病的流行特征及日均气温对其流行的滞后效应[J].中华医学杂志,2020,100(34):2696-2700. LI K,WU Z H,LIU G T,et al.Epidemiological characteristics of hand,foot and mouth disease in Beijing and the lag effect of daily average temperature on its epidemic[J].Natl Med J China,2020,100(34):2696-2700.(in Chinese) [19] 王梦,雷娟,王子云,等.气象因素对贵阳市5岁及以下儿童手足口病的影响及其交互效应研究[J].现代预防医学,2023,50(15):2726-2730. WANG M,LEI J,WANG Z Y,et al.Study on the influence and interaction of meteorological factors on HFMD in children aged 5 and under in Guiyang city[J].Mod Prev Med,2023,50(15):2726-2730.(in Chinese)
