title: Changing epidemiology of hand, foot, and mouth disease in Hong Kong, 2001-2009.
abstract: We report the surveillance findings of hand, foot, and mouth disease (HFMD) collected from a general practitioner-based sentinel surveillance system and outbreaks reported by institutions and a laboratory-based enterovirus surveillance system in Hong Kong from 2001 to 2009. A seasonal peak was detected in the warmer months (May-July), along with a smaller winter peak (October-December) from 2006 onwards. The number of older children (>5 years) infected increased from 25.4% in 2001 to 33.0% in 2009 (P=0.01, Mantel-Haenszel chi-square test). Laboratory surveillance detected a cyclical high enterovirus 71 activity every 3 to 4 years. This activity was associated with a higher average hospitalization rate for HFMD patients in the outbreaks reported in the corresponding year, although the difference was only marginally significant (P=0.09, linear regression test). The changing epidemiology of HFMD warrants continuous surveillance in order to guide preventive public-health actions.
authors.affiliation: Surveillance and Epidemiology Branch, Centre for Health Protection, Department of Health, Hong Kong Special Administrative Region, China. smo_ss4@dh.gov.hk
authors.forename: Edmond
authors.initials: E
authors.lastname: Ma
authors.forename: Terence
authors.initials: T
authors.lastname: Lam
authors.forename: K C
authors.initials: KC
authors.lastname: Chan
authors.forename: Christine
authors.initials: C
authors.lastname: Wong
authors.forename: S K
authors.initials: SK
authors.lastname: Chuang
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks / Q000706:statistics & numerical data*; D004770:Enterovirus / Q000145:classification / Q000302:isolation & purification*; D005260:Female; D058006:General Practice / Q000706:statistics & numerical data*; D006232:Hand, Foot and Mouth Disease / Q000453:epidemiology* / Q000473:pathology / Q000821:virology; D006723:Hong Kong / Q000453:epidemiology; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D008297:Male; D012621:Seasons; D018571:Sentinel Surveillance; D055815:Young Adult