Changing epidemiology of hand, foot, and mouth disease in Hong Kong, 2001-2009

Jpn J Infect Dis. 2010 Nov;63(6):422-6.


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.

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Child
  • Child, Preschool
  • Disease Outbreaks / statistics & numerical data*
  • Enterovirus / classification
  • Enterovirus / isolation & purification*
  • Female
  • General Practice / statistics & numerical data*
  • Hand, Foot and Mouth Disease / epidemiology*
  • Hand, Foot and Mouth Disease / pathology
  • Hand, Foot and Mouth Disease / virology
  • Hong Kong / epidemiology
  • Hospitalization / statistics & numerical data
  • Humans
  • Infant
  • Male
  • Seasons
  • Sentinel Surveillance*
  • Young Adult