Objective  To analyze the epidemiological characteristics of hand, foot and mouth disease (HFMD) in Enshi Prefecture, explore the impacts of socioeconomic and meteorological factors, and evaluate the intervention effects of pandemic prevention and control measures on HFMD.

Methods  ArcGIS 10.8 was used to visualize the spatiotemporal characteristics of HFMD cases across 88 township-level administrative units in Enshi Prefecture. Estimating the number and proportion of susceptible individuals using the SEIR model. Bayesian spatiotemporal models were employed to analyze the influences of socioeconomic and meteorological factors on disease distribution. A time-series model was constructed to predict the incidence trend in 2020 and quantify the impact of pandemic control measures.

Results  From 2010 to 2020, a total of 58 954 HFMD cases were reported, with an average annual incidence rate of 11.90 per 100 000, a mortality rate of 0.01 per 100 000, and children aged ≤5 years accounted for 93.20% of cases. A 1-standard-deviation increase in household savings deposits was associated with a 1.1% decrease in incidence (P<0.05). Higher temperatures (β=0.182) and increased precipitation (β=0.229) were linked to elevated incidence risk. pandemic control measures reduced monthly cases by 415 (P=0.049). However, after the relaxation of prevention and control measures, the number of cases in December 2020 increased by 266.6% compared with the same period in 2019, indicating a compensatory epidemic.

Conclusion  This study reveals the spatiotemporal distribution characteristics and socioeconomic-meteorological drivers of HFMD in Enshi Prefecture, quantifies the effect of pandemic prevention and control measures, and provides multi-dimensional evidence for precision prevention and control of infectious diseases in mountainous areas.

1.World Health Organization. A guide to clinical management and public health response for hand, foot and mouth disease (HFMD) [R]. Geneva: World Health Organization, 2011.

2.陈小佳, 黄邓高, 冯桃. 2008~2018年我国手足口病流行性分析[J]. 海南医学院学报, 2021, 27(15): 1142-1148, 1155. [Chen XJ, Huang DG, Feng T, et al. Prevalence analysis of hand, foot and mouth disease in China, 2008-2018[J]. Journal of Hainan Medical University, 2021, 27(15): 1142-1148, 1155.] DOI: 10.13210/j.cnki.jhmu.20210526.003.

3.国家卫生健康委员会. 中国卫生健康统计年鉴（2021）[M]. 北京: 中国协和医科大学出版社, 2021: 105-110.

4.杨雅斯, 卢亚陵, 方莅媛, 等. 气象因素对四川省手足口病发病率的影响及预测模型构建[J]. 四川大学学报（医学版）, 2020, 51(5): 685-690. [Yang YS, Lu YL, Fang LY, et al. Influence of meteorological factors on HFMD and construction of prediction model in Sichuan province[J]. Journal of Sichuan University(Medical Sciences), 2020, 51(5): 685-690.] DOI: 10.12182/20200960106.

5.Ye XY, Wang YD, Zou YX, et al. Associations of socioeconomic status with infectious diseases mediated by lifestyle, environmental pollution and chronic comorbidities: a comprehensive evaluation based on UK Biobank[J]. Infect Dis Poverty, 2023, 12(1): 5. DOI: 10.1186/s40249-023-01056-5.

6.Man HJ, Huang HT, Qin ZY, et al. Analysis of a SARIMA-XGBoost model for hand, foot, and mouth disease in Xinjiang, China[J]. Epidemiol Infect, 2023, 151: e200. DOI: 10.1017/S0950268823001905.

7.Li CH, Mao JJ, Wu YJ, et al. Combined impacts of environmental and socioeconomic covariates on HFMD risk in China: a spatiotemporal heterogeneous perspective[J]. PLoS Negl Trop Dis, 2023, 17(5): e0011286. DOI: 10.1371/journal.pntd.0011286.

8.Liu WC, Wang RN, Li Y, et al. The indirect impacts of nonpharmacological COVID-19 control measures on other infectious diseases in Yinchuan, Northwest China: a time series study[J]. BMC Public Health, 2023, 23(1): 1089. DOI: 10.1186/s12889-023-15878-3.

9.张皓丹, 归国平, 郭锋,等. 基于干预分析模型的 COVID-19疫情对手足口病的影响[J]. 中华疾病控制杂志, 2023, 27(3): 339-344. [Zhang HD, Gui GP, Guo F, et al. Study on the influence of COVID-19 epidemic to hand, food and mouth disease based on intervention analysis model[J]. Chinese Journal of Disease Control & Prevention, 2023, 27(3): 339-344.] DOI: 10.16462/j.cnki.zhjbkz.2023.03.017.

10.国家卫生健康委员会. 手足口病诊疗指南（2018年版）[EB/OL]. (2018-05-15) [2025-03-20]. https://www.gov.cn/zhengce/zhengceku/2018-12/31/content_5435156.htm.

11.Banerjee S, Carlin BP, Gelfand AE. Hierarchical modeling and analysis for spatial data[M]. New York : Chapman and Hall/CRC, 2014: 25-30.

12.Liu LL, Wang L, Qi C, et al. Epidemiological characteristics and spatiotemporal analysis of hand-foot-mouth diseases from 2010 to 2019 in Zibo city, Shandong, China[J]. BMC Public Health, 2021, 21(1): 1640. DOI: 10.1186/s12889-021-11665-0.

13.Huang Y, Deng T, Yu SC, et al. Effect of meteorological variables on the incidence of hand, foot, and mouth disease in children: a time-series analysis in Guangzhou, China[J]. BMC Infect Dis, 2013, 13: 134. DOI: 10.1186/1471-2334-13-134.

14.Ying ML, Wang SJ, Bai C, et al. Rural-urban differences in health outcomes, healthcare use, and expenditures among older adults under universal health insurance in China[J]. PLoS One, 2020, 15(10): e0240194. DOI: 10.1371/journal.pone.0240194.

15.陈思秇, 孙立梅, 马文军, 等. 基于贝叶斯时空模型广州市手足口病精细时空尺度下发病影响因素分析[J]. 中国公共卫生, 2020, 36(8): 1171-1176. [Chen SY, Sun LM, Ma WJ, et al. Risk factors of hand, foot, and mouth disease in Guangzhou city, 2010-2014: a Bayesian fine-scale spatio-temporal modeling analysis[J]. Chinese Journal of Public Health, 2020, 36(8): 1171-1176.] DOI: 10.11847/zgggws1121488.

16.张琳, 曹雷, 李燕, 等. 2017—2021年中国肠道病毒71型灭活疫苗接种现状分析[J]. 中华流行病学杂志，2023, 44(4): 561-567. [Zhang L, Cao L, Li Y, et al. Analysis of the vaccination status of enterovirus type 71 inactivated vaccine in China from 2017 to 2021[J]. Chinese Journal of Epidemiology, 2023, 44(4): 561-567.] DOI: 10.3760/cma.j.cn112338-20220811-00704.

17.张儒豪, 光旭, 何逸飞, 等. 2013—2022年广东省深圳市手足口病流行特征和病原学分析[J]. 疾病监测, 2024, 39(10): 1263-1269. [Zhang RH, Guang X, He YF, et al. Epidemiological and etiological characteristics of hand, foot and mouth disease in Shenzhen, Guangdong, 2013—2022[J]. Disease Surveillance, 2024, 39(10): 1263-1269.] DOI: 10.3784/jbjc.202312120654.

18.韦懿芸, 孙亚敏, 鲁宁. 2010—2019年北京市海淀区手足口病发病时空特征分析[J]. 中国健康教育, 2021, 37(11): 996-998, 1004. [Wei YY, Sun YM, Lu N. Spatial-temporal distribution of Hand-foot-mouth Disease (HFMD) in Haidian district during 2010-2019[J]. Chinese Journal of Health Education, 2021, 37(11): 996-998, 1004.] DOI: 10.16168/j.cnki.issn.1002-9982.2021.11.008.

19.Zhou HX, Yao Y, Long QJ, et al. Epidemiological characteristics and influencing factors of hand, foot and mouth disease reinfection cases in Jiulongpo District, Chongqing, China, 2009-2023[J]. Front Public Health, 2025, 13: 1543450. DOI: 10.3389/fpubh.2025.1543450.

20.Prihartono I, Guo XX, Tariq A, et al. Global school closures in response to COVID-19 pandemic: comparison of national initial estimates and actual lengths of school closures during 2019-2020 academic year[J]. Social Sciences & Humanities Open, 2024, 9: 100871. DOI: 10.1016/j.ssaho.2024.100871.

21.谢聪, 彭雨霜, 黄增辉, 等. 基于湖北省统筹传染病监测预警平台的疫情信息报告质量与效率分析[J]. 疾病监测, 2025, 40(1): 44-48. [Xie C, Peng YS, Huang ZH, et al. Analysis on quality and efficiency of epidemic information reporting based on regional infectious disease surveillance and early warning platform in Hubei[J]. Disease Surveillance, 2025, 40(1): 44-48.] DOI: 10.3784/jbjc.202411180663.

22.吴北平, 杨典, 王劲峰, 等. 利用贝叶斯时空模型分析山东省手足口病时空变化及影响因素[J]. 地球信息科学学报, 2016, 18(12): 1645-1652. [Wu BP, Yang D, Wang JF, et al. Space-time variability and determinants of hand, foot and mouth in Shandong province: a Bayesian spatio-temporal modeling approach[J]. Journal of Geo-Information Science, 2016, 18(12): 1645-1652.] DOI: 10.3724/SP.J.1047.2016.01645.

23.宋飏, 刘艳晓, 张瑜, 等. 中国手足口病时空分异特征及影响因素[J]. 地理学报, 2022, 77(3): 574-588 [Song Y, Liu YX, Zhang Y, et al. Spatio-temporal differentiation characteristics and influencing factors of hand, foot, and mouth disease in China[J]. Acta Geographica Sinice, 2022, 77(3): 574-588.] DOI: 10.11821/dlxb202203006.

24.张云婷, 马生霞, 陈畅, 等. 中国儿童青少年身体活动指南[J]. 中国循证儿科杂志, 2017, 12(6): 401-409. [Zhang YT, Ma SX, Chen C, et al. Physical activity guidelines for Chinese children and adolescents[J]. Chinese Journal of Evidence Based Pediatrics, 2017, 12(6): 401-409.] DOI: 10.3969/j.issn.1673-5501.2017.06.001.

25.邓永超, 唐喜春, 李逊, 等. 新型冠状病毒肺炎疫情后儿童维生素D营养状况调查[J]. 中国当代儿科杂志, 2021, 23(11): 1091-1096. [Deng YC, Tang XC, Li X, et al. An investigation of vitamin D nutritional status in children after outbreak of coronavirus disease 2019[J]. Chinese Journal of Contemporary Pediatrics, 2021, 23(11): 1091-1096.] DOI: 10.7499/j.issn.1008-8830.2106155.

26.Brockman-Schneider RA, Pickles RJ, Gern JE. Effects of vitamin D on airway epithelial cell morphology and rhinovirus replication[J]. PLoS One, 2014, 9(1): e86755. DOI: 10.1371/journal.pone.0086755.

27.Li YP, Deng HL, Wang WJ, et al. Vitamin D receptor gene methylation in patients with hand, foot, and mouth disease caused by enterovirus 71[J]. Arch Virol, 2020, 165(9): 1979-1985. DOI: 10.1007/s00705-020-04701-8.

28.陶希, 张玲, 向兵, 等. 恩施州某农村留守儿童伤害综合干预效果评价[J]. 中华疾病控制杂志, 2016, 20(3): 271-274. [Tao X, Zhang L, Xiang B, et al. Effectiveness evaluation of comprehensive intervention about injury among the left-behind children in rural area of Enshi[J]. Chinese Journal of Disease Control & Prevention, 2016, 20(3): 271-274]. DOI: 10.16462/j.cnki.zhjbkz.2016.03.014.

29.Butler-Jones D, Wong T. Infectious disease, social determinants and the need for intersectoral action[J]. Can Commun Dis Rep, 2016, 42(Suppl 1): S118-S120. DOI: 10.14745/ccdr.v42is1a04.