Effect of climatic factors on hand, foot, and mouth disease in South Korea, 2010-2013

Bryan Inho Kim, Hyunok Ki, Sunhee Park, Eunhi Cho, Byung Chul Chun

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54 Citations (Scopus)


Hand, foot, and mouth disease (HFMD) causes characteristic blisters and sores mainly in infants and children, and has been monitored in South Korea through sentinel surveillance since 2009. We described the patterns of HFMD occurrence and analyzed the effect of climatic factors on national HFMD incidence. Weekly clinically diagnosed HFMD case rates (per 1,000 outpatients) in sentinel sites and weekly climatic factors, such as average temperature, relative humidity, duration of sunshine, precipitation, and wind speed from 2010 to 2013, were used in this study. A generalized additive model with smoothing splines and climatic variables with time lags of up to 2 weeks were considered in the modeling process. To account for long-term trends and seasonality, we controlled for each year and their corresponding weeks. The autocorrelation issue was also adjusted by using autocorrelation variables. At an average temperature below 18°C, the HFMD rate increased by 10.3% for every 1°C rise in average temperature (95% confidence interval (CI): 8.4, 12.3%). We also saw a 6.6% increase in HFMD rate (95% CI: 3.6, 9.7%) with every 1% increase in relative humidity under 65%, with a 1.5% decrease in HFMD rate observed (95% CI: 0.4, 2.7%) with each 1% humidity increase above 65%. Modeling results have shown that average temperature and relative humidity are related to HFMD rate. Additional research on the environmental risk factors of HFMD transmission is required to understand the underlying mechanism between climatic factors and HFMD incidence.

Original languageEnglish
Article numbere0157500
JournalPloS one
Issue number6
Publication statusPublished - 2016 Jun 1
Externally publishedYes

Bibliographical note

Funding Information:
Funding: The authors received no specific funding for this work. We acknowledge the Korea Meteorological Administration for providing the supporting climatic data and all sentinel sites both for their participation in the national infectious disease surveillance and for their dedication to promoting public health. The results of this study do not necessarily represent the official position of the Korea Centers for Disease Control and Prevention.

Publisher Copyright:
© 2016 Kim et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

ASJC Scopus subject areas

  • General Biochemistry,Genetics and Molecular Biology
  • General Agricultural and Biological Sciences
  • General


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