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Spatio-temporal distribution and hotspots of Hand, Foot and Mouth Disease (HFMD) in northern Thailand.

Samphutthanon R, Tripathi NK, Ninsawat S, Duboz R - Int J Environ Res Public Health (2013)

Bottom Line: The results indicate that the disease can occur at any time of the year, but appears to peak in the rainy and cold seasons.When separated by season, it was found that there was a significant correlation with the direction of the southwest monsoon at the same time.In particular, a new hotspot was found in the recent year in Mae Hong Son province.

View Article: PubMed Central - PubMed

Affiliation: Remote Sensing and Geographic Information Systems Field of Study, School of Engineering and Technology, Asian Institute of Technology, P.O. Box 4, Klong Luang, Pathumthani 12120, Thailand. ratchaphon.samphutthanon@ait.ac.th.

ABSTRACT
Hand, Foot and Mouth Disease (HFMD) is an emerging viral disease, and at present, there are no antiviral drugs or vaccines available to control it. Outbreaks have persisted for the past 10 years, particularly in northern Thailand. This study aimed to elucidate the phenomenon of HFMD outbreaks from 2003 to 2012 using general statistics and spatial-temporal analysis employing a GIS-based method. The spatial analysis examined data at the village level to create a map representing the distribution pattern, mean center, standard deviation ellipse and hotspots for each outbreak. A temporal analysis was used to analyze the correlation between monthly case data and meteorological factors. The results indicate that the disease can occur at any time of the year, but appears to peak in the rainy and cold seasons. The distribution of outbreaks exhibited a clustered pattern. Most mean centers and standard deviation ellipses occurred in similar areas. The linear directional mean values of the outbreaks were oriented toward the south. When separated by season, it was found that there was a significant correlation with the direction of the southwest monsoon at the same time. An autocorrelation analysis revealed that hotspots tended to increase even when patient cases subsided. In particular, a new hotspot was found in the recent year in Mae Hong Son province.

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HFMD outbreaks in number of patients per million inhabitants at the regional level, annually from 2003 to 2012 and the 10 year average.
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ijerph-11-00312-f001: HFMD outbreaks in number of patients per million inhabitants at the regional level, annually from 2003 to 2012 and the 10 year average.

Mentions: Hand, Foot and Mouth Disease (HFMD) is an emerging illness infecting infants and children. It is characterized by fever, painful sores in the mouth and a rash with blisters on the hands, feet and buttocks. HFMD is most frequently caused by coxsackievirus A16 (CA16) and enterovirus 71 (EV-71) [1,2,3]; however, most patients with fatal complications are infected with EV-71 [4]. At present, no effective chemoprophylaxis or vaccination approaches for dealing with HFMD are available [5,6]. The transmission of HFMD occurs from person to person through direct contact with nasal discharge, saliva or fluid from the blisters. Other infection paths include food or water contaminated with fecal droplets, nasal discharge, fluid or saliva from an infectious person. Weather variables may affect the transmission of HFMD either directly or indirectly [7]. Globally, HFMD outbreaks have been documented for more than four decades. It has been reported that in the last decade the western Pacific region, including countries such as Japan, Malaysia, Singapore, Thailand and China, was the area most severely affected by HFMD [8,9,10,11,12,13]. Other countries, such as Taiwan, Hong Kong, the Republic of Korea, Vietnam, Cambodia, Brunei and Mongolia, were also impacted. HFMD has also progressed to become a leading cause of suffering and mortality in some developing countries, with Thailand finding itself among these. The current epidemic situation in Thailand, as reported by the Bureau of Epidemiology, Ministry of Public Health, includes HFMD outbreaks during the past 10 years, with the more severe in the last 5 to 6 years. Four deaths were caused by HFMD in 2008, and another four were reported in 2009. In 2011 and 2012, six and two deaths were reported, respectively. The northern region of Thailand has had the highest infection rate every year from 2003 to 2012 (Figure 1).


Spatio-temporal distribution and hotspots of Hand, Foot and Mouth Disease (HFMD) in northern Thailand.

Samphutthanon R, Tripathi NK, Ninsawat S, Duboz R - Int J Environ Res Public Health (2013)

HFMD outbreaks in number of patients per million inhabitants at the regional level, annually from 2003 to 2012 and the 10 year average.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3924446&req=5

ijerph-11-00312-f001: HFMD outbreaks in number of patients per million inhabitants at the regional level, annually from 2003 to 2012 and the 10 year average.
Mentions: Hand, Foot and Mouth Disease (HFMD) is an emerging illness infecting infants and children. It is characterized by fever, painful sores in the mouth and a rash with blisters on the hands, feet and buttocks. HFMD is most frequently caused by coxsackievirus A16 (CA16) and enterovirus 71 (EV-71) [1,2,3]; however, most patients with fatal complications are infected with EV-71 [4]. At present, no effective chemoprophylaxis or vaccination approaches for dealing with HFMD are available [5,6]. The transmission of HFMD occurs from person to person through direct contact with nasal discharge, saliva or fluid from the blisters. Other infection paths include food or water contaminated with fecal droplets, nasal discharge, fluid or saliva from an infectious person. Weather variables may affect the transmission of HFMD either directly or indirectly [7]. Globally, HFMD outbreaks have been documented for more than four decades. It has been reported that in the last decade the western Pacific region, including countries such as Japan, Malaysia, Singapore, Thailand and China, was the area most severely affected by HFMD [8,9,10,11,12,13]. Other countries, such as Taiwan, Hong Kong, the Republic of Korea, Vietnam, Cambodia, Brunei and Mongolia, were also impacted. HFMD has also progressed to become a leading cause of suffering and mortality in some developing countries, with Thailand finding itself among these. The current epidemic situation in Thailand, as reported by the Bureau of Epidemiology, Ministry of Public Health, includes HFMD outbreaks during the past 10 years, with the more severe in the last 5 to 6 years. Four deaths were caused by HFMD in 2008, and another four were reported in 2009. In 2011 and 2012, six and two deaths were reported, respectively. The northern region of Thailand has had the highest infection rate every year from 2003 to 2012 (Figure 1).

Bottom Line: The results indicate that the disease can occur at any time of the year, but appears to peak in the rainy and cold seasons.When separated by season, it was found that there was a significant correlation with the direction of the southwest monsoon at the same time.In particular, a new hotspot was found in the recent year in Mae Hong Son province.

View Article: PubMed Central - PubMed

Affiliation: Remote Sensing and Geographic Information Systems Field of Study, School of Engineering and Technology, Asian Institute of Technology, P.O. Box 4, Klong Luang, Pathumthani 12120, Thailand. ratchaphon.samphutthanon@ait.ac.th.

ABSTRACT
Hand, Foot and Mouth Disease (HFMD) is an emerging viral disease, and at present, there are no antiviral drugs or vaccines available to control it. Outbreaks have persisted for the past 10 years, particularly in northern Thailand. This study aimed to elucidate the phenomenon of HFMD outbreaks from 2003 to 2012 using general statistics and spatial-temporal analysis employing a GIS-based method. The spatial analysis examined data at the village level to create a map representing the distribution pattern, mean center, standard deviation ellipse and hotspots for each outbreak. A temporal analysis was used to analyze the correlation between monthly case data and meteorological factors. The results indicate that the disease can occur at any time of the year, but appears to peak in the rainy and cold seasons. The distribution of outbreaks exhibited a clustered pattern. Most mean centers and standard deviation ellipses occurred in similar areas. The linear directional mean values of the outbreaks were oriented toward the south. When separated by season, it was found that there was a significant correlation with the direction of the southwest monsoon at the same time. An autocorrelation analysis revealed that hotspots tended to increase even when patient cases subsided. In particular, a new hotspot was found in the recent year in Mae Hong Son province.

Show MeSH
Related in: MedlinePlus