Association of public health and social measures on the hand-foot-mouth epidemic in South Korea

Sukhyun Ryu; Changhee Han; Sheikh Taslim Ali; Chiara Achangwa; Bingyi Yang; Sen Pei

doi:10.1016/j.jiph.2023.03.029

Association of public health and social measures on the hand-foot-mouth epidemic in South Korea

J Infect Public Health. 2023 Jun;16(6):859-864. doi: 10.1016/j.jiph.2023.03.029. Epub 2023 Mar 31.

Authors

Sukhyun Ryu¹, Changhee Han², Sheikh Taslim Ali³, Chiara Achangwa⁴, Bingyi Yang⁵, Sen Pei⁶

Affiliations

¹ Department of Preventive Medicine, Konyang University College of Medicine, Daejeon, South Korea. Electronic address: gentryu@onehealth.or.kr.
² Department of Preventive Medicine, Konyang University College of Medicine, Daejeon, South Korea; Business Analytics, University of Texas at Dallas, Dallas, USA.
³ World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China; Laboratory of Data Discovery for Health Limited (D24H), Hong Kong Science Park, New Territories, Hong Kong, China.
⁴ Department of Preventive Medicine, Konyang University College of Medicine, Daejeon, South Korea.
⁵ World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China.
⁶ Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, USA.

PMID: 37031625
DOI: 10.1016/j.jiph.2023.03.029

Abstract

Background: School based-measures such as school closure and school holidays have been considered a viable intervention during the hand-foot-mouth disease (HFMD) epidemic. The aim of this study was to explore the association of nationwide public health and social measures (PHSMs) including planned school vacation on the transmissibility and attack rate of the HFMD epidemic in South Korea.

Methods: In this study, we used Korean national surveillance data on HFMD from 2014 to 2019 to estimate the temporal changes in HFMD transmissibility (instantaneous reproductive number, R_t). Furthermore, to assess the changes in the HFMD attack rate, we used a stochastic transmission model to simulate the HFMD epidemic with no school vacation and nationwide PHSMs in 2015 South Korea.

Results: We found that school vacations and 2015 PHSMs were associated with the reduced R_t by 2-7 % and 13 %, respectively. Model projections indicated school vacations and 2015 PHSMs were associated with reduced HFMD attack rate by an average of 1.10 % (range: 0.38-1.51 %).

Conclusions: PHSMs likely have a larger association with reduced HFMD transmissibility than school-based measures alone (i.e. school vacations). Preventive measures targeting preschoolers could be considered as potential options for reducing the future burden of HFMD.

Keywords: Hand-foot-and-mouth disease; Nonpharmaceutical measure; Public health and social measures; School holidays; Simulation; Transmissibility; Vacation.

MeSH terms

China / epidemiology
Epidemics*
Hand, Foot and Mouth Disease* / epidemiology
Humans
Incidence
Mouth
Public Health