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Hand-foot-and-month disease (HFMD), especially the enterovirus A71 (EV-A71) subtype, is a major health problem in Beijing, China. Previous studies mainly used regressive models to forecast the prevalence of HFMD, ignoring its intrinsic age groups. This study aims to predict HFMD of EV-A71 subtype in three age groups (0–3, 3–6 and > 6 years old) from 2011 to 2018 using residual-convolutional-recurrent neural network (CNNRNN-Res), convolutional-recurrent neural network (CNNRNN) and recurrent neural network (RNN). They were compared with auto-regressio, global auto-regression and vector auto-regression on both short-term and long-term prediction. Results showed that CNNRNN-Res and RNN had higher accuracies on point forecast tasks, as well as robust performances in long-term prediction. Three deep learning models also had better skills in peak intensity forecast, and CNNRNN-Res achieved the best results in the peak month forecast. We also found that three age groups had consistent outbreak trends and similar patterns of prediction errors. These results highlight the superior performance of deep learning models in HFMD prediction and can assist the decision-makers to refine the HFMD control measures according to age groups. [ABSTRACT FROM AUTHOR]

Background: Hand, foot, and mouth disease (HFMD) mostly affects the health of infants and preschool children. Many studies of HFMD in different regions have been published. However, the epidemiological characteristics and space-time patterns of individual-level HFMD cases in a major city such as Beijing are unknown. The objective of this study was to investigate epidemiological features and identify high relative risk space-time HFMD clusters at a fine spatial scale. Methods: Detailed information on age, occupation, pathogen and gender was used to analyze the epidemiological features of HFMD epidemics. Data on individual-level HFMD cases were examined using Local Indicators of Spatial Association (LISA) analysis to identify the spatial autocorrelation of HFMD incidence. Spatial filtering combined with scan statistics methods were used to detect HFMD clusters. Results: A total of 157,707 HFMD cases (60.25% were male, 39.75% were female) reported in Beijing from 2008 to 2012 included 1465 severe cases and 33 fatal cases. The annual average incidence rate was 164.3 per 100,000 (ranged from 104.2 in 2008 to 231.5 in 2010). Male incidence was higher than female incidence for the 0 to 14-year age group, and 93.88% were nursery children or lived at home. Areas at a higher relative risk were mainly located in the urban-rural transition zones (the percentage of the population at risk ranged from 33.89% in 2011 to 39.58% in 2012) showing High-High positive spatial association for HFMD incidence. The most likely space-time cluster was located in the mid-east part of the Fangshan district, southwest of Beijing. Conclusions: The spatial-time patterns of Beijing HFMD (2008–2012) showed relatively steady. The population at risk were mainly distributed in the urban-rural transition zones. Epidemiological features of Beijing HFMD were generally consistent with the previous research. The findings generated computational insights useful for disease surveillance, risk assessment and early warning. [ABSTRACT FROM AUTHOR]

This paper presents an empirical analysis of the epidemiological data concerning the 18445 HFMD-infected cases in Beijing in 2008. The main findings are as follows. (i) Seasonal variations in incidence were observed, with a peak observed during the summer season, especially in May. Male patients outnumber female patients by 1.57:1. (ii) Most cases occurred in children 4 years old or younger. Outperforming Weibull distribution and Gamma distribution as to model fitness when analyzing patient ages, log-normal distribution indicates that the estimated mean age is 3.4 years. (iii) The age distribution seems to indicate cyclic peaks with roughly one-year intervals. (iv) Correlation analyses (ρ = 0.9864) show that time of birth in different months has an impact on the chance of being infected by HFMD. Birth month seems to present a high risk factor on infants and young children. (v) The morbidity rate is 132.7/100000 during the HFMD epidemic in Beijing in 2008. The morbidity map shows that the risks of HFMD infection in areas close to the city center and suburbans are much lower than those in the urban-rural transition zones. Spatial risks inferred from the morbidity map demonstrate a clear circular pattern. (vi) The prevention and control measures taken by the public health departments seem to be effective during the summer season, resulting in the early ending of the epidemic (one month earlier than the natural season) and reduced outbreak size. [ABSTRACT FROM AUTHOR]