Spatiotemporally comparative analysis of three common infectious diseases in China during 2013–2015

BACKGROUND: Dengue fever (DF), influenza, and hand, foot, and mouth disease (HFMD) have had several various degrees of outbreaks in China since the 1900s, posing a serious threat to public health. Previous studies have found that these infectious diseases were often prevalent in the same areas and during the same periods in China. METHODS: This study combined traditional descriptive statistics and spatial scan statistic methods to analyze the spatiotemporal features of the epidemics of DF, influenza, and HFMD during 2013–2015 in mainland China at the provincial level. RESULTS: DF got an intensive outbreak in 2014, while influenza and HFMD were stable from 2013 to 2015. DF mostly occurred during August–November, influenza appeared during November–next March, and HFMD happened during April–November. The peaks of these diseases form a year-round sequence; Spatially, HFMD generally has a much higher incidence than influenza and DF and covers larger high-risk areas. The hotspots of influenza tend to move from North China to the southeast coast. The southeastern coastal regions are the high-incidence areas and the most significant hotspots of all three diseases. CONCLUSIONS: This study suggested that the three diseases can form a year-round sequence in southern China, and the southeast coast of China is a particularly high-risk area for these diseases. These findings may have important implications for the local public health agency to allocate the prevention and control resources.