Table 2.

Studies on the relationship between climate changes and HFMD

Study	Results	Conclusions
HanWang et al. Beijing, China 2011 [4]	Spring OR = 1.4–1.6 Other seasons OR ≤1.2 Increased risk of transmission:  Temperature 21.1–26.6 °C  High relative humidity  Low wind speed  High rainfall  High population density  Schools open	Strong relationship between climatic factors and the transmission of HFMD
Hii et al. Umeå, Sweden 2011 [29]	With each degree Celsius that the maximum temperature rises above 32 °C, the risk of disease incidence increases by 36 %  Rainfall below 75 mm increases risk by 0.3 %. Above 75 mm, risk fell by 0.5 %  Temperature differences of more than 7 °C between the minimum and maximum temperature increase the incidence rate by 41 %	The results suggest a strong association between HFMD and climate changes
Park et al. South Korea, 2010 [12]	Having a non-water closet toilet, changes in water quality, and contact with HFMD patients were associated with risk of HFMD (OR = 3.3, 2.8, 6.9, and 5.0, respectively)  Visiting a hospital, changes in water quality, presence of a skin wound, eating out, and going shopping were significantly associated with the risk of HFMD (OR = 9.0, 37.0, 11.0, 12.0, 37.0, and 5.0, respectively)	The results suggest that seasonal variations, geographic localization, person to-person contact and contaminated water could be the principal modes of transmission of HFMD

HFMD hand, foot and mouth disease