Abstract: Objective To analyze the epidemiological and etiological characteristics, as well as the spatiotemporal clustering of hand, foot and mouth disease (HFMD) in Shenzhen from 2017 to 2022, to inform the policy-making for HFMD prevention and control strategies in the region. Methods Comprehensive data from individual HFMD cases and sentinel hospital surveillance in Shenzhen between 2017 to 2022 were systematically gathered. The epidemic features were analyzed using descriptive epidemiological methods. ArcMap 10.8 software was used for global spatial autocorrelation analysis and local spatial autocorrelation analysis. SaTScan 9.0 software was used for spatiotemporal clustering analysis based on discrete Poisson distribution. Results Over the six-year period, Shenzhen reported a total of 267 124 cases of HFMD, with an average annual reporting rate of 291.60 per 100 000. The average annual reporting rate before the COVID-19 pandemic (2017-2019) was 519.57 per 100 000, which was significantly higher than the rate during the COVID-19 period (2020-2022) at 124.33 per 100 000 (P<0.01). HFMD cases were reported throughout the year, with higher incidence observed from May to July and September to November. Most cases occurred in children aged three years and below (207 854 cases, 77.81%), particularly among scattered children (194 214 cases, 72.71%) and those in early childhood care (58 641 cases, 21.95%). HFMD cases were reported across all ten districts of Shenzhen, with Futian District having the highest annual reporting rate at 774.47 per 100 000, followed by Guangming District at 410.97 per 100 000 and Longgang District at 266.23 per 100 000. The predominant strains of HFMD pathogens were Cox A6 and Cox A16. In 2022 there was statistically significant global spatial autocorrelation coefficient Moran's I (Z=2.688, P<0.05) and spatial aggregation. From 2017 to 2022, HFMD in Shenzhen showed obvious clustering in time and space. The first type of clustering area was mainly centered in the streets of Buji and Fuyong in Bao'an District and Longgang District, and the clustering time was mainly concentrated from May to November. Conclusions The prevalence of HFMD in Shenzhen from 2017 to 2022 showed obvious seasonal, regional, and population distribution characteristics. The average annual reporting rate of HFMD during the COVID-19 epidemic period is lower than that before the epidemic, and there is an obvious spatial and temporal clustering of cases.

Key words: Hand-foot-mouth disease, Epidemiology, Etiology, Spatiotemporal clustering, Impact factor