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The disease exhibits high epidemic intensity and frequent outbreak clusters in Beijing, the capital of China. However, the spatiotemporal characteristics of these outbreak clusters and their future epidemic trends remain poorly understood. This study aims to fill this gap by analyzing the spatiotemporal epidemiology of HFMD outbreak clusters and developing a forecasting model to inform targeted prevention strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The present study analyzed data on HFMD outbreak clusters in Beijing from 2019 to 2024. Epidemiological characteristics were described, including demographic features, clinical manifestations, transmission settings, and spatial distribution. Group comparisons were performed using Kruskal-Wallis and chi-squared tests. The spatial distribution of outbreak clusters was visualized and analyzed by geographic region. A Seasonal Autoregressive Integrated Moving Average (SARIMA) model was developed to forecast incidence trends.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Beijing reported 4,265 HFMD outbreak clusters (12,396 cases) during 2019\u20132024, exhibiting a biennial high-incidence pattern. Compared to 2019 (1,206 clusters), the mean annual clusters during 2020\u20132022 decreased by 74.4% (305\/year), rebounding to 1,719 clusters in 2023\u201442.5% higher than 2019. Most clusters (77.2%) involved\u2009&lt;\u20095 cases. Median age was 5 years (IQR: 4\u20137), increasing to 6 years in 2023. Males predominated (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). School-aged cases rose to 54.4% in 2023, while kindergarten cases declined. Kindergartens predominated overall (52.7%), but schools became the main setting in 2023 (44.9%), 4.2 times the pandemic average (10.6%). Clusters concentrated in near-suburban areas (&gt;\u200950% in multiple years). CV-A6 was dominant (60.2%), peaking at 90.7% in 2023; EV-A71 was rare (0.12%). Cluster size varied by pathogen (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). The SARIMA model forecast a bimodal pattern for 2025, with primary autumn peak (299 clusters) and secondary summer peak (165 clusters).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>HFMD outbreak clusters in Beijing exhibited a biennial pattern, with suppression during 2020\u20132022 due to COVID-19 NPIs followed by a rebound in 2023 exceeding pre-pandemic levels. Clusters concentrated in near-suburban areas with consistent bimodal seasonality, and the SARIMA model projects a similar pattern for 2025. These findings underscore the need for setting-specific strategies prioritizing schools alongside kindergartens, targeted interventions in high-risk suburbs, and continued pathogen monitoring.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12879-026-13182-0","type":"journal-article","created":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T16:59:51Z","timestamp":1774544391000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Spatiotemporal epidemiology and SARIMA-based forecasting of hand, foot, and mouth disease outbreak clusters in Beijing, 2019\u20132024"],"prefix":"10.1186","volume":"26","author":[{"given":"Hao","family":"Zhao","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Da","family":"Huo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuaibing","family":"Dong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiyong","family":"Gao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiaxin","family":"Feng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renqing","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhichao","family":"Liang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Jia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoli","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peng","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daitao","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,3,26]]},"reference":[{"key":"13182_CR1","doi-asserted-by":"publisher","first-page":"517","DOI":"10.1016\/j.pop.2015.08.006","volume":"42","author":"P Ramdass","year":"2015","unstructured":"Ramdass P, Mullick S, Farber HF. 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BMC Infect Dis. 2025;25:1501. https:\/\/doi.org\/10.1186\/s12879-025-11838-x.","journal-title":"BMC Infect Dis"}],"container-title":["BMC Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12879-026-13182-0","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-026-13182-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-026-13182-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T20:56:51Z","timestamp":1781643411000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12879-026-13182-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,26]]},"references-count":41,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["13182"],"URL":"https:\/\/doi.org\/10.1186\/s12879-026-13182-0","relation":{},"ISSN":["1471-2334"],"issn-type":[{"value":"1471-2334","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,26]]},"assertion":[{"value":"25 January 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 March 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 March 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was approved by the Institutional Review Board of Beijing Center for Disease Prevention and Control. The data used in this study were retrospectively collected from the Beijing HFMD routine surveillance system from 2019 to 2024. All data were fully anonymized prior to analysis, with all personally identifiable information removed. As this study involved no direct contact with human participants, no intervention, and used only anonymized secondary data from routine public health surveillance, the requirement for informed consent was waived by the ethics committee. This waiver is in accordance with Article 39 of the Measures for the Ethical Review of Biomedical Research Involving Humans issued by the National Health Commission of the People\u2019s Republic of China, which permits waiver of informed consent for research using anonymized data where subjects cannot be traced and the research does not involve personal privacy or commercial interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"900"}}