Digital epidemiology and Infodemiology of hand-foot-mouth disease (HFMD) in Italy. Disease trend assessment via Google and Wikipedia.


Omar Enzo Santangelo
Vincenza Gianfredi
Sandro Provenzano
Fabrizio Cedrone


Hand-foot-mouth disease, HFMD, Italy, Digital Epidemiology, Google, Wikipedia, Epidemiology, Infectious Diseases, Infodemiology, Medical Informatics Computing


Background and aim: The study aimed to evaluate the epidemiological trend of hand, foot and mouth disease (HFMD) in Italy using data on Internet searches volume

Methods: A cross-sectional study design was used. Data on Internet searches have been obtained from Google Trends (GT) and Wikipedia. We used the following Italian search term: “Malattia mano-piede-bocca” (Hand-foot-mouth disease, in English). One monthly time-frame elapsing have been extracted partly overlapping, from July 2015 to December 2022. We overlapped GT and Wikipedia data to perform a linear regression and correlation analysis. Statistical analyses were performed using the Spearman's rank correlation coefficient (rho). A linear regression was performed considering Wikipedia and GT.

Results: The search peaks for both Wikipedia and GT are in the months November-December for the autumn-winter season, in the month of June for the spring-summer season, with the exception of the period from June 2020 to June 2021 (probably due to the restrictions of the COVID19 pandemic). A temporal correlation was observed between GT and Wikipedia search trends.

Conclusions: This is the first study in Italy that tries to clarify the epidemiology of HFMD, Google search and Wikipedia can be useful for public health surveillance; however, to date, digital epidemiology cannot replace the classical surveillance system.


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