To analyze the epidemic features and etiology of hand, foot and mouth disease (HFMD) in Huangshi from 2010 to 2013, and to provide scientific basis for making preventive and control measures of HFMD.

Total of 18 011 cases collected from the National Disease Surveillance Information Management Program of HFMD were analyzed by descriptive epidemiological method. Nucleic acid of enterovirus genome of 3 089 HFMD cases were detected by real-time RT-PCR.

Among the reported cases, above 95.40% were children less than 5 years old and the majority (72.09%) of cases occurred in scattered children. There were significantly more cases of HFMD in boys compared with girls (χ² = 10.91, P < 0.01) in the 0-5 years aged group, and the male-to-female sex ratio was 2.03/1 (12 061/5 950). The incidence rate of HFMD in urban area was higher than that in rural area. HFMD occurred at the begining of March each year. The number of cases increased significantly, with the highest peak in April to June, and then declined each month. There was a slight rise, presenting another peak in November through December in 2012 and 2013. The majority of the pathogen was Coxsackievirus (CoxA16) in 2011 and Enterovirus 71 (EV71) was predominant in 2012 and 2013.

The warmer climate and favorable humidity may be main causes of HFMD spread and transmission, that HFMD epidemics may be colsely related to local temperature and humidity, and may have been shown to occur in 2-year cycles. The major pathogens causing HFMD were EV 71 and CoxA16, presenting an alternating dominant characteristics of the major pathogens.