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Shifting epidemiological patterns and strain replacement of hand, foot, and mouth disease in southern China, 2009-2022: A longitudinal study.

PLoS One · 2026 · PMC12826469 · PMID 41570026

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an increasing trendno p-value reported
An increasing trend in reported cases was observed in both even- and odd-numbered years, indicating a stable one-year outbreak periodicity in the pre-vaccination period.

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Quoted from the open-access full text in Europe PMC under the licence the publisher applied. The sentence is reproduced exactly as published; the emphasis is ours.