SUMMARYHand, foot and mouth disease (HFMD) is an acute contagious condition caused by a spectrum of human enteroviruses. HFMD reinfection is common in the absence of cross-protection from other virus subtypes. This study focused on reinfection in children in Anhui province, China between 2008 and 2013 using surveillance system data. We classified 8960 cases as reinfected, corresponding to a rate of 2·02%. The reinfection rate was higher in boys than in girls [odds ratio (OR) 1·27, 95% confidence interval (CI) 1·21–1·32, P < 0·001], children aged < 3 years (OR 3·82, 95% CI 3·58–4·07, P < 0·001), and children living in rural areas (OR 1·09, 95% CI 1·04–1·14, P = 0·001). The reinfection rate in children who were originally infected with non-enterovirus A71 (non-EVA71) enteroviruses was higher than those infected with EVA71 (OR 1·36, 95% CI 1·02–1·80, P = 0·034). Influential factors of reinfection rate included annual incidence (β coefficient = 0·715, P = 0·002) and the proportion of EVA71 in patients with mild HFMD (β coefficient = −0·509, P = 0·018). These results demonstrate that boys aged <3 years, especially those in rural areas or regions with a lower EVA71 proportion are more prone to reinfection, and specific health education programmes should be developed to protect these susceptible populations.

Abstract. The shrub Artemisia halodendron and the annual herb Agriophyllum squarrosum, which typically co-occur in a mobile sandy habitat in eastern inner Mongolia, China, were used to determine whether the presence of A. halodendron influences seed deposition and seedling recruitment of A. squarrosum under and around the shrub canopy in relation to wind direction, sampling position (windward vs. leeward sides) and distance from the shrub. The numbers of seeds deposited, seedlings emerged, and individuals recruited of A. squarrosum around adult shrubs were sampled along four transects aligned to the four main wind directions at 0.5, 1, 2, 3, 4.5 and 6 m from the shrub base on both windward and leeward sides of each transect. Spatial pattern of seed deposition was strongly altered by the presence of shrubs, but effects varied with wind direction, sampling position and distance from shrubs. Significantly more seeds tended to deposit on the leeward than on the windward sides in all four transects, with the exception of transects along the least prevailing wind direction. The presence of shrubs as nursing plants caused a marked variation in seed deposition across sampling locations, but this effect was detected only in the most, secondary and third most prevailing wind directions, but not in the least prevailing wind direction. In general, the shrub’s influence was within a 2 m radius from the shrub, despite some differences among transects. Although seed bank density had no direct effect on A. squarrosum recruitment patterns, it contributed to the observed variation in recruitment indirectly through density-dependent emergence of seedlings. Our findings provide further evidence of shrubs as a source of spatial heterogeneity in seed availability and thereby a common factor determining population dynamics of understorey herbaceous species.