1 Reporting Team NHS Choices Hand, Foot and Mouth Disease October 2013

2 Contents – by data sources Webtrends  Visits to HFMD condition pages  Percentage of NHS Choices traffic going to HFMD condition pages  Daily visits to HFMD content during October  Top 10 HFMD pages during October 2013  Seasonal Influence Hitwise  Websites receiving most traffic from HFMD search terms

3 Introduction Hand, foot and mouth disease (HFMD) is a viral infection. It is usually caused by the coxsackie A virus, but can also be caused by the enterovirus 71 and other types of coxsackie virus. It is highly-contagious and is spread in much the same way as the common cold. Most cases affect children who are 10 years of age or younger, although occasionally adults can also be affected. It often occurs in late summer and early autumn. Typical symptoms include: Cold-like symptoms – loss of appetite, cough and moderately high temperature A non-itchy, red rash that develops on the hands and feet Painful mouth ulcers There is currently no cure for hand, foot and mouth disease.

4 Webtrends During October 2013, visits to HFMD conditions pages peaked at 397,065. This was 375% higher than they were in 2012 and 89% higher than those recorded in October In comparison, from October 2012 to October 2013 overall site traffic rose by 85%. July 2013 also saw a smaller spike in visits, when they reached 176,772. A similar pattern was also seen in July 2012, though visits were still 39% less than those recorded in July The only month during 2013 to see a fall in visits compared to previous years, was May, when they down 16% compared to the same month in Despite the dip in May compared to 2012, visits were still noticeably higher than those in May 2010 and 2011.

5 Webtrends For the first quarter of 2013 the proportion of overall choices visits made up by HFMD content saw an average of 0.29%, which was similar to averages seen in 2010 and July saw visits rise in all years, with July 2012 seeing the highest percentage at 0.80%. The most significant rise in visits to HFMD pages as a percentage of all NHS Choices visits was seen during October 2011, when close to 2% of all NHS Choices visits were to HFMD pages. A similar spike was also recorded in October 2013, when the percentage reached 1.09%.

6 Webtrends Daily visits to HFMD condition pages have been significantly higher during October 2013, with a clear weekly pattern of visits being at their highest on each Monday of the month and being lowest on each Saturday. This follows the general pattern for overall NHS Choices visits too. Peak visits were recorded on Monday 21 st October 2013, when they reached 17,607. Visits followed a similar pattern during October 2011, with peak visits reaching 10,238, which was 72% lower than peak visits in During 2010 and 2012, visits remained more even throughout the month. During these two years, visits to HFMD condition pages were dramatically less than in 2011 and 2013, with daily visits never passing the 4,000 mark.

7 Webtrends The HFMD introduction page was the most visited during October 2013, with 255,583 visits. This was 287% higher than the page in second place. In addition to the top ten conditions pages above, there were also over 28,200 visits to the common health question (CHQ) ‘what are the risks of hand, foot and mouth disease during pregnancy?’, which places it as the third most visited HFMD-related page during October 2013.

8 Seasonal Influence Although HFMD is a year-round illness, it often occurs in late summer and early autumn. Although there was a small spike during July, visits saw a much more dramatic rise between September and October, suggesting cases of the condition increased during this time. If compared with two other common childhood conditions, chickenpox and slapped cheek syndrome, which through the first half of the year had more visits than HFMD, you can see that as the prime ‘HFMD season’ hits, visits to HFMD content are then higher than the other two conditions.

9 Hitwise NHS Choices received the most traffic from HFMD searches during October 2013, with over 50% of related searches going to the NHS Choices website. The most popular HFMD related search term during October 2013, was ‘hand foot and mouth’ with a 68.94% share.