Geographical Analysis of the Distribution and Spread of Human Rabies in China from 2005 to 2011

Abstract

BackgroundRabies is a significant public health problem in China in that it records the second highest case incidence globally. Surveillance data on canine rabies in China is lacking and human rabies notifications can be a useful indicator of areas where animal and human rabies control could be integrated. Previous spatial epidemiological studies lacked adequate spatial resolution to inform targeted rabies control decisions. We aimed to describe the spatiotemporal distribution of human rabies and model its geographical spread to provide an evidence base to inform future integrated rabies control strategies in China.MethodsWe geo-referenced a total of 17,760 human rabies cases of China from 2005 to 2011. In our spatial analyses we used Gaussian kernel density analysis, average nearest neighbor distance, Spatial Temporal Density-Based Spatial Clustering of Applications with Noise and developed a model of rabies spatiotemporal spread.FindingsHuman rabies cases increased from 2005 to 2007 and decreased during 2008 to 2011 companying change of the spatial distribution. The ANN distance among human rabies cases increased between 2005 and 2011, and the degree of clustering of human rabies cases decreased during that period. A total 480 clusters were detected by ST-DBSCAN, 89.4% clusters initiated before 2007. Most of clusters were mainly found in South of China. The number and duration of cluster decreased significantly after 2008. Areas with the highest density of human rabies cases varied spatially each year and in some areas remained with high outbreak density for several years. Though few places have recovered from human rabies, most of affected places are still suffering from the disease.ConclusionHuman rabies in mainland China is geographically clustered and its spatial extent changed during 2005 to 2011. The results provide a scientific basis for public health authorities in China to improve human rabies control and prevention program.

Animal-Associated Exposure to Rabies Virus among Travelers, 1997–2012

“…Of 10 patients, 6 were exposed in 5 countries (Thailand, Indonesia, Nepal, China, and India). Large numbers of human rabies cases among the local population are reported from these 5 countries, with the exception of Thailand (Technical Appendix), where only sporadic cases of rabies in humans are now reported ( 1 , 17 – 25 ; J.M. Shresta, 2012, pers.…”

“…In Thailand, rabies cases in humans show no specific geographic distribution. In Indonesia and Nepal, cases are concentrated in specific areas ( 1 , 17 – 25 ; P. Rupali, 2012, pers. comm.).…”

Community-based interventions to enhance knowledge, protective attitudes and behaviors towards canine rabies: results from a health communication intervention study in Guangxi, China

“…2). Village selection was also based on existing reports that these are important endemic foci for rabies in China [3] and on the suggestion from the officers of Longlin animal husbandry and veterinary bureau that these could represent typical rural communities.

Fig. 2Map of the study area

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“…Currently in China, rabies ranks third in the list of 39 infectious diseases of mandatory notification in both 2012 and 2013 [2]. Recent studies have demonstrated that most rabies cases cluster in the provinces of the south of China [3] with reports indication a reemergence in Guangxi province [4]. …”

Geographical Distribution and Cluster Detection of Childhood Leukemia in the Metropolitan Area of Guadalajara, Mexico

“…Spatial analysis was performed in the AL cases dataset to find clusters according to their location using the Density-Based Spatial Clustering of Applications with Noise (DB-SCAN) [16][17][18] algorithm on R statistical software 19,20 using the flexible procedures for clustering package 21 . This algorithm identifies clusters by finding point subsets, which have a minimum number of points that are density-connected from each point's neighborhood within a given radius.…”