Spatiotemporal Transmission Dynamics of Hemorrhagic Fever with Renal Syndrome in China, 2005–2012

Abstract

BackgroundHemorrhagic fever with renal syndrome (HFRS) is a rodent-borne disease caused by many serotypes of hantaviruses. In China, HFRS has been recognized as a severe public health problem with 90% of the total reported cases in the world. This study describes the spatiotemporal dynamics of HFRS cases in China and identifies the regions, time, and populations at highest risk, which could help the planning and implementation of key preventative measures.MethodsData on all reported HFRS cases at the county level from January 2005 to December 2012 were collected from Chinese Center for Disease Control and Prevention. Geographic Information System-based spatiotemporal analyses including Local Indicators of Spatial Association and Kulldorff's space-time scan statistic were performed to detect local high-risk space-time clusters of HFRS in China. In addition, cases from high-risk and low-risk counties were compared to identify significant demographic differences.ResultsA total of 100,868 cases were reported during 2005–2012 in mainland China. There were significant variations in the spatiotemporal dynamics of HFRS. HFRS cases occurred most frequently in June, November, and December. There was a significant positive spatial autocorrelation of HFRS incidence during the study periods, with Moran's I values ranging from 0.46 to 0.56 (P<0.05). Several distinct HFRS cluster areas were identified, mainly concentrated in northeastern, central, and eastern of China. Compared with cases from low-risk areas, a higher proportion of cases were younger, non-farmer, and floating residents in high-risk counties.ConclusionsThis study identified significant space-time clusters of HFRS in China during 2005–2012 indicating that preventative strategies for HFRS should be particularly focused on the northeastern, central, and eastern of China to achieve the most cost-effective outcomes.

Hantavirus infection: a global zoonotic challenge

“…Although China has recorded what were likely hantavirus infections in ancient literature, dating back to the 12 th century (Song, 1999), HFRS was first clinically recognized in 1931 in northeast China (Zhang WY et al, 2014). HFRS first came to the attention of western physicians when 3,200 United Nations troops fell ill in Korea between 1951and 1954(Schmaljohn and Hjelle, 1997.…”

“…In China, HFRS is classified as a class B notifiable disease (Zou et al, 2016) and is considered a severe public health challenge (Zhang WY et al, 2014;Jiang et al, 2016). HTNV and SEOV are the major causes of HFRS (Song, 1999;Zhang S et al, 2014).…”

“…So far, HFRS cases have been reported in 30 out of 32 provinces in China (excluding Hong Kong, Macao, and Taiwan) (Zhang S et al, 2014). Several provinces in northeastern China exhibit the highest overall risk (Zhang WY et al, 2014). Nine provinces with the highest incidence account for 84.16% of the total number of cases.…”

A Space-Time Study of Hemorrhagic Fever with Renal Syndrome (HFRS) and Its Climatic Associations in Heilongjiang Province, China

“…Their results indicated that the geographical distribution of HFRS incidences was clustered, particularly in the northeastern, central and eastern parts of China. The observed hotspots shifted and expanded from year to year, whereas most HFRS cases were mainly reported during the spring and the autumn-winter seasons [14][15][16]. In these studies, global indicators of spatial autocorrelation (GISA), local indicators of spatial association (LISA) and Kulldorff 's scan statistic were employed to characterize the spatial variation of HFRS incidence during several time periods.…”

Sequence-Independent, Single-Primer Amplification Next-Generation Sequencing of Hantaan Virus Cell Culture–Based Isolates

“…4,5 HFRS is highly endemic in east Asia, with over 20,000 cases per year with mortality rates ranging from 1% to 15%. 6 The isolation and whole-genome sequencing of HTNV are required for the development of anti-viral strategies and the understanding of hantavirology.…”