The Epidemic Characteristics and Changing Trend of Hemorrhagic Fever with Renal Syndrome in Hubei Province, China

Abstract

BackgroundHemorrhagic fever with renal syndrome (HFRS) is caused by different hantaviruses within the Bunyaviridae family. HFRS is a fulminant, infectious disease that occurs worldwide and is endemic in all 31 provinces of China. Since the first HFRS case in Hubei Province was reported in 1957, the disease has spread across the province and Hubei has become one of the seriously affected areas in China with the greatest number of reported HFRS cases in the 1980's. However, the epidemic characteristics of HFRS in Hubei are still not entirely clear and long-term, systematic investigations of this epidemic area have been very limited.MethodsThe spatiotemporal distribution of HFRS was investigated using data spanning the years 1980 to 2009. The annual HFRS incidence, fatality rate and seasonal incidence between 1980 and 2009 were calculated and plotted. GIS-based spatial analyses were conducted to detect the spatial distribution and seasonal pattern of HFRS. A spatial statistical analysis, using Kulldorff's spatial scan statistic, was performed to identify clustering of HFRS.ResultsA total of 104,467 HFRS cases were reported in Hubei Province between 1980 and 2009. Incidence of and mortality due to HFRS declined after the outbreak in 1980s and HFRS cases have been sporadic in recent years. The locations and scale of disease clusters have changed during the three decades. The seasonal epidemic pattern of HFRS was characterized by the shift from the unimodal type (autumn/winter peak) to the bimodal type.ConclusionsSocioeconomic development has great influence on the transmission of hantaviruses to humans and new epidemic characteristics have emerged in Hubei Province. It is necessary to reinforce preventative measures against HFRS according to the newly-presented seasonal variation and to intensify these efforts especially in the urban areas of Hubei Province.

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

“…Interestingly, this bimodal temporal pattern was also found in Hubei province after 1995, as result of the Seoul virus-related HFRS spring outbreaks and the Hantaan virus-related HFRS winter outbreaks [54]. Another study found that HFRS associated with wild and house rodents occur during different seasons [55].…”

“…For both series, stable and consistent variations were observed at low frequency regions, although certain discrete fluctuations can be found in the HFRS spectra that are not observed in the MEI spectra. Such differences may not be explained by climate change (MEI) but rather in terms of non-climatic factors, e.g., population immunity, public health condition, and socio-economic factors [10,54,67].…”

Construction of a Seasonal Difference-Geographically and Temporally Weighted Regression (SD-GTWR) Model and Comparative Analysis with GWR-Based Models for Hemorrhagic Fever with Renal Syndrome (HFRS) in Hubei Province (China)

“…Hubei Province is one of the main HFRS outbreak areas in mainland China since the first case was discovered in Wuhan, China, in the 1980s. The fatality rate of HFRS in Hubei Province was 8.31 per 100,000 in 1980, which was the record until the early 21st century [6]. From 2004 to 2014, the average annual HFRS incidence rate in Hubei Province dropped to 0.43 per 100,000 and the average annual HFRS fatality rate dropped to 0.01 per 100,000 (the statistical data was acquired from the Hubei Provincial Center for Disease Control and Prevention and Chinese Center for Disease Control and Prevention).…”

“…Zhang et al, found that from 1980 to 2009, the annual average incidence of the HFRS in Hubei Province in the countryside area ranged from 0 to 655.04 per 100,000. The highest incidence rate, which exceeded 40 per 100,000, happened in Hubei Province in 1983 [6]. Finding the reasons and key factors that contribute to HFRS outbreaks could assist their prediction and control.…”

“…HFRS caused a strong seasonal epidemic in Changsha City (Hunan Province) from 2000 to 2009 and in Anhui Province [23,24]. In our previous study, we have proved that the seasonal epidemic pattern of HFRS in Hubei Province was characterized by a shift from the unimodal type (autumn/winter peak) to the bimodal type [6]. OLS models and GWR- based models (GWR and GTWR) cannot deal with the unique seasonal characteristics of HFRS.…”