Abstract
BackgroundHFRS is a serious public health problem in China and the study on HFRS is important in China for its large population. The present study aimed to explore the impact of climatic variables and reservoir on the incidence of HFRS in Huludao City, an epidemic focus of the disease in northeastern China.MethodsStructure Equation Model (SEM), a statistical technique for testing and estimating causal relationships, was conducted based on climatic variables, virus-carrying index among rodents, and incidence of HFRS in the city during the period 1990 to 2006. The linear structural relationships (LISREL) software (Scientific Software International, Lincolnwood, IL) was used to fit SEMs.ResultsTemperature, precipitation, relative humidity and virus-carrying index among rodents have shown positive correlations with the monthly incidence of HFRS, while air pressure had a negative correlation with the incidence. The best-fit SEM model fitted well with the data-based correlation matrix, P value was more than 0.56, root mean square error of approximation (RMSEA) equaled to 0, goodness-of-fit index (GFI) was more than 0.99.ConclusionClimate and reservoirs have affected the incidence of HFRS in Huludao City, located in northeastern China. Climate affects HFRS incidence mainly through the effect on reservoir in the study area. HFRS prevention and control should give more consideration to rodent control and climate variations.
Highlights
Hemorrhagic fever with renal syndrome (HFRS) is a serious public health problem in China and the study on HFRS is important in China for its large population
There are two kinds of rodent-borne virus epidemic of HFRS in Liaoning province: Hantaan virus transmitted by the striped field mouse (Apodemus agrarius) and Seoul virus transmitted by the brown rat (Rattus norvegicus)
There was a clear seasonal variation in the incidence of HFRS in Huludao City, with most cases acquired in the winter to spring, starting generally from December, reaching a peak in March/April and ending in June (Figure 3–A,B)
Summary
HFRS is a serious public health problem in China and the study on HFRS is important in China for its large population. Rodent control, environment management and other related measures have been implemented, HFRS remains a serious public health problem in mainland China with 20,000–50,000 human cases annually reported[5]. Liaoning Province is one of the most serious affected areas with the most cases in mainland China and the highest incidence during the years 2004 and 2005[6], and an outbreak of HFRS was reported in Liaoning in 2006[7]. Huludao city was selected as the study area because Huludao city is the traditional HFRS epidemic focus of the Seoul virus. It was recognized as an epidemic focus of HFRS in 1984 and has since served as a national HFRS surveillance site[8,9]
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