Landscape, Environmental and Social Predictors of Hantavirus Risk in São Paulo, Brazil.

Paula Ribeiro Prist,Renata Pardini,Paulo Sérgio D´Andrea,Maria Uriarte,Jean Paul Metzger,Amanda Prado,Leandro Reverberi Tambosi,Tetsuro Ikegami

doi:10.1371/journal.pone.0163459

Paula Ribeiro Prist, Renata Pardini + Show 6 more

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https://doi.org/10.1371/journal.pone.0163459

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Abstract

Hantavirus Pulmonary Syndrome (HPS) is a disease caused by Hantavirus, which are negative-sense RNA viruses in the family Bunyaviridae that are highly virulent to humans. Numerous factors modify risk of Hantavirus transmission and consequent HPS risk. Human-driven landscape change can foster transmission risk by increasing numbers of habitat generalist rodent species that serve as the principal reservoir host. Climate can also affect rodent population dynamics and Hantavirus survival, and a number of social factors can influence probability of HPS transmission to humans. Evaluating contributions of these factors to HPS risk may enable predictions of future outbreaks, and is critical to development of effective public health strategies. Here we rely on a Bayesian model to quantify associations between annual HPS incidence across the state of São Paulo, Brazil (1993–2012) and climate variables (annual precipitation, annual mean temperature), landscape structure metrics (proportion of native habitat cover, number of forest fragments, proportion of area planted with sugarcane), and social factors (number of men older than 14 years and Human Development Index). We built separate models for the main two biomes of the state (cerrado and Atlantic forest). In both biomes Hantavirus risk increased with proportion of land cultivated for sugarcane and HDI, but proportion of forest cover, annual mean temperature, and population at risk also showed positive relationships in the Atlantic forest. Our analysis provides the first evidence that social, landscape, and climate factors are associated with HPS incidence in the Neotropics. Our risk map can be used to support the adoption of preventive measures and optimize the allocation of resources to avoid disease propagation, especially in municipalities that show medium to high HPS risk (> 5% of risk), and aimed at sugarcane workers, minimizing the risk of future HPS outbreaks.

Highlights

Multiple lines of evidence suggest that ecological and anthropogenic factors play important roles in elevating incidence of diseases around the world [1]
Habitat fragmentation and decreasing habitat patch size increase the risk of Lyme disease transmission in North America [4; 5] and Hantavirus Cardiopulmonary Syndrome (HPS) transmission risk in Panamá [6]
Rodents in the family Cricetidae are the primary hosts of HPS in Brazil [10; 11], a virus that causes two syndromes in humans: HPS in the Americas, and hemorrhagic fever with renal syndrome (HFRS) in Eurasia and Africa [11]

Summary

Introduction

Multiple lines of evidence suggest that ecological and anthropogenic factors play important roles in elevating incidence of diseases around the world [1]. HPS ranks among the major emerging diseases of the last century, and is expected to remain a public health threat into the future [7]. It was first recognized in May 1993 in the Four Corners region of the US [8], and a few months later, in the city of Juquitiba, in the state of São Paulo, Brazil [9]. Rodents in the family Cricetidae are the primary hosts of HPS in Brazil [10; 11], a virus (family Bunyaviridae) that causes two syndromes in humans: HPS in the Americas, and hemorrhagic fever with renal syndrome (HFRS) in Eurasia and Africa [11]. HPS is associated with high lethality rates (35% in the US; 41% in Brazil; 38% in Canada) [14; 9; 15]

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