Abstract
BackgroundHemorrhagic fever with renal syndrome (HFRS) is highly endemic in mainland China, where human cases account for 90% of the total global cases. Zibo City is one of the most serious affected areas in Shandong Province China with the HFRS incidence increasing sharply from 2009 to 2012. However, the hotspots of HFRS in Zibo remained unclear. Thus, a spatial analysis was conducted with the aim to explore the spatial, spatial-temporal and seasonal patterns of HFRS in Zibo from 2009 to 2012, and to provide guidance for formulating regional prevention and control strategies.MethodsThe study was based on the reported cases of HFRS from the National Notifiable Disease Surveillance System. Annualized incidence maps and seasonal incidence maps were produced to analyze the spatial and seasonal distribution of HFRS in Zibo City. Then spatial scan statistics and space-time scan statistics were conducted to identify clusters of HFRS.ResultsThere were 200 cases reported in Zibo City during the 4-year study period. One most likely cluster and one secondary cluster for high incidence of HFRS were identified by the space-time analysis. And the most likely cluster was found to exist at Yiyuan County in October to December 2012. The human infections in the fall and winter reflected a seasonal characteristic pattern of Hantaan virus (HTNV) transmission. The secondary cluster was detected at the center of Zibo in May to June 2009, presenting a seasonal characteristic of Seoul virus (SEOV) transmission.ConclusionTo control and prevent HFRS in Zibo city, the comprehensive preventive strategy should be implemented in the southern areas of Zibo in autumn and in the northern areas of Zibo in spring.
Highlights
Hemorrhagic fever with renal syndrome (HFRS), a rodentborne disease caused by hantaviruses, is characterized by fever, acute renal dysfunction, and hemorrhage manifestations [1,2]
Descriptive Analysis of HFRS in Zibo City A total of 200 cases were reported in Zibo City during the 4
The monthly distribution of HFRS cases was shown in figure 2, which indicated that the occurrence of HFRS presented significant seasonality
Summary
Hemorrhagic fever with renal syndrome (HFRS), a rodentborne disease caused by hantaviruses (family Bunyaviridae), is characterized by fever, acute renal dysfunction, and hemorrhage manifestations [1,2]. In China, the causative agents of HFRS are predominately Hantaan virus (HTNV) and Seoul virus (SEOV), which result in case fatality rates of approximately 10% and 1%, respectively [4]. Occurrence of HFRS cases is seasonal with a bimodal pattern and studies suggest that the pattern is linked to varying transmission dynamics of the two serotypes of hantaviruses among their animal hosts. HTNVcaused HFRS cases occur year-round but tend to peak in the winter while SEOV-caused infections typically peak in the spring [6,8,9]. A spatial analysis was conducted with the aim to explore the spatial, spatial-temporal and seasonal patterns of HFRS in Zibo from 2009 to 2012, and to provide guidance for formulating regional prevention and control strategies
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