Spatiotemporal association of rapid urbanization and water-body distribution on hemorrhagic fever with renal syndrome: A case study in the city of Xi'an, China.

Li Shen,Qingwu Hu,Xiao Wei,Yao Bai,Shuxuan Song,Zhongjun Shao,Weilu Zhang,Kun Liu,Minghao Sun,Boxuan Gao,Jifeng Liu,Waleed Saleh Al-Salem

doi:10.1371/journal.pntd.0010094

Abstract

Hemorrhagic fever with renal syndrome (HFRS) is a zoonosis characterized by clinical features of high fever, hemorrhage, and renal damage. China has the largest number of HFRS cases worldwide, accounting for over 90% of the total reported cases. In this paper, we used surveyed HFRS data and satellite imagery to conduct geostatistical analysis for investigating the associations of rapid urbanization, water bodies, and other factors on the spatiotemporal dynamics of HFRS from year 2005 to 2018 in Xi’an City, Northwest China. The results revealed an evident epidemic aggregation in the incidence of HFRS within Xi’an City with a phenomenal fluctuation in periodic time series. Rapid urbanization was found to greatly affect the HFRS incidence in two different time phases. HFRS caused by urbanization influences farmers to a lesser extent than it does to non-farmers. The association of water bodies with the HFRS incidence rate was found to be higher within the radii of 696.15 m and 1575.39 m, which represented significant thresholds. The results also showed that geomatics approaches can be used for spatiotemporally investigating the HFRS dynamic characteristics and supporting effective allocations of resources to formulate strategies for preventing epidemics.

Highlights

Hemorrhagic fever with renal syndrome (HFRS) is a zoonosis caused by Hantaviruses [1,2,3]
The spatial dynamic of the HFRS incidence in Xi’an is presented in S2 Fig. It can be clearly seen that most districts with high incidence were distributed in the middle region of Xi’an
For the temporal distribution of HFRS incidence in Xi’an City, the overall variation of cyclical fluctuations was obtained from the fitted time trend line shown in S3 Fig. A high endemic outbreak of HFRS infection may occur each year at two specific time periods: June–July and November–January

Summary

Introduction

Hemorrhagic fever with renal syndrome (HFRS) is a zoonosis caused by Hantaviruses (family Bunyaviridae) [1,2,3] This disease is clinically characterized by fever, hemorrhage, and renal dysfunction, with a fatality rate of 0.5%–40% depending on the specific viral strain involved [4]. People living in poor conditions and working in crowded places are more vulnerable to hantaviruses because they are frequently exposed to the body fluids and excreta of infected rodents [5,6]. Chinese government has carried out some effective initiatives for the prevention and control of HFRS, such as tracking changes in the habitats of rodents, sharing epidemic information with the general public, improving living and working conditions of its people, and implementing free vaccination drives. HFRS still remains one of the top nine communicable diseases in mainland China, and it continues to reemerge in certain epidemic-prone areas, especially in the northeastern and northwestern provinces, posing a serious long-term danger to public health and safety

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