Abstract
Hemorrhagic Fever with Renal Syndrome (HFRS) is considered as a globally distributed infectious disease, which results in many deaths annually in Hubei Province, China. The outbreak of HFRS is usually characterized with spatio-temporal heterogeneity and is seasonally distributed. Further, it might also be impacted by the influencing factors such as socio-economic and geographical environment. To better understand and predict the outbreak of HFRS in the Hubei Province, the spatio-temporal pattern and influencing factors were investigated in this study. Moran’s I Index value was adopted in spatial global autocorrelation analysis to identify the overall spatio-temporal pattern of HFRS outbreak. Kulldorff scan statistical analysis was performed to further identify the changing trends of the clustering patterns of HFRS outbreak. Spearman's rank correlation analysis was used to explore the possible influencing factors on HFRS epidemics such as climate and geographic. The results demonstrated that HFRS outbreak in Hubei Province decreased from 2005 to 2012 in general while increasing slightly from 2012 to 2014. The spatial and temporal scan statistical analysis indicated that HFRS epidemic was temporally clustered in summer and autumn from 2005 to 2014 except 2008 and 2011. The seasonal epidemic pattern of HFRS in Hubei Province was characterized by a bimodal pattern (March to May and September to November) while peaks often occurring in the spring time. SEOV-type HFRS was presumed to influence more on the total number of HFRS incidence than HTNV-type HFRS do. The average humidity and human population density were the main influencing factors during these years. HFRS outbreaks were more in plains than in other areas of Hubei Province. We did not find that whether the terrain of the wetland (water system) plays a significant role in the outbreak of HFRS incidence. With a better understanding of rodent infection rate, socio-economic status and ecological environment characteristics, this study may help to reduce the outbreak of HFRS disease.
Highlights
In China, Hemorrhagic Fever with Renal Syndrome (HFRS) was mainly caused by two types of Hantaviruses, named Hantaan virus (HTNV) and Seoul virus (SEOV), each associated with a unique rodent host [1,2,3]
Compared with the peaks happened in each year, and data revealed from Fig 5, we could infer that if peaks mostly emerged in spring time during a year, it could be presumed that SEOV-type HFRS have more influences vice versa
The findings in our research presented some new features regarding the trend and influencing factors for the HFRS outbreaks in Hubei Province
Summary
In China, HFRS was mainly caused by two types of Hantaviruses, named Hantaan virus (HTNV) and Seoul virus (SEOV), each associated with a unique rodent host [1,2,3]. Moran’s I spatial autocorrelation statistical and retrospective spatio-temporal clustering methods were used by Wu et al to analyze the spatio-temporal distribution in Liaoning Province from 1988 to 2001 They demonstrated that the outbreak of HFRS had homogeneous spatio-temporal characteristics [5]. Lin et al performed Spatial smoothing and Martin Kulldorff’s spatial scan test to study the spatial distribution and variation of the HFRS outbreak in Liaoning Province between 2000 and 2005 [4]. They found that the clusters of HFRS cases were consistently influencing by humidity and the amount of forestation. The results demonstrated that ARIMA model had a good feasibility to forecast the HFRS outbreak [13]
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