Abstract
BackgroundHemorrhagic fever with renal syndrome (HFRS) is an important infectious disease caused by different species of hantaviruses. As a rodent-borne disease with a seasonal distribution, external environmental factors including climate factors may play a significant role in its transmission. The city of Shenyang is one of the most seriously endemic areas for HFRS. Here, we characterized the dynamic temporal trend of HFRS, and identified climate-related risk factors and their roles in HFRS transmission in Shenyang, China.MethodsThe annual and monthly cumulative numbers of HFRS cases from 2004 to 2009 were calculated and plotted to show the annual and seasonal fluctuation in Shenyang. Cross-correlation and autocorrelation analyses were performed to detect the lagged effect of climate factors on HFRS transmission and the autocorrelation of monthly HFRS cases. Principal component analysis was constructed by using climate data from 2004 to 2009 to extract principal components of climate factors to reduce co-linearity. The extracted principal components and autocorrelation terms of monthly HFRS cases were added into a multiple regression model called principal components regression model (PCR) to quantify the relationship between climate factors, autocorrelation terms and transmission of HFRS. The PCR model was compared to a general multiple regression model conducted only with climate factors as independent variables.ResultsA distinctly declining temporal trend of annual HFRS incidence was identified. HFRS cases were reported every month, and the two peak periods occurred in spring (March to May) and winter (November to January), during which, nearly 75% of the HFRS cases were reported. Three principal components were extracted with a cumulative contribution rate of 86.06%. Component 1 represented MinRH0, MT1, RH1, and MWV1; component 2 represented RH2, MaxT3, and MAP3; and component 3 represented MaxT2, MAP2, and MWV2. The PCR model was composed of three principal components and two autocorrelation terms. The association between HFRS epidemics and climate factors was better explained in the PCR model (F = 446.452, P < 0.001, adjusted R2 = 0.75) than in the general multiple regression model (F = 223.670, P < 0.000, adjusted R2 = 0.51).ConclusionThe temporal distribution of HFRS in Shenyang varied in different years with a distinctly declining trend. The monthly trends of HFRS were significantly associated with local temperature, relative humidity, precipitation, air pressure, and wind velocity of the different previous months. The model conducted in this study will make HFRS surveillance simpler and the control of HFRS more targeted in Shenyang.
Highlights
Hemorrhagic fever with renal syndrome (HFRS) is an important infectious disease caused by different species of hantaviruses
The association between HFRS epidemics and climate factors was better explained in the principal components regression model (PCR) model (Figure 4, F = 446.452, P < 0.001, adjusted R2 = 0.75) than in the general multiple regression model (F = 223.670, P < 0.000, adjusted R2 = 0.51)
The results of the present study showed that MT1, MaxT2 and MaxT3 were negatively associated with the monthly HFRS cases in Shenyang
Summary
Hemorrhagic fever with renal syndrome (HFRS) is an important infectious disease caused by different species of hantaviruses. The city of Shenyang is one of the most seriously endemic areas for HFRS. Hemorrhagic fever with renal syndrome (HFRS), with characteristics of fever, hemorrhage, kidney damage and hypotension, is an important infectious disease caused by different species of hantaviruses. In hantavirus-endemic areas, HFRS outbreaks have occurred among farmers and others who have close contact with excreta of infected rodents [1,2]. HFRS is endemic in 28 of 31 provinces, autonomous regions, and metropolitan areas in mainland China [6]. Some prevention and control measures such as scientific rodent control, vaccination and environmental management have been performed, HFRS remains a serious public health problem with about 20,000-50,000 human cases annually in mainland China [7]
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