Abstract

BackgroundHemorrhagic fever with renal syndrome (HFRS), an infectious disease caused by hantaviruses, is endemic in China and remains a serious public health problem. Historically, Shandong Province has had the largest HFRS burden in China. However, we do not have a comprehensive and clear understanding of the current epidemic foci of HFRS in Shandong Province.Methodology/principal findingsThe incidence and mortality rates were calculated, and a phylogenetic analysis was performed after laboratory testing of the virus in rodents. Spatial epidemiology analysis was applied to investigate the epidemic foci, including their sources. A total of 6,206 HFRS cases and 59 related deaths were reported in Shandong Province. The virus carriage rates of the rodents Rattus norvegicus, Apodemus agrarius and Mus musculus were 10.24%, 6.31% and 0.27%, respectively. The phylogenetic analysis indicated that two novel viruses obtained from R. norvegicus in Anqiu City and Qingzhou City were dissimilar to the other strains, but closely related to strains previously isolated in northeastern China. Three epidemic foci were defined, two of which were derived from the Jining and Linyi epidemic foci, respectively, while the other was the residue of the Jining epidemic focus.Conclusions/significanceThe southeastern and central Shandong Province are current key HFRS epidemic foci dominated by A. agrarius and R. norvegicus, respectively. Our study could help local departments to strengthen prevention and control measures in key areas to reduce the hazards of HFRS.

Highlights

  • Hemorrhagic fever with renal syndrome (HFRS), a global infectious disease caused by hantaviruses (HV) in the Bunyaviridae family, is characterized by fever, hemorrhage, kidney damage and hypotension

  • A total of 6,206 HFRS cases and 59 related deaths were reported in Shandong Province

  • HFRS is a zoonosis mainly caused by Hantaan virus (HTNV) and Seoul virus (SEOV), which natural rodent hosts are A. agrarius and R. norvegicus, respectively

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Summary

Introduction

Hemorrhagic fever with renal syndrome (HFRS), a global infectious disease caused by hantaviruses (HV) in the Bunyaviridae family, is characterized by fever, hemorrhage, kidney damage and hypotension. Over 90% of all cases of HFRS in the world have occurred in China in recent decades[4,5]. Shandong Province, which has the second largest population among all the provinces in China, has been suffering from a large HFRS burden for several decades. Shandong Province remained in the top five of all provinces in China regarding the number of HFRS cases[1]. Hemorrhagic fever with renal syndrome (HFRS), an infectious disease caused by hantaviruses, is endemic in China and remains a serious public health problem. Shandong Province has had the largest HFRS burden in China.

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