Hemorrhagic Fever With Renal Syndrome Incidence Research Articles

Spatiotemporal distribution and meteorological factors of hemorrhagic fever with renal syndrome in Hubei province.

Hemorrhagic fever with renal syndrome (HFRS) is a vital rodent-borne disease, and poses a serious public health threat in Hubei province. We aimed to explore the spatiotemporal distribution of HFRS in Hubei province during 2005-2022, and the effects of meteorological factors. Data on HFRS cases at the county level in Hubei province during 2005-2022 were obtained from the Chinese Center for Disease Prevention and Control Information System. The monthly meteorological data at the city level was extracted from the China Meteorological Data Sharing Service System from 2016 to 2020. Descriptive analyses, joinpoint regression model, spatial correlation analyses, Geodetector model and autoregressive integrated moving average (ARIMA) model were conducted to investigate the epidemic characteristics, temporal trend, spatial distribution, influencing factors of HFRS and predict its trend. A total of 6,295 cases were reported in Hubei province during 2005-2022, with an average incidence of 6/1,000,000. Most cases were males (74.52%) and aged 40-69 years (71.87%). The monthly HFRS cases showed two seasonal peaks, which were summer (May to June) and winter (November to December). The HFRS incidence remained fluctuating at a low level during 2005-2015, followed an increasing trend during 2015-2018, and then decreased during 2018-2022. Hotspots were concentrated in the center of Hubei province in all 3 periods, including Qianjiang, Tianmen and some counties from Xiangyang, Jingmen and Jingzhou cities. The distribution of HFRS had a positive association with wind speed, while a "V"-shaped correlation with mean temperature, with an explanatory power of 3.21% and 1.03% respectively (both P <0.05). The ARIMA model predicted about 1,223 cases occurred in the next 3 years. HFRS cases showed seasonal fluctuation and spatial clustering in Hubei province. Central plain areas showed high risk of HFRS. Wind speed and mean temperature had significant effects on the transmission of HFRS in Hubei province. The results alert health authorities to conduct disease-climate surveillance and comprehensive prevention strategies, especially in high-risk counties.

The 2016 Severe Floods and Incidence of Hemorrhagic Fever With Renal Syndrome in the Yangtze River Basin

Hemorrhagic fever with renal syndrome (HFRS), a neglected zoonotic disease, has received only short-term attention in postflood prevention and control initiatives, possibly because of a lack of evidence regarding the long-term association of flooding with HFRS. To quantify the association between severe floods and long-term incidence of HFRS in the Yangtze River basin and to examine the modifying role of geographical factors in this association. This cross-sectional study collected data on HFRS cases between July 1, 2013, and June 30, 2019, from 58 cities in 4 provinces (Anhui, Hubei, Hunan, and Jiangxi) in the Yangtze River basin of China, with a breakpoint of flooding in July 2016, generating monthly data. The 3 years after July 2016 were defined as the postflood period, while the 3 years before the breakpoint were defined as the control period. Statistical analysis was performed from October to December 2023. City-level monthly flooding, elevation, ruggedness index, and closest distance from each city to the Yangtze River and its tributaries. The primary outcomes were the number of city-level monthly HFRS cases and the number of type 1 (spring or summer) and type 2 (autumn or winter) HFRS cases. A total of 11 745 patients with HFRS were reported during the study period: 5216 patients (mean [SD] age, 47.1 [16.2] years; 3737 men [71.6%]) in the control period and 6529 patients (mean [SD] age, 49.8 [15.8] years; 4672 men [71.6%]) in the postflood period. The pooled effects of interrupted time series analysis indicated a long-term association between flooding and HFRS incidence (odds ratio, 1.38; 95% CI, 1.13-1.68), with type 1 cases being at highest risk (odds ratio, 1.71; 95% CI, 1.40-2.09). The metaregression results indicated that elevation and ruggedness index were negatively associated with the risk of HFRS, while the distance to rivers interacted with these associations. This cross-sectional study of the long-term association between flooding and HFRS incidence, as well as the modification effects of geographical factors, suggests that severe floods were associated with an increased risk of HFRS within 3 years. This study provides evidence for the development of HFRS prevention and control strategies after floods.

Using empirical dynamic modeling to identify the impact of meteorological factors on hemorrhagic fever with renal syndrome in Weifang, Northeastern China, from 2011 to 2020.

Hemorrhagic Fever with Renal Syndrome (HFRS) continues to pose a significant public health threat to the well-being of the population. Given that the spread of HFRS is susceptible to meteorological factors, we aim to probe into the meteorological drivers of HFRS. Thus, novel techniques that can discern time-delayed non-linear relationships from nonlinear dynamical systems are compulsory. We analyze the epidemiological features of HFRS in Weifang City, 2011-2020, via the employment of the Empirical Dynamic Modeling (EDM) method. Our analysis delves into the intricate web of time-delayed non-linear associations between meteorological factors and HFRS. Additionally, we investigate the repercussions of minor perturbations in meteorological variables on future HFRS incidence. A total of 2515 HFRS cases were reported in Weifang from 2011 to 2020. The number of cases per week was 4.81, and the average weekly incidence was 0.52 per 1,000,000. The propagation of HFRS is significantly impacted by the mean weekly temperature, relative humidity, cumulative rainfall, and wind speed, and the ρCCM converges to 0.55,0.48,0.38 and 0.39, respectively. The graphical representation of the relationship between temperature (lagged by 2 weeks) and the incidence of HFRS exhibits an inverted U-shaped curve, whereby the incidence of HFRS culminates as the temperature reaches 10 °C. Moreover, temperature, relative humidity, cumulative rainfall, and wind speed exhibit a positive correlation with HFRS incidence, with a time lag of 4-6 months. Our discoveries suggest that meteorological factors can drive the transmission of HFRS both at a macroscopic and microscopic scale. Prospective alterations in meteorological conditions, for instance, elevations in temperature, relative humidity, and precipitation will instigate an upsurge in the incidence of HFRS after 4-6 months, and thus, timely public health measures should be taken to mitigate these changes.

Epidemic Characteristics and Meteorological Risk Factors of Hemorrhagic Fever With Renal Syndrome in 151 Cities in China From 2015 to 2021: Retrospective Analysis.

Hemorrhagic fever with renal syndrome (HFRS) continues to pose a significant public health threat to the population in China. Previous epidemiological evidence indicates that HFRS is climate sensitive and influenced by meteorological factors. However, past studies either focused on too-narrow geographical regions or investigated time periods that were too early. There is an urgent need for a comprehensive analysis to interpret the epidemiological patterns of meteorological factors affecting the incidence of HFRS across diverse climate zones. In this study, we aimed to describe the overall epidemic characteristics of HFRS and explore the linkage between monthly HFRS cases and meteorological factors at different climate levels in China. The reported HFRS cases and meteorological data were collected from 151 cities in China during the period from 2015 to 2021. We conducted a 3-stage analysis, adopting a distributed lag nonlinear model and a generalized additive model to estimate the interactions and marginal effects of meteorological factors on HFRS. This study included a total of 63,180 cases of HFRS; the epidemic trends showed seasonal fluctuations, with patterns varying across different climate zones. Temperature had the greatest impact on the incidence of HFRS, with the maximum hysteresis effects being at 1 month (-19 ºC; relative risk [RR] 1.64, 95% CI 1.24-2.15) in the midtemperate zone, 0 months (28 ºC; RR 3.15, 95% CI 2.13-4.65) in the warm-temperate zone, and 0 months (4 ºC; RR 1.72, 95% CI 1.31-2.25) in the subtropical zone. Interactions were discovered between the average temperature, relative humidity, and precipitation in different temperature zones. Moreover, the influence of precipitation and relative humidity on the incidence of HFRS had different characteristics under different temperature layers. The hysteresis effect of meteorological factors did not end after an epidemic season, but gradually weakened in the following 1 or 2 seasons. Weather variability, especially low temperature, plays an important role in epidemics of HFRS in China. A long hysteresis effect indicates the necessity of continuous intervention following an HFRS epidemic. This finding can help public health departments guide the prevention and control of HFRS and develop strategies to cope with the impacts of climate change in specific regions.

Spatial-temporal patterns and influencing factors for hemorrhagic fever with renal syndrome: A 16-year national surveillance analysis in China

BackgroundChina is confronted with the significant menace posed by hemorrhagic fever with renal syndrome (HFRS). Nevertheless, the long-term spatial-temporal variations, regional prevalence patterns, and fundamental determinants' mechanisms for HFRS remain inadequately elucidated. MethodsNewly diagnosed cases of HFRS from January 2004 to December 2019 were acquired from the China Public Health Science Data repository. We used Age-period-cohort and Bayesian Spacetime Hierarchy models to identify high-risk populations and regions in mainland China. Additionally, the Geographical Detector model was employed to quantify the determinant powers of significant driver factors to the disease. ResultsA total of 199,799 cases of HFRS were reported in mainland China during 2004–2019. The incidence of HFRS declined from 1.93 per 100,000 in 2004 to 0.69 per 100,000 in 2019. The incidence demonstrated an inverted U-shaped trend with advancing age, peaking in the 50–54 age group, with higher incidences observed among individuals aged 20–74 years. Hyperendemic areas were mainly concentrated in the northeastern regions of China, while some western provinces exhibited a potential upward trend. Geographical detector model identified that the spatial variations of HFRS were significantly associated with the relative humidity (Q = 0.36), forest cover (Q = 0.26), rainfall (Q = 0.18), temperature (Q = 0.16), and the surface water resources (Q = 0.14). ConclusionsThis study offered comprehensive examinations of epidemic patterns, identified high-risk areas quantitatively, and analyzed factors influencing HFRS transmission in China. The findings may contribute to the necessary implementations for the effective prevention and control of HFRS.

Hantavirus Infections: Review of the Epidemiological Situation around the World. Analysis of the Epidemiological Situation on Hemorrhagic Fever with Renal Syndrome in the Russian Federation in 2023 and Forecast of Its Development for 2024

The paper describes the epidemiological situation in the countries of the world in terms of the incidence of Hantavirus diseases. The results of an epidemiological analysis of the incidence of hemorrhagic fever with renal syndrome (HFRS) in the Russian Federation in 2023 by federal districts are presented and a forecast for 2024 is made. In 2023, 5 093 cases of HFRS were registered in the Russian Federation (3.47 per 100 thousand population). The incidence was reported in 7 out of 8 federal districts of the country. The age structure was dominated by people in the 30–59 age category (65.7 %); 247 cases of the disease were noted among children under 17 years of age. The proportion of the male population was 70.3 %. 63.2 % of the total number of cases was registered among the urban residents. The mortality rate was at the level of 0.49 % – 25 lethal outcomes. Analysis of the data has revealed a decrease in the incidence of HFRS in Russia by 27.2 % as compared to the previous year. However, the data from epizootiological monitoring and the results of laboratory research of field material indicate a continuing tense situation in the country as a whole. In a number of regions, a high risk of complications of the epidemiological situation is predicted (mainly, in the constituent entities of the Volga and Central Federal Districts). Moderate risks of developing local complications of the epidemiological situation at the level of long-term average morbidity are expected to be realized in the entities of the Northwestern, Ural and Far Eastern Federal Districts. Sporadic cases of the disease in the territory of the Southern Federal District are not excluded. The aggravation of the situation on HFRS in the territory of the North-Caucasian and Siberian Federal Districts is not anticipated in 2024.

Epidemiology of Hemorrhagic Fever with Renal Syndrome and Host Surveillance in Zhejiang Province, China, 1990-2021.

Hemorrhagic fever with renal syndrome (HFRS) is caused by hantaviruses (HVs) and is endemic in Zhejiang Province, China. In this study, we aimed to explore the changing epidemiology of HFRS cases and the dynamics of hantavirus hosts in Zhejiang Province. Joinpoint regression was used to analyze long-term trends in the incidence of HFRS. The comparison of animal density at different stages was conducted using the Mann-Whitney Test. A comparison of HV carriage rates between stages and species was performed using the chi-square test. The incidence of HFRS shows a continuous downward trend. Cases are widely distributed in all counties of Zhejiang Province except Shengsi County. There was a high incidence belt from west to east, with low incidence in the south and north. The HFRS epidemic showed two seasonal peaks in Zhejiang Province, which were winter and summer. It showed a marked increase in the age of the incidence population. A total of 23,073 minibeasts from 21 species were captured. Positive results were detected in the lung tissues of 14 rodent species and 1 shrew species. A total of 80% of the positive results were from striped field mice and brown rats. No difference in HV carriage rates between striped field mice and brown rats was observed (χ2 = 0.258, p = 0.611).

Long‐ and Short‐Run Asymmetric Effects of Meteorological Parameters on Hemorrhagic Fever with Renal Syndrome in Heilongjiang: A Population‐Based Retrospective Study

Examining both long‐term and short‐term effects can enhance the precision and reliability of time series analysis. This study aimed to delve into the asymmetric effects of weather conditions on hemorrhagic fever with renal syndrome (HFRS) in the long and short terms and build a forecasting system. Data comprising monthly HFRS incidents and weather factors in Heilongjiang from January 2004 to December 2019 were extracted. Subsequently, the long‐ and short‐term asymmetric impacts were examined using the autoregressive distributed lag (ARDL) and nonlinear ARDL (NARDL) models. Next, the samples were partitioned into training and testing subsets to evaluate the predictive potential of both models. From 2004 to 2019, HFRS exhibited a declining trend (average annual percentage change = −6.744%, 95% CI: −13.52%–0.563%) and a dual seasonal pattern, with a prominent peak in June and a secondary one in October–December. This study identified long‐term asymmetric effects of rainfall (Wald long‐run asymmetry (WLR) = 3.292, p = 0.001), wind velocity (WLR = −3.271, p = 0.001), and air pressure (WLR = −6.453, p &lt; 0.001) on HFRS. Additionally, this study observed short‐term asymmetric impacts of relative humidity (Wald short‐run symmetry (WSR) = −1.547, p = 0.001), rainfall (WSR = −1.984, p = 0.049), and air pressure (WSR = −2.33, p = 0.021) on HFRS. A unit increase in relative humidity, sunshine hours, and air pressure resulted in about 10.9%, 1.9%, and 13.6% decreases in HFRS, respectively; a unit decrease in relative humidity, rainfall, and sunshine hours led to about 6.7%, 1.8%, and 2% decreases in HFRS, respectively. When temperature increased and decreased by one unit, the HFRS incidence increased by 11.6% and 22.5%, respectively. HFRS also varied significantly with the positive and negative changes in differenced (D) temperature, D (relative humidity), D (wind velocity), D (rainfall), D (air pressure), and D (sunshine hours) at 0−3‐month delays over the short term. The NARDL model exhibited notably lower error rates in forecasting compared to the ARDL model. Meteorological parameters affect HFRS in both the long and short term, often showing asymmetric effects. The NARDL model, capable of incorporating various weather parameters, proves to be valuable in predicting HFRS epidemic and guiding strategies for prevention and control.

Time series analyses based on the joint lagged effect analysis of pollution and meteorological factors of hemorrhagic fever with renal syndrome and the construction of prediction model.

Hemorrhagic fever with renal syndrome (HFRS) is a rodent-related zoonotic disease induced by hantavirus. Previous studies have identified the influence of meteorological factors on the onset of HFRS, but few studies have focused on the stratified analysis of the lagged effects and interactions of pollution and meteorological factors on HFRS. We collected meteorological, contaminant and epidemiological data on cases of HFRS in Shenyang from 2005-2019. A seasonal autoregressive integrated moving average (SARIMA) model was used to predict the incidence of HFRS and compared with Holt-Winters three-parameter exponential smoothing model. A distributed lag nonlinear model (DLNM) with a maximum lag period of 16 days was applied to assess the lag, stratification and extreme effects of pollution and meteorological factors on HFRS cases, followed by a generalized additive model (GAM) to explore the interaction of SO2 and two other meteorological factors on HFRS cases. The SARIMA monthly model has better fit and forecasting power than its own quarterly model and the Holt-Winters model, with an optimal model of (1,1,0) (2,1,0)12. Overall, environmental factors including humidity, wind speed and SO2 were correlated with the onset of HFRS and there was a non-linear exposure-lag-response association. Extremely high SO2 increased the risk of HFRS incidence, with the maximum RR values: 2.583 (95%CI:1.145,5.827). Extremely low windy and low SO2 played a significant protective role on HFRS infection, with the minimum RR values: 0.487 (95%CI:0.260,0.912) and 0.577 (95%CI:0.370,0.898), respectively. Interaction indicated that the risk of HFRS infection reached its highest when increasing daily SO2 and decreasing humidity. The SARIMA model may help to enhance the forecast of monthly HFRS incidence based on a long-range dataset. Our study had shown that environmental factors such as humidity and SO2 have a delayed effect on the occurrence of HFRS and that the effect of humidity can be influenced by SO2 and wind speed. Public health professionals should take greater care in controlling HFRS in low humidity, low windy conditions and 2-3 days after SO2 levels above 200 μg/m3.

Incidence of Orthohantavirus infection in humans follows observed changes in rodent reservoirs, Hubei Province, China (1984-2010).

Orthohantaviruses (genus Orthohantavirus, family Hantaviridae of order Bunyavirales) are rodent-borne viruses causing 2 human diseases: hemorrhagic fever with renal syndrome (HFRS) and hantavirus pulmonary syndrome (HPS), which are mainly prevalent in Eurasia and the Americas, respectively. We initiated this study to investigate and analyze the Orthohantaviruses infection in rodent reservoirs and humans in the Hubei Province of China from 1984 to 2010. The study included 10,314 mouse and 43,753 human serum samples. In this study, we analyzed the incidence of Orthohantavirus infection in humans and observed changes in rodent reservoirs in Hubei Province. The results indicated that although the incidence of HFRS declined from the 1990s, the human inapparent infection did not decrease dramatically. Although elements of the disease ecology have changed over the study period, Apodemus agrarius and Rattus norvegicus remain the major species and a constituent ratio of Rattus norvegicus increased. Rodent population density fluctuated between 16.65% and 2.14%, and decreased quinquennially, showing an obvious downward trend in recent years. The average orthohantaviruses-carrying rate was 6.36%, of which the lowest rate was 2.92% from 2006 to 2010. The analysis of rodent species composition showed that Rattus norvegicus and Apodemus agrarius were the dominant species over time (68.6% [1984 to 1987] and 90.4% [2000 to 2011]), while the composition and variety of other species decreased. The density of rodents was closely related to the incidence of HFRS (r = 0.910, P = .032). Our long-term investigation demonstrated that the occurrence of HFRS is closely related to rodent demographic patterns. Therefore, rodent monitoring and rodent control measures for prevention against HFRS in Hubei are warranted.

Methodological Approaches to Assessing the Economic Damage Associated with the Incidence of Hemorrhagic Fever with Renal Syndrome in the Russian Federation

The aim of the study was to develop methodological approaches to assessing the economic damage associated with the incidence of hemorrhagic fever with renal syndrome (HFRS) and to calculate the economic damage by the example of an outbreak of HFRS in the Saratov region in 2019. Materials and methods. The paper analyzes the economic indicators of the Federal State Statistics Service; data on the incidence of HFRS in the Russian Federation for the period of 2019–2022. To calculate the cost of outpatient and inpatient medical care, as well as the costs associated with the medical follow-up of convalescents, the indicators of the Program of state guarantees of free provision of medical care to citizens for 2022 and for the scheduled period of 2023 and 2024 were used. The calculation of economic losses associated with the payment of temporary disability benefits was carried out according to the equation provided in the Federal Law No. 255-FZ dated December 29, 2006 (as amended on October 07, 2022). Economic losses associated with premature death at an economically active age were calculated based on the value of unproduced GDP due to lost years of life in the corresponding age group. Results and discussion. The costs of treatment, rehabilitation and payment of temporary disability benefits for 1 case of HFRS at the age of 0 to 56.5 years for the female population and from 0 to 61.5 years for the male population amount to 140 495 rubles; over the age of 56.5 years for the female population and 61.5 years for the male population – 95 412 rubles, respectively. Each fatal case of HFRS aged 0 to 16 years among the male population costs the state 38 976 231 rubles; among the female population – 34 708 331 rubles; in active working age – the value of economic damage varies depending on the age of the person who died of HFRS. The economic damage of the outbreak of HFRS in the Saratov Region (2019), taking into account the direct expenditures of the healthcare system and indirect losses of the country’s economy amounted to 441 453 432 rubles. It is of note that the structure of the main damage is dominated by indirect losses in the economy caused by the premature death of people in economically active age.

Analysis of the Epidemiological Situation of Hemorrhagic Fever with Renal Syndrome in the Russian Federation in 2022 and Forecast of its Development for 2023

The paper provides the analysis of epidemiological process of hemorrhagic fever with renal syndrome (HFRS) in the Russian Federation in the context of federal districts in 2022 and a forecast of the HFRS incidence for 2023. According to the results of the analysis, there was a three-fold increase in the morbidity rates of HFRS in Russia in 2022 as compared to the indicators of 2021. The evidence of epizootiological survey and laboratory studies in certain federal districts of the Russian Federation indicate the continuing tense epidemiological situation on HFRS. In a number of regions of the country, high risk of infection with HFRS is predicted due to the favorable natural and climatic conditions of the winter period 2022/2023 for reservoir hosts of pathogenic for humans Hantaviruses. The findings of infected rodents attest to a high probability of complication of the epidemiological situation in the territories of increased epidemic hazard as regards HFRS.

A long-term retrospective analysis of the haemorrhagic fever with renal syndrome epidemic from 2005 to 2021 in Jiangxi Province, China

Jiangxi is one of the provinces in China most seriously affected by the haemorrhagic fever with renal syndrome (HFRS) epidemic. The aim of this paper was to systematically explore the HFRS epidemic in Jiangxi from the perspective of Hantavirus (HV) prevalence in rodents and humans and virus molecular characteristics. Individual information on all HFRS cases in Jiangxi from 2005 to 2021 was extracted from the China Information System for Disease Control and Prevention. All S and M fragment sequences of the Seoul virus and Hantan virus strains uploaded by Jiangxi and its neighbouring provinces and some representative sequences from provinces in China or some countries of Southeast Asia with the highest HV prevalence were retrieved and downloaded from NCBI GenBank. Periodogram and spatial autocorrelation were adopted for temporal periodicity and spatial clustering analysis of the HFRS epidemic. Joinpoint regression was utilized to explore the changing morbidity trend patterns of HFRS. Multiple sequence alignment and amino acid variation analysis were used to explore the homology and variation of strain prevalence in Jiangxi. Based on monthly morbidity time series, the periodogram analysis showed that the prevalence of HFRS had periodicities of 6 months and 12 months. Spatial autocorrelation analysis showed that HFRS distributed in Jiangxi was not random, with a “High-High” clustering area around Gaoan County. HFRS morbidity among the 0 ~ 15-year-old and ~ 61-year-old or older populations in Jiangxi increased significantly during the period of 2008–2015. Generally, HFRS morbidity was significantly positively correlated with the index of rat with virus (IRV) (r = 0.742) in the counties surrounding Gaoan from 2005 to 2019. HTNV strains in Jiangxi were in one independent branch, while the SEOV strains in Jiangxi were relatively more diverse. Both the YW89-15 and GAW30/2021 strains shared approximately 85% nucleotide homology and approximately 97% amino acid homology with their corresponding standard strains and vaccine strains. GAW30/2021 and YW89-15 had some amino acid site variations in nucleoprotein, glycoprotein precursor and RNA-dependent polymerase with their corresponding vaccine strains Z10 (HTNV) and Z37 (SEOV). The HFRS epidemic in Jiangxi has obvious temporal periodicity and spatial clustering, and the significant increase in the non-Immunization Expanded Program (EPI) targeted population (children and elderly) suggests that HFRS vaccination in this population needs to be considered. Although applying the EPI played a certain role in curbing the incidence of HFRS in Jiangxi from the perspective of ecological epidemiology, HTNV and SEOV strains prevalent in Jiangxi have some amino acid site variations compared to their corresponding vaccine strains, suggesting that HV variation needs to be continuously monitored in the future to observe vaccine protective efficiency.

Dual seasonal pattern for hemorrhagic fever with renal syndrome and its potential determinants in China

Hemorrhagic fever with renal syndrome (HFRS) continued to affect human health across Eurasia, which complicated by climate change has posed a challenge for the disease prevention measures. Nation-wide surveillance data of HFRS cases were collected during 2008–2020.The seasonality and epidemiological features were presented by combining the HFRS incidence and the endemic types data. Factors potentially involved in affecting incidence and shaping disease seasonality were investigated by generalized additive mixed model, distributed lag nonlinear model and multivariate meta-analysis. A total of 76 cities that reported totally 111,054 cases were analyzed. Three endemic types were determined, among them the Type I cities (Hantaan virus-dominant) were related to higher incidence level, showing one spike every year in Autumn-Winter season; Type II (Seoul virus-dominant) cities were related to lower incidence, showing one spike in Spring, while Type III (Hantaan/Seoul-mixed type) showed dual peaks with incidence lying between. Persistently heavy rainfall had significantly negative influence on HFRS incidence in Hantaan virus-dominant endemic area, while a significantly opposite effect was identified when continuously heavy rainfall induced floods, where temperature and relative humidity affected HFRS incidence via an approximately parabolic or linear manner, however few or no such effects was shown in Seoul virus-dominant endemic areas, which was more vulnerable to temperature variation. Dual seasonal pattern of HFRS was depended on the dominant genotypes of hantavirus, and impact of climate on HFRS was greater in Hantaan virus-dominant endemic areas, than in Seoul virus-dominant areas.

Meteorological change and hemorrhagic fever with renal syndrome epidemic in China, 2004–2018

Hemorrhagic fever with renal syndrome (HFRS), caused by hantavirus, is a serious public health problem in China. Despite intensive countermeasures including Patriotic Health Campaign, rodent control and vaccination in affected areas, HFRS is still a potential public health threat in China, with more than 10,000 new cases per year. Previous epidemiological evidence suggested that meteorological factors could influence HFRS incidence, but the studies were mainly limited to a specific city or region in China. This study aims to evaluate the association between monthly HFRS cases and meteorological change at the country level using a multivariate distributed lag nonlinear model (DLNM) from 2004 to 2018. The results from both univariate and multivariate models showed a non-linear cumulative relative risk relationship between meteorological factors (with a lag of 0–6 months) such as mean temperature (Tmean), precipitation, relative humidity (RH), sunshine hour (SH), wind speed (WS) and HFRS incidence. The risk for HFRS cases increased steeply as the Tmean between − 23 and 14.79 °C, SH between 179.4 and 278.4 h and RH remaining above 69% with 50–95 mm precipitation and 1.70–2.00 m/s WS. In conclusion, meteorological factors such as Tmean and RH showed delayed-effects on the increased risk of HFRS in the study and the lag varies across climate factors. Temperature with a lag of 6 months (RR = 3.05) and precipitation with a lag of 0 months (RR = 2.08) had the greatest impact on the incidence of HFRS.

Genetic Evolution Analysis and Host Characteristics of Hantavirus in Yunnan Province, China.

For a long time, the epidemic situation of hemorrhagic fever with renal syndrome (HFRS) caused by hantavirus (HV) in Yunnan Province of China has been relatively severe. The molecular epidemiology and host characteristics of HV in Yunnan Province are still not completely clear, and the systematic and long-term investigation of the epidemic area is very limited. In this study, a total of 488 murine-shaped animals were captured in the three regions of Mile City, Mangshi City and Lianghe County in Yunnan Province, and then the type of HV was identified by multiplex real-time RT-PCR and sequenced. The results indicate that 2.46% of the murine-shaped animal specimens were infected with HV. A new subtype of Seoul virus (SEOV) was found in the rare rat species Rattus nitidus in Lianghe County, and the two strains of this new subtype were named YNLH-K40 and YNLH-K53. Through the phylogenetic analysis of this new subtype, it is shown that this new subtype is very similar to the type S5 of SEOV, which is previously described as the main cause for the high incidence of HFRS in Longquan City, Zhejiang Province, China. This new subtype is highly likely to cause human infection and disease. Therefore, in addition to further promoting the improvement of the HV gene database and strengthening the discovery and monitoring of the host animals in Yunnan Province, more attention should be paid to the pathogenic potential of the newly discovered HV type.

Bayesian spatiotemporal modelling analysis of hemorrhagic fever with renal syndrome outbreaks in China using R-INLA.

Hemorrhagic fever with renal syndrome (HFRS) is a category B infectious disease caused by Hantavirus infection, which can cause acute kidney injury and has a high mortality rate. At present, China is the country most severely afflicted by HFRS in the world, and it is critical to carry out efficient HFRS prevention and management in a scientific and accurate manner. The study used data on the incidence of HFRS in mainland China from 2015 to 2018, built a Bayesian hierarchical spatiotemporal distribution model, and applied the Integrated Nested Laplace Approximation algorithm to analyse the factors influencing the development of HFRS, the spatial and temporal distribution characteristics, and the threshold exceedance locations. The results revealed that the woodland and grassland area (RR=1.357, 95% CI: 1.005-1.791), economic level (RR=1.299, 95% CI: 1.007-1.649), and traffic level (RR=2.442, 95% CI: 1.825-3.199) were all significantly and positively associated with the development of HFRS, with traffic level having the strongest promoting effect. The seasonal cycle was obvious in time, with peaks in May-June and October-December each year, most notably in November. Spatially, there was a south-heavy north-light trend, with a high risk of incidence largely in places rich in mountain and forest vegetation, of which Guizhou, Guangxi, Guangdong, and Jiangxi provinces continuing to have a high incidence in recent years, and the evolution of the epidemic in Hubei and Hunan was becoming more serious. When the early warning threshold was set at 0.2, the detection impact was best, and Guizhou, Guangxi, Guangdong, Jiangxi, Hainan, and Tianjin were positioned near the critical point of the exceedance threshold with the highest risk of incidence. It is recommended that the relevant managers call for active vaccination of outdoor workers, such as those working in agriculture and construction sites, implement rat prevention and extermination before winter arrives, and warn high-risk and medium-high-risk areas to conduct early outbreak surveillance. Move the prevention and control gates forward based on the exceedance threshold for doing preventive and control detection and epidemic research and judgement work.

Overview of Hantavirus Infections in the World, the Epidemiological Situation on Hemorrhagic Fever with Renal Syndrome in the Russian Federation in 2021, and Forecast for 2022

The paper presents a description of the epidemiological situation on Hantavirus infection incidence in the countries around the world. Comparative analysis of the intensity and dynamics of the epidemiological process of hemorrhagic fever with renal syndrome (HFRS) in the Russian Federation by Federal Districts in 2021 has been carried out and forecast of the HFRS incidence for 2022 prepared. The study has revealed that tense situation on incidence of hantavirus diseases was observed in the world in 2021. On the territory of the Russian Federation, there was a decrease in the HFRS incidence in 2021 (by 1.7 times compared to 2020). However, the results of epidemiological analysis of the HFRS incidence, epizootiological data and laboratory studies in certain Federal Districts of the Russian Federation indicate that the epidemiological situation on HFRS remains tense. High risk of HFRS infection is predicted in a number of regions of the country due to the favorable natural and climatic conditions in the winter period of 2021–2022 with a heavy snow cover, which contributed to the under-snow reproduction of small mammals, the main carriers of HFRS. The presence of infected rodents testifies to a high likelihood of complication of the epidemiological situation in areas of increased epidemic risk of HFRS.

Epidemiological Manifestation of Combined Natural Foci of Tularemia, Leptospirosis and Hemorrhagic Fever with Renal Syndrome: Mixed Infections

Epidemiological Manifestation of Combined Natural Foci of Tularemia, Leptospirosis and Hemorrhagic Fever with Renal Syndrome: Mixed Infections

Screening and identification of HTNVpv entry inhibitors with high-throughput pseudovirus-based chemiluminescence

Hantaviruses, such as Hantaan virus (HTNV) and Seoul virus, are the causative agents of Hantavirus cardiopulmonary syndrome (HCPS) and hemorrhagic fever with renal syndrome (HFRS), and are important zoonotic pathogens. China has the highest incidence of HFRS, which is mainly caused by HTNV and Seoul virus. No approved antiviral drugs are available for these hantaviral diseases. Here, a chemiluminescence-based high-throughput-screening (HTS) assay was developed and used to screen HTNV pseudovirus (HTNVpv) inhibitors in a library of 1813 approved drugs and 556 small-molecule compounds from traditional Chinese medicine sources. We identified six compounds with in vitro anti-HTNVpv activities in the low-micromolar range (EC50 values of 0.1–2.2 ​μmol/L; selectivity index of 40–900). Among the six selected compounds, cepharanthine not only showed good anti-HTNVpv activity in vitro but also inhibited HTNVpv-fluc infection in Balb/c mice 5 ​h after infection by 94% (180 ​mg/kg/d, P ​< ​0.01), 93% (90 ​mg/kg/d, P ​< ​0.01), or 92% (45 ​mg/kg/d, P ​< ​0.01), respectively, in a bioluminescent imaging mouse model. A time-of-addition analysis suggested that the antiviral mechanism of cepharanthine involves the membrane fusion and entry phases. Overall, we have established a HTS method for antiviral drugs screening, and shown that cepharanthine is a candidate for HCPS and HFRS therapy. These findings may offer a starting point for the treatment of patients infected with hantaviruses.