Spatial-temporal characteristics and the epidemiology of haemorrhagic fever with renal syndrome from 2007 to 2016 in Zhejiang Province, China

Abstract

Zhejiang Province is one of the six provinces in China that has the highest incidence of haemorrhagic fever with renal syndrome (HFRS). Data on HFRS cases in Zhejiang Province from January 2007 to July 2017 were obtained from the China Information Network System of Disease Prevention and Control. Joinpoint regression analysis was used to observe the trend of the incidence rate of HFRS. The monthly incidence rate was predicted by autoregressive integrated moving average(ARIMA) models. Spatial autocorrelation analysis was performed to detect geographic clusters. A multivariate time series model was employed to analyze heterogeneous transmission of HFRS. There were a total of 4,836 HFRS cases, with 15 fatal cases reported in Zhejiang Province, China in the last decade. Results show that the mean absolute percentage error (MAPE) of the modelling performance and the forecasting performance of the ARIMA model were 27.53% and 16.29%, respectively. Male farmers and middle-aged patients account for the majority of the patient population. There were 54 high-high clusters and 1 high-low cluster identified at the county level. The random effect variance of the autoregressive component is 0.33; the spatio-temporal component is 1.30; and the endemic component is 2.45. According to the results, there was obvious spatial heterogeneity in the endemic component and spatio-temporal component but little spatial heterogeneity in the autoregressive component. A significant decreasing trend in the incidence rate was identified, and obvious clusters were discovered. Spatial heterogeneity in the factors driving HFRS transmission was discovered, which suggested that a targeted preventive effort should be considered in different districts based on their own main factors that contribute to the epidemics.

A case-control study on the risk factors for hemorrhagic fever with renal syndrome

“…It is possible that hantavirus can be infected by inhaling the aerosol and ingesting the food contaminated by the rodent excreta, that is, the virus may transmit through respiratory and digestive tracts [5,8,[10][11][12]. The reason why cleaning spare rooms was the influencing factor might be that the human activities in the All exposure factors were within the previous 1 month prior to disease onset OR Odds ratio, CI Confidence interval spare rooms were infrequent and these rooms were poorly ventilated, which was conducive to rodent reproduction.…”

“…Hemorrhagic fever with renal syndrome (HFRS), formerly known as epidemic hemorrhagic fever (EHF), is caused by several rodent-borne hantaviruses in the Hantaviridae family of the order Bunyavirales [1,2]. HFRS is clinically characterized by fever, haemorrhage, kidney disease, headache, back pain, abdominal pain and hypotension [3][4][5]. Every year, thousands of people are infected by hantaviruses in developing and developed countries alike, case fatality rates range from 0.5 to 40% depending on the viral strain [2,6,7].…”

“…Approximately 150,000 to 200,000 patients with HFRS are hospitalized each year throughout the world [8]. With the highest occurrence of HFRS, China has experienced approximately 90% of the cases worldwide over the last few decades [3][4][5]9]. From 2008 to 2018, a total of 118,124 cases of HFRS were reported in the country, making HFRS a critical public health issue.…”

“…Transmission of hantaviruses is thought to occur mainly through contact with infected animal excreta or ingest food contaminated with infected animal excreta (faeces, urine and saliva). Though the aerosol route of infection is undoubtedly the most common means of transmission among rodents and to humans [5,8,[10][11][12], virus transmission by bite occurs among rodents and may also result in human infection [8].…”

Spatial-temporal characteristics of severe fever with thrombocytopenia syndrome and the relationship with meteorological factors from 2011 to 2018 in Zhejiang Province, China

“…ω ji is the spatial contiguity weights matrix, which describes the strength of transmission from region j to region i. There are usually three models of neighborhood weights, including the first-order neighborhood model, the power law model and the second-order neighborhood model [30,31]. The first-order neighborhood model assumes that an epidemic can only arrive from directly adjacent districts and that all districts have the same coefficient for importing cases from neighboring districts.…”