Spatiotemporal dynamics of hemorrhagic fever with renal syndrome in Jiangxi province, China

Abstract

Historically, Jiangxi province has had the largest HfRS burden in china. However, thus far, the comprehensive understanding of the spatiotemporal distributions of HfRS is limited in Jiangxi. in this study, seasonal decomposition analysis, spatial autocorrelation analysis, and space-time scan statistic analyses were performed to detect the spatiotemporal dynamics distribution of HfRS cases from 2005 to 2018 in Jiangxi at the county scale. The epidemic of HFRS showed the characteristic of bi-peak seasonality, the primary peak in winter (November to January) and the second peak in early summer (May to June), and the amplitude and the magnitude of HFRS outbreaks have been increasing. The results of global and local spatial autocorrelation analysis showed that the HfRS epidemic exhibited the characteristic of highly spatially heterogeneous, and Anyi, fengxin, Yifeng, Shanggao, Jing'an and Gao'an county were hot spots areas. A most likely cluster, and two secondary likely clusters were detected in 14-years duration. The higher risk areas of the HFRS outbreak were mainly located in Jiangxi northern hilly state, spreading to Wuyi mountain hilly state as time advanced. this study provided valuable information for local public health authorities to design and implement effective measures for the control and prevention of HfRS. Hemorrhagic fever with renal syndrome (HFRS) is a rodent-borne infectious disease caused by hantaviruses in the Bunyaviridae family 1. Transmission of hantavirus to humans occurs via inhalation of aerosolized viral particles present in the urine, feces, and saliva excreted into the environment by rodents infected with it 2. In China, the major causative agents of HFRS are Hantaan virus (HTNV) and Seoul virus (SEOV), whose natural rodents hosts are respectively striped field mice (A. agrarius) and Norway rats (R. norvegicus) 3,4. So far, China remains the most endemic country, and there were more than 11,000 HFRS cases reported annually from 2016 to 2018 5. Jiangxi province, which is located in the southern bank of the middle and lower reaches of the Yangzi River, is one of the most serious HFRS endemic areas of China. Since the first case of HFRS was reported in Pengze county in 1961, the HFRS epidemic has rapidly spread to 6 counties in the 1960s, 39 counties in the 1970s, 65 counties in the 1980s, and 88 counties in the 1990s. The number of HFRS cases has also risen sharply, and reached a peak in 1985, with an incidence of 21/100,000 persons. The epidemic of HFRS has expanded throughout the central and northern Jiangxi and reached Ningdu county, Ganzhou city, in the south 6. Jiangxi currently remains one of the provinces with the highest HFRS incidence during recent years according to the national HFRS surveillance data 7. The susceptible population of HFRS is heterogeneous in space, socioeconomic status, and the geographical difference between different regions 8. Furthermore, infectious disease outbreaks can occur in very short time periods and infect a large number of individuals 9,10. As a resu...

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