The role of environmental factors in the spatial distribution of Japanese encephalitis in mainland China

Population genetic structure of Culex tritaeniorhynchus in different types of climatic zones in China

BACKGROUND

Culex tritaeniorhynchus is widely distributed in China, from Hainan Island in the south to Heilongjiang in the north, covering tropical, subtropical, and temperate climate zones. Culex tritaeniorhynchus carries 19 types of arboviruses. It is the main vector of the Japanese encephalitis virus (JEV), posing a serious threat to human health. Understanding the effects of environmental factors on Culex tritaeniorhynchus can provide important insights into its population structure or isolation patterns, which is currently unclear.

RESULTS

In total, 138 COI haplotypes were detected in the 552 amplified sequences, and the haplotype diversity (Hd) value increased from temperate (0.534) to tropical (0.979) regions. The haplotype phylogeny analysis revealed that the haplotypes were divided into two high-support evolutionary branches. Temperate populations were predominantly distributed in evolutionary branch II, showing some genetic isolation from tropical/subtropical populations and less gene flow between groups. The neutral test results of HNQH (Qionghai) and HNHK(Haikou) populations were negative (P < 0.05), indicating many low-frequency mutations in the populations and that the populations might be in the process of expansion. Moreover, Wolbachia infection was detected only in SDJN (Jining) (2.24%), and all Wolbachia genotypes belonged to supergroup B. To understand the influence of environmental factors on mosquito-borne viruses, we examined the prevalence of Culex tritaeniorhynchus infection in three ecological environments in Shandong Province. We discovered that the incidence of JEV infection was notably greater in Culex tritaeniorhynchus from lotus ponds compared to those from irrigation canal regions. In this study, the overall JEV infection rate was 15.27 per 1000, suggesting the current risk of Japanese encephalitis outbreaks in Shandong Province.

CONCLUSIONS

Tropical and subtropical populations of Culex tritaeniorhynchus showed higher genetic diversity and those climatic conditions provide great advantages for the establishment and expansion of Culex tritaeniorhynchus. There are differences in JEV infection rates in wild populations of Culex tritaeniorhynchus under different ecological conditions. Our results suggest a complex interplay of genetic differentiation, population structure, and environmental factors in shaping the dynamics of Culex tritaeniorhynchus. The low prevalence of Wolbachia in wild populations may reflect the recent presence of Wolbachia invasion in Culex tritaeniorhynchus.

Spatial distribution of Japanese encephalitis cases and correlated geo-environmental factors in southern and northern counties of China

Japanese encephalitis (JE) is a mosquito-borne disease with a spatial distribution that is linked to geo-environmental factors. The spatial distribution of JE cases and correlated geo-environmental factors were investigated in two critical counties in southern and northern China. Based on maps, enhanced thematic mapper (ETM) remote sensing datasets from Landsat and spatial datasets of JE cases, spatial distribution and spatial cluster analyses of JE cases at the village scale were performed by using the standard deviational ellipse and Ripleys K-function. Global and regional spatial cluster analyses of JE cases were also performed by using Moran's index. Regression analysis was used to analyze the relationships between geo-environmental characteristics and the risk of JE cases. At the study sites, the JE cases were not spatially clustered at the village or district (global) level, whereas there was a spatial cluster at the district (local) level. Diversity-related features for JE patients at the district and village levels were detected at two sites. In the southern counties, the distance of a village from a road was related to the village-level JE risk (OR: 0.530, 95 CI: 0.297-0.947, P = 0.032), and the number of township-level JE cases was linked to the distance of the district center from the road (R =-0.467, P = 0.025) and road length (R = 0.516, P = 0.012) in the administrative area. In northern China, the modified normalized difference water index (MNDWI) in the 5 km buffer around the village was related to village-level JE risk (OR: 0.702, 95% CI: 0.524-0.940, P = 0.018), and the number of township-level JE cases was related to the MNDWI in the administrative region (R =-0.522, P = 0.038). This study elucidates the spatial distribution patterns of JE cases and risk, as well as correlated geo-environmental features, at various spatial scales. This study will significantly assist the JE control efforts of the local Centers for Disease Control and Prevention (CDC), which is the base-level CDC, particularly concerning the allocation of medicine and medical staff, the development of immunological plans, and the allocation of pesticides and other control measures for the mosquito vectors of JE.

Potential distribution of three invasive agricultural pests in China under climate change

Invasive pests reduce biodiversity and ecosystem service functions, thereby leading to economic and also agricultural losses. Banana skipper (Erionota torus Evans), red palm weevil (Rhynchophorus ferrugineus), and coconut caterpillar (Opisina arenosella Walker) are invasive insect pests in the palm-growing regions and they have had serious consequences for the planting of bananas (Musa nana), palms (Trachycarpus fortune) and coconut (Cocos nucifera). Based on screened occurrence data, the present research utilized Maximum Entropy model (Maxent) to simulate the distribution dynamics of these three invasive insects in China, under current and future climate (2050s, 2070s, 2090s) in two shared socio-economic pathways (SSPs: 126 and 585) of the newly released coupled model intercomparison project phase6 (CMIP6). The results show that: (1) Under current and future climate conditions, all model groups exhibited an AUC value exceeding 0.92, which shows that the model prediction results are very good;(2) The suitable habitat area of E. torus Evans remains relatively stable with some expansion in the SSP126 of 2090s and some contraction in the SSP585 of 2090s. The suitable habitat area of R. ferrugineus showed an overall contraction, with substantial contraction in the SSP585 of 2090s.The suitable habitat area of O. arenosella has an overall expansion, with the most pronounced expansion in the SSP585 of 2070s; (3) The current centroid of suitable habitats for R. ferrugineus and E. torus Evans is located in Guangxi Province and wholely shift toward the south direction under future climate. The centroid of suitable habitats for O. arenosella is currently located in the northeastern maritime area of Hainan Province and will shift toward the north direction under future climate; (4) Temperature, precipitation and Human disturbance factors (Population density and Human influence index) were crucial variables for describing the distribution of the three species. For E. torus Evans in particular, percentage contributions of Population density was up to 31.4, which is only 0.1 different from ranked first Bio19 (Precipitation of the coldest quarter). The dynamics of habitats of these three species and the correlating driver factors proposed in this work provide essential insights into future spatial management of the three invasive insects in China. Our work is necessary and timely in identifying newly areas at high risk of expansion of the three invasive insects in the future, then suggesting strategic control measures to prevent their spread, and finally providing scientific evidence for the early prevention and rapid response to the three invasive insects.

Exploring mosquito abundance and Plasmodium infection through nested-PCR: implications for disease surveillance and control

The Plasmodium is responsible for malaria which poses a major health threat, globally. This study is based on the estimation of the relative abundance of mosquitoes, and finding out the correlations of meteorological parameters (temperature, humidity and rainfall) with the abundance of mosquitoes. In addition, this study also focused on the use of nested PCR (species-specific nucleotide sequences of 18S rRNA genes) to explore the Plasmodium spp. in female Anopheles. In the current study, the percentage relative abundance of Culex mosquitoes was 57.65% and Anopheles 42.34% among the study areas. In addition, the highest number of mosquitoes was found in March in district Mandi Bahauddin at 21 °C (Tmax = 27, Tmin = 15) average temperature, 69% average relative humidity and 131 mm rainfall, and these climatic factors were found to affect the abundance of the mosquitoes, directly or indirectly. Molecular analysis showed that overall, 41.3% of the female Anopheles pools were positive for genus Plasmodium. Among species, the prevalence of Plasmodium (P.) vivax (78.1%) was significantly higher than P. falciparum (21.9%). This study will be helpful in the estimation of future risk of mosquito-borne diseases along with population dynamic of mosquitoes to enhance the effectiveness of vector surveillance and control programs.

Trends in temporal and spatial changes of Japanese encephalitis in Chinese mainland, 2004-2019: A population-based surveillance study

BACKGROUND

Japanese encephalitis (JE) is a serious health concern in China, with approximately 80 % of global infections occurring in China. To develop effective prevention and control strategies, this study explored the epidemiological characteristics of JE in China based on spatiotemporal data, to understand the patterns and trends of JE incidence in different regions and time periods.

METHOD

The incidence and mortality rates of JE were extracted from the Public Health Data Center, the official website of the National Health Commission of the People's Republic of China, and the National Notifiable Infectious Disease Surveillance System from 2004 to 2019. Joinpoint regression was applied to examine the spatiotemporal patterns and annual percentage change in incidence and mortality of the JE.

RESULTS

From 2004 to 2019, a total of 43,569 cases of JE were diagnosed, including 2081 deaths. The annual incidence rate of JE decreased from 0.4171/100,000 in 2004 to 0.0298/100,000 in 2019, with an annual percentage change (APC) of -13.5 % (P < 0.001). The annual mortality rate of JE showed three stages of change, with inflection points in 2006 and 2014. The incidence and mortality rates of JE have declined in all provinces of China, and more cases were reported in 0-14 years of age, accounting for nearly 80 % of all patients.

CONCLUSIONS

The morbidity and mortality rates of JE in China are generally on a downward trend, and emphasis should be placed on strengthening disease surveillance in special areas and populations, popularizing vaccination, and increasing publicity.

Changes in the Range of Four Advantageous Grasshopper Habitats in the Hexi Corridor under Future Climate Conditions

Angaracris rhodopa (Fischer et Walheim), Calliptamus abbreviatus (Ikonnikov), Myrmeleotettix palpalis (Zubowsky), and Oedaleus decorus asiaticus (Bey-Bienko) are the main grasshoppers that harm the natural grassland in the Hexi Corridor in Gansu, northwest China. In this study, the MaxEnt model was employed to identify the key environmental factors affecting the distribution of the four grasshoppers' habitats and to assess their distribution under current and future climate conditions. The aim was to provide a basis for grasshopper monitoring, prediction, and precise control. In this study, distribution of suitable habitats for A. rhodopa, C. abbreviates, M. palpalis, O. decorus asiaticus were predicted under current and future climatic scenarios using the Maxent model. The average AUC (area under the ROC curve) and TSS (true skill statistic) values of the four grasshoppers were greater than 0.9, and the simulation results were excellent and highly reliable. The mean annual precipitation was the main factor limiting the current range of suitable areas for these four species. Under the current climate, A. rhodopa, C. abbreviatus, and O. decorus asiaticus were mainly distributed in the central and eastern parts of the Hexi Corridor, and M. palpalis was distributed throughout the Hexi Corridor, with a suitable area of 1.29 × 104, 1.43 × 104, 1.44 × 104, and 2.12 × 104 km2, accounting for 13.7%, 15.2%, 15.3%, and 22.5% of the total area of the grasslands in the Hexi Corridor, respectively. The highly suitable areas of A. rhodopa, C. abbreviatus, and O. decorus asiaticus were mainly distributed in the eastern-central part of Zhangye City, the western part of Wuwei City, and the western and southern parts of Jinchang City, with areas of 0.20 × 104, 0.29 × 104, and 0.35 × 104 km2, accounting for 2.2%, 3%, and 3.7% of the grassland area, respectively. The high habitat of M. palpalis was mainly distributed in the southeast of Jiuquan City, the west, middle, and east of Zhangye City, the west of Wuwei City, and the west and south of Jinchang City, with an area of 0.32 × 104 km2, accounting for 3.4% of the grassland area. In the 2030s, the range of A. rhodopa, C. abbreviatus, and O. decorus asiaticus was predicted to increase; the range of M. palpalis will decrease. The results of this study could provide a theoretical basis for the precise monitoring and control of key areas of grasshoppers in the Hexi Corridor.

Modelling the risk of Japanese encephalitis virus in Victoria, Australia, using an expert-systems approach

Predictive models for vector-borne diseases (VBDs) are instrumental to understanding the potential geographic spread of VBDs and therefore serve as useful tools for public health decision-making. However, predicting the emergence of VBDs at the micro-, local, and regional levels presents challenges, as the importance of risk factors can vary spatially and temporally depending on climatic factors and vector and host abundance and preferences. We propose an expert-systems-based approach that uses an analytical hierarchy process (AHP) deployed within a geographic information system (GIS), to predict areas susceptible to the risk of Japanese encephalitis virus (JEV) emergence. This modelling approach produces risk maps, identifying micro-level risk areas with the potential for disease emergence. The results revealed that climatic conditions, especially the minimum temperature and precipitation required for JEV transmission, contributed to high-risk conditions developed during January and March of 2022 in Victora. Compared to historical climate records, the risk of JEV emergence was increased in most parts of the state due to climate. Importantly, the model accurately predicted 7 out of the 8 local government areas that reported JEV-positive cases during the outbreak of 2022 in Victorian piggeries. This underscores the model's potential as a reliable tool for supporting local risk assessments in the face of evolving climate change.

Spatiotemporal distribution and environmental influences of severe fever with thrombocytopenia syndrome in Shandong Province, China

BACKGROUND

Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease discovered in China in 2009. The purpose of this study was to describe the spatiotemporal distribution of SFTS and to identify its environmental influencing factors and potential high-risk areas in Shandong Province, China.

METHODS

Data on the SFTS incidence from 2010 to 2021 were collected. Spatiotemporal scan statistics were used to identify the time and area of SFTS clustering. The maximum entropy (MaxEnt) model was used to analyse environmental influences and predict high-risk areas.

RESULTS

From 2010 to 2021, a total of 5705 cases of SFTS were reported in Shandong. The number of SFTS cases increased yearly, with a peak incidence from April to October each year. Spatiotemporal scan statistics showed the existence of one most likely cluster and two secondary likely clusters in Shandong. The most likely cluster was in the eastern region, from May to October 2021. The first secondary cluster was in the central region, from May to October 2021. The second secondary cluster was in the southeastern region, from May to September 2020. The MaxEnt model showed that the mean annual wind speed, NDVI, cattle density and annual cumulative precipitation were the key factors influencing the occurrence of SFTS. The predicted risk map showed that the area of high prevalence was 28,120 km2, accounting for 18.05% of the total area of the province.

CONCLUSIONS

The spatiotemporal distribution of SFTS was heterogeneous and influenced by multidimensional environmental factors. This should be considered as a basis for delineating SFTS risk areas and developing SFTS prevention and control measures.

Spatiotemporal epidemiology and risk factors of scrub typhus in Hainan Province, China, 2011-2020

Background

The re-emergence of scrub typhus in the southern provinces of China in recent decades has been validated, thereby attracting the attention of public health authorities. There has been a spatial and temporal expansion of scrub typhus in Hainan Province, but the epidemiological characteristics, environmental drivers, and potential high-risk areas for scrub typhus have not yet been investigated.

Objective

The aims of this study were to characterize the spatiotemporal epidemiology of scrub typhus, identify dominant environmental risk factors, and map potential risk areas in Hainan Province from 2011 to 2020.

Methods

The spatiotemporal dynamics of scrub typhus in Hainan Province between 2011 and 2020 were analyzed using spatial analyses and seasonal-trend decomposition using regression (STR). The maximum entropy (MaxEnt) model was applied to determine the key environmental predictors and environmentally suitable areas for scrub typhus, and the demographic diversity of the predicted suitable zones was evaluated.

Results

During 2011-2020, 3260 scrub typhus cases were recorded in Hainan Province. The number of scrub typhus cases increased continuously each year, particularly among farmers (67.61%) and individuals aged 50-59 years (23.25%) who were identified as high-risk groups. A dual epidemic peak was detected, emerging annually from April to June and from July to October. The MaxEnt-based risk map illustrated that highly suitable areas, accounting for 25.36% of the total area, were mainly distributed in the northeastern part of Hainan Province, where 75.43% of the total population lived. Jackknife tests revealed that ground surface temperature, elevation, cumulative precipitation, evaporation, land cover, population density, and ratio of dependents were the most significant environmental factors.

Conclusion

In this study, we gained insights into the spatiotemporal epidemiological dynamics, pivotal environmental drivers, and potential risk map of scrub typhus in Hainan Province. These results have important implications for researchers and public health officials in guiding future prevention and control strategies for scrub typhus.

Recent Population Dynamics of Japanese Encephalitis Virus

Japanese encephalitis virus (JEV) causes acute viral encephalitis in humans and reproductive disorders in pigs. JEV emerged during the 1870s in Japan, and since that time, JEV has been transmitted exclusively throughout Asia, according to known reporting and sequencing records. A recent JEV outbreak occurred in Australia, affecting commercial piggeries across different temperate southern Australian states, and causing confirmed infections in humans. A total of 47 human cases and 7 deaths were reported. The recent evolving situation of JEV needs to be reported due to its continuous circulation in endemic regions and spread to non-endemics areas. Here, we reconstructed the phylogeny and population dynamics of JEV using recent JEV isolates for the future perception of disease spread. Phylogenetic analysis shows the most recent common ancestor occurred about 2993 years ago (YA) (95% Highest posterior density (HPD), 2433 to 3569). Our results of the Bayesian skyline plot (BSP) demonstrates that JEV demography lacks fluctuations for the last two decades, but it shows that JEV genetic diversity has increased during the last ten years. This indicates the potential JEV replication in the reservoir host, which is helping it to maintain its genetic diversity and to continue its dispersal into non-endemic areas. The continuous spread in Asia and recent detection from Australia further support these findings. Therefore, an enhanced surveillance system is needed along with precautionary measures such as regular vaccination and mosquito control to avoid future JEV outbreaks.

The spatial-temporal pattern of Japanese encephalitis and its influencing factors in Guangxi, China

Japanese encephalitis (JE) is a major global public health threat. Using Japanese encephalitis incidence data from 2004 to 2010 in Guangxi Province, China, this study comprehensively explored the driving forces and the interactive effects between environmental and social factors of Japanese encephalitis using the Geo-detector method. The results indicated that the incidence of Japanese encephalitis showed a fluctuating downward trend from 2004 to 2010. The onset of JE was seasonal, mainly concentrated in June-July, and highly aggregated in northwestern Guangxi. Among the factors associated with Japanese encephalitis, days with temperatures >30 °C, accumulated temperatures >25 °C, slope, the normalized difference vegetation index, the gross domestic product of tertiary industries, the gross domestic product of primary industries and the number of pigs slaughtered showed higher contributions to Japanese encephalitis incidence. An enhanced interactive effect was found between environmental and social factors, and the interaction between days with humidity levels >80% and the gross domestic product of tertiary industries had the greatest combined effect on JE. These findings enhanced the understanding of the combined effect of social and environmental factors on the incidence of Japanese encephalitis and could help improve Japanese encephalitis transmission control and prevention strategies.

Different responses of Japanese encephalitis to weather variables among eight climate subtypes in Gansu, China, 2005-2019

This study evaluated epidemic temporal aspects of Japanese encephalitis (JE) and investigated the weather threshold of JE response across eight climate subtypes between 2005 and 2019 in Gansu Province, China. Epidemiological data were collected from the China Information System for Disease Control and Prevention (CISDCP). Three epidemic temporal indices [frequency index (α), duration index (β), and intensity index (γ)] were adopted for the comparison of epidemic features among different climate subtypes. In addition, the local indicators of spatial association (LISA) technique was used to detect the hot-spot areas. The category and regression tree (CART) model was used to detect the response threshold of weather variables in hot-spot areas across climate subtypes. Among eight climate subtypes in Gansu, in most hot-spot areas (i.e., high-high clusters), α, β, and γ were detected in the climate subtypes of subtropical winter dry (Cwa), temperate oceanic continental (Cwb), and continental winter dry (Dwa and Dwb). According to the CART analysis, a minimum monthly temperature is required for Japanese encephalitis virus (JEV) transmission, with different threshold values among the climatic subtypes. In temperate climate zones (Cwa and Cwb), this threshold is 19 °C at a 1-month lag. It is lower in continental winter dry climate zones: 18 °C in Dwa (snow climate, dry winter, and hot summer) and 16 °C in Dwb (snow climate, dry winter, and warm summer). Additionally, some areas of the areas with temperate arid (BWk and BSk) had the first JE cases. Further studies to detect whether the climate change influence the JEV's distribution in Gansu Province are needed.

Exposure-response relationship between temperature, relative humidity, and varicella: a multicity study in South China

Varicella is a rising public health issue. Several studies have tried to quantify the relationships between meteorological factors and varicella incidence but with inconsistent results. We aim to investigate the impact of temperature and relative humidity on varicella, and to further explore the effect modification of these relationships. In this study, the data of varicella and meteorological factors from 2011 to 2019 in 21 cities of Guangdong Province, China were collected. Distributed lag nonlinear models (DLNM) were constructed to explore the relationship between meteorological factors (temperature and relative humidity) and varicella in each city, controlling in school terms, holidays, seasonality, long-term trends, and day of week. Multivariate meta-analysis was applied to pool the city-specific estimations. And the meta-regression was used to explore the effect modification for the spatial heterogeneity of city-specific meteorological factors and social factors (such as disposable income per capita, vaccination coverage, and so on) on varicella. The results indicated that the relationship between temperature and varicella in 21 cities appeared nonlinear with an inverted S-shaped. The relative risk peaked at 20.8 ℃ (RR = 1.42, 95% CI: 1.22, 1.65). The relative humidity-varicella relationship was approximately L-shaped, with a peaking risk at 69.5% relative humidity (RR = 1.25, 95% CI: 1.04, 1.50). The spatial heterogeneity of temperature-varicella relationships may be caused by income or varicella vaccination coverage. And varicella vaccination coverage may contribute to the spatial heterogeneity of the relative humidity-varicella relationship. The findings can help us deepen the understanding of the meteorological factors-varicella association and provide evidence for developing prevention strategy for varicella epidemic.

Spatial statistical and environmental correlation analyses on vector density, vector infection index and Japanese encephalitis cases at the village and pigsty levels in Liyi County, Shanxi Province, China

Background

In the eco-epidemiological context of Japanese encephalitis (JE), geo-environmental features influence the spatial spread of the vector (Culex tritaeniorhynchus, Giles 1901) density, vector infection, and JE cases.

Methods

In Liyi County, Shanxi Province, China, the spatial autocorrelation of mosquito vector density, vector infection indices, and JE cases were investigated at the pigsty and village scales. The map and Enhanced Thematic Mapper (ETM) remote sensing databases on township JE cases and geo-environmental features were combined in a Geographic Information System (GIS), and the connections among these variables were analyzed with regression and spatial analyses.

Results

At the pigsty level, the vector density but not the infection index of the vector was spatially autocorrelated. For the pigsty vector density, the cotton field area was positively related, whereas the road length and the distance between pigsties and gullies were negatively related. In addition, the vector infection index was correlated with the pigsty vector density (PVD) and the number of pigs. At the village level, the vector density, vector infection index, and number of JE cases were not spatially autocorrelated. In the study area, the geo-environmental features, vector density, vector infection index, and JE case number comprised the Geo-Environment-Vector-JE (GEVJ) intercorrelation net system. In this system, pig abundance and cotton area were positive factors influencing the vector density first. Second, the infection index was primarily influenced by the vector density. Lastly, the JE case number was determined by the vector infection index and the wheat area.

Conclusions

This study provided quantitative associations among geo-environmental features, vectors, and the incidence of JE in study sties, one typical northern Chinese JE epidemiological area without rice cultivation. The results highlighted the importance of using a diverse range of environmental management methods to control mosquito disease vectors and provided useful information for improving the control of vector mosquitoes and reducing the incidence of JE in the northern Chinese agricultural context.

Graphical Abstract

Supplementary Information

The online version contains supplementary material available at 10.1186/s13071-022-05305-8.

Climate Change and Vector-Borne Diseases in China: A Review of Evidence and Implications for Risk Management

Simple Summary

Vector-borne diseases are among the most rapidly spreading infectious diseases and are widespread all around the world. In China, many types of vector-borne diseases have been prevalent in different regions, which is a serious public health problem with significant association with meteorological factors and weather events. Under the background of current severe climate change, the outbreaks and transmission of vector-borne diseases have been proven to be impacted greatly due to rapidly changing weather conditions. This study summarizes research progress on the association between climate conditions and all types of vector-borne diseases in China. A total of seven insect-borne diseases, two rodent-borne diseases, and a snail-borne disease were included, among which dengue fever is the most concerning mosquito-borne disease. Temperature, rainfall, and humidity have the most significant effect on vector-borne disease transmission, while the association between weather conditions and vector-borne diseases shows vast differences in China. We also make suggestions about future research based on a review of current studies.

Abstract

Vector-borne diseases have posed a heavy threat to public health, especially in the context of climate change. Currently, there is no comprehensive review of the impact of meteorological factors on all types of vector-borne diseases in China. Through a systematic review of literature between 2000 and 2021, this study summarizes the relationship between climate factors and vector-borne diseases and potential mechanisms of climate change affecting vector-borne diseases. It further examines the regional differences of climate impact. A total of 131 studies in both Chinese and English on 10 vector-borne diseases were included. The number of publications on mosquito-borne diseases is the largest and is increasing, while the number of studies on rodent-borne diseases has been decreasing in the past two decades. Temperature, precipitation, and humidity are the main parameters contributing to the transmission of vector-borne diseases. Both the association and mechanism show vast differences between northern and southern China resulting from nature and social factors. We recommend that more future research should focus on the effect of meteorological factors on mosquito-borne diseases in the era of climate change. Such information will be crucial in facilitating a multi-sectorial response to climate-sensitive diseases in China.

Identification of bio-climatic determinants and potential risk areas for Kyasanur forest disease in Southern India using MaxEnt modelling approach

BACKGROUND

Kyasanur forest disease (KFD), known as monkey fever, was for the first time reported in 1957 from the Shivamogga district of Karnataka. But since 2011, it has been spreading to the neighbouring state of Kerala, Goa, Maharashtra, and Tamil Nadu. The disease is transmitted to humans, monkeys and by the infected bite of ticks Haemaphysalis spinigera. It is known that deforestation and ecological changes are the main reasons for KFD emergence, but the bio-climatic understanding and emerging pathways remain unknown.

METHODS

The present study aims to understand the bio-climatic determinants of distribution of tick vector of KFD in southern India using the Maximum Entropy (MaxEnt) model. The analysis was done using 34 locations of Haemaphysalis spinigera occurrence and nineteen bio-climatic variables from WorldClim. Climatic variables contribution was assessed using the Jackknife test and mean AUC 0.859, indicating the model performs with very high accuracy.

RESULTS

Most influential variables affecting the spatial distribution of Haemaphysalis spinigera were the average temperature of the warmest quarter (bio10, contributed 32.5%), average diurnal temperature range (bio2, contributed 21%), precipitation of wettest period (bio13, contributed 17.6%), and annual precipitation (bio12, contributed 11.1%). The highest probability of Haemaphysalis spinigera presence was found when the mean warmest quarter temperature ranged between 25.4 and 30 °C. The risk of availability of the tick increased noticeably when the mean diurnal temperature ranged between 8 and 10 °C. The tick also preferred habitat having an annual mean temperature (bio1) between 23 and 26.2 °C, mean temperature of the driest quarter (bio9) between 20 and 28 °C, and mean temperature of the wettest quarter (bio8) between 22.5 and 25 °C.

CONCLUSIONS

The results have established the relationship between bioclimatic variables and KFD tick distribution and mapped the potential areas for KFD in adjacent areas wherein surveillance for the disease is warranted for early preparedness before the occurrence of outbreaks etc. The modelling approach helps link bio-climatic variables with the present and predicted distribution of Haemaphysalis spinigera tick.

The Ecology and Evolution of Japanese Encephalitis Virus

Japanese encephalitis virus (JEV) is a mosquito-borne flavivirus mainly spread by Culex mosquitoes that currently has a geographic distribution across most of Southeast Asia and the Western Pacific. Infection with JEV can cause Japanese encephalitis (JE), a severe disease with a high mortality rate, which also results in ongoing sequalae in many survivors. The natural reservoir of JEV is ardeid wading birds, such as egrets and herons, but pigs commonly play an important role as an amplifying host during outbreaks in human populations. Other domestic animals and wildlife have been detected as hosts for JEV, but their role in the ecology and epidemiology of JEV is uncertain. Safe and effective JEV vaccines are available, but unfortunately, their use remains low in most endemic countries where they are most needed. Increased surveillance and diagnosis of JE is required as climate change and social disruption are likely to facilitate further geographical expansion of Culex vectors and JE risk areas.

Environmental factors and spatiotemporal distribution of Japanese encephalitis after vaccination campaign in Guizhou Province, China (2004-2016)

Background

Although a vaccination campaign has been conducted since 2004, Japanese encephalitis (JE) is still a public health problem in Guizhou, one of the provinces with the highest incidence of JE in China. The aim of this study was to understand the spatiotemporal distribution of JE and its relationship with environmental factors in Guizhou Province in the post-vaccination era, 2004–2016.

Methods

We collected data on human JE cases in Guizhou Province from 2004 to 2016 from the national infectious disease reporting system. A Poisson regression model was used to analyze the relationship between JE occurrence and environmental factors amongst counties.

Results

Our results showed that the incidence and mortality of JE decreased after the initiation of vaccination. JE cases were mainly concentrated in preschool and school-age children and the number of cases in children over age 15 years was significantly decreased compared with the previous 10 years; the seasonality of JE before and after the use of vaccines was unchanged. JE incidence was positively associated with cultivated land and negatively associated with gross domestic product (GDP) per capita, vegetation coverage, and developed land. In areas with cultivated land coverage < 25%, vegetation coverage > 55%, and urban area coverage > 25%, the JE risk was lower. The highest JE incidence was among mid-level GDP areas and in moderately urbanized areas.

Conclusions

This study assessed the relationship between incidence of JE and environmental factors in Guizhou Province. Our results highlight that the highest risk of JE transmission in the post-vaccination era is in mid-level developed areas.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12879-021-06857-3.

Spatial distribution of Culex mosquito abundance and associated risk factors in Hanoi, Vietnam

Japanese encephalitis (JE) is the major cause of viral encephalitis (VE) in most Asian-Pacific countries. In Vietnam, there is no nationwide surveillance system for JE due to lack of medical facilities and diagnoses. Culex tritaeniorhynchus, Culex vishnui, and Culex quinquefasciatus have been identified as the major JE vectors in Vietnam. The main objective of this study was to forecast a risk map of Culex mosquitoes in Hanoi, which is one of the most densely populated cities in Vietnam. A total of 10,775 female adult Culex mosquitoes were collected from 513 trapping locations. We collected temperature and precipitation information during the study period and its preceding month. In addition, the other predictor variables (e.g., normalized difference vegetation index [NDVI], land use/land cover and human population density), were collected for our analysis. The final model selected for estimating the Culex mosquito abundance included centered rainfall, quadratic term rainfall, rice cover ratio, forest cover ratio, and human population density variables. The estimated spatial distribution of Culex mosquito abundance ranged from 0 to more than 150 mosquitoes per 900m2. Our model estimated that 87% of the Hanoi area had an abundance of mosquitoes from 0 to 50, whereas approximately 1.2% of the area showed more than 100 mosquitoes, which was mostly in the rural/peri-urban districts. Our findings provide better insight into understanding the spatial distribution of Culex mosquitoes and its associated environmental risk factors. Such information can assist local clinicians and public health policymakers to identify potential areas of risk for JE virus. Risk maps can be an efficient way of raising public awareness about the virus and further preventive measures need to be considered in order to prevent outbreaks and onwards transmission of JE virus.

The detection of Japanese encephalitis virus in Megachiropteran bats in West Kalimantan, Indonesia: A potential enzootic transmission pattern in the absence of pig holdings

The West Kalimantan province in Borneo island, Indonesia belongs to endemic area of Japanese encephalitis (JE) that accounts for approximately 30% of total cases yearly. As the presence of pig holdings is uncommon in West Kalimantan, another reservoir host might have played a role in the local transmission of JE virus in this area. Current study aimed to identify the potential role of bats in the local transmission of JE by performing molecular detection of JE virus in bats and mosquitoes using RT-PCR. Sample collection was performed in 3 districts in West Kalimantan, covering 3 different ecosystems: forest, coastal, and residential areas. Bat collection was performed using mist net and harp net, while mosquito collection was carried out using animal-baited trap and human landing collection. A total of 373 blood samples from bats were tested for JE virus, among which 21 samples (5.6%) showed positive results, mainly from Cynopterus brachyotis (lesser short-nosed fruit bat) found in residential areas. Out of 53 mosquito pools, 3 JE-positive pools of Culex tritaeniorhynchus and Cx. vishnui were collected at the same location as JE-positive bats. Current study showed the first evidence of JE virus detection in several species of Megachiropteran bats in Indonesia, demonstrated the potential role of frugivorous bats in local transmission of JE in West Kalimantan. More aggressive measures are required in JE risk mitigation, particularly in initiating JE vaccination campaign and in avoiding disruption of bats’ natural habitats through changes in land-use.

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First evidence of JE virus detection in Megachiropteran bats in Indonesia.

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Molecular detection of JE virus using RT-PCR instead of using antibodies.

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Collection of JE-positive bats and mosquitoes at the same site.

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Involvement of bats in JE transmission cycle in the absence of pig holdings.

Association between meteorological factors and the prevalence dynamics of Japanese encephalitis

Japanese encephalitis (JE) is an acute infectious disease caused by the Japanese encephalitis virus (JEV) and is transmitted by mosquitoes. Meteorological conditions are known to play a pivotal role in the spread of JEV. In this study, a zero-inflated generalised additive model and a long short-term memory model were used to assess the relationship between the meteorological factors and population density of Culex tritaeniorhynchus as well as the incidence of JE and to predict the prevalence dynamics of JE, respectively. The incidence of JE in the previous month, the mean air temperature and the average of relative humidity had positive effects on the outbreak risk and intensity. Meanwhile, the density of all mosquito species in livestock sheds (DMSL) only affected the outbreak risk. Moreover, the region-specific prediction model of JE was developed in Chongqing by used the Long Short-Term Memory Neural Network. Our study contributes to a better understanding of the JE dynamics and helps the local government establish precise prevention and control measures.

Long-Term Epidemiological Dynamics of Japanese Encephalitis Infection in Gansu Province, China: A Spatial and Temporal Analysis

The incidence of Japanese encephalitis (JE) has greatly declined in China. However, JE incidence has significantly increased in Gansu in recent years, on the top of ranks among all provinces in China. To explore the spatial spread and resurgence of JE transmission in Gansu in the past 60 years, we collected yearly data on reported JE in each county (1958–2017) and monthly data on JE cases (1968–2017), respectively. We grouped the dataset into six categories, each consisting of a 10-year period between 1958 and 2017. Spatial cluster analysis was applied to identify the potential space–time clusters of JE incidence, and logistic regression models were used to identify the spatial and temporal dispersion of JE. Japanese encephalitis incidence in Gansu showed an upward trend from 1970 to 1977 and peaked in 1974, then declined, and fluctuated over the study period until an outbreak again in 2017. Japanese encephalitis incidence for the first 30-year period (1958–1987) peaked in September each year and thereafter peaked in July and August during 1988–2017. Spatial cluster analysis showed the geographical range of JE transmission fluctuated over the past 60 years. The high-incidence clusters of JE were primarily concentrated in the southeast of Gansu. We found significant space–time clustering characteristics of JE in Gansu, and the geographical range of notified JE cases has significantly expanded over recent years. The potential rebound of JE transmission occurred in 2016–2017 should be placed on the top priority of government work during the control and prevention of JE in Gansu, China.

Nonlinear and Threshold Effect of Meteorological Factors on Japanese Encephalitis Transmission in Southwestern China

Although previous studies have reported that meteorological factors might affect the risk of Japanese encephalitis (JE), the relationship between meteorological factors and JE remains unclear. This study aimed to evaluate the relationship between meteorological factors and JE and identify the threshold temperature. Daily meteorological data and JE surveillance data in Dazhou, Sichuan, were collected for the study period from 2005 to 2012 (restricting to May-October because of the seasonal distribution of JE). A distributed lag nonlinear model was used to analyze the lagged and cumulative effect of daily average temperature and daily rainfall on JE transmission. A total of 622 JE cases were reported over the study period. We found JE was positively associated with daily average temperature and daily rainfall with a 25-day lag and 30-day lag, respectively. The threshold value of the daily average temperature is 20°C. Each 5°C increase over the threshold would lead to a 13% (95% CI: 1-17.3%) increase in JE. Using 0 mm as the reference, a daily rainfall of 100 mm would lead to a 132% (95% CI: 73-311%) increase in the risk of JE. Japanese encephalitis is climate-sensitive; meteorological factors should be taken into account for the future prevention and control measure making, especially in a warm and rainy weather condition.

The potential distribution and dynamics of important vectors Culex pipiens pallens and Culex pipiens quinquefasciatus in China under climate change scenarios: an ecological niche modelling approach

BACKGROUND

Intense studies have been carried out on the effects of climate change on vector-borne diseases and vectors. Culex pipiens pallens and Culex pipiens quinquefasciatus are two medically concerned mosquito species in temperate and tropical areas, which serve as important disease-transmitting pests of a variety of diseases. The ongoing geographical expansion of these mosquitoes has brought an increasing threat to public health.

RESULTS

Based on mosquito occurrence records and high-resolution environmental layers, an ecological niche model was established to model their current and future potential distribution in China. Our model showed that the current suitable area for Cx. p. pallens is distributed in the central, eastern and northern parts of China, while Cx. p. quinquefasciatus is distributed in vast areas in southern China. Under future climate change scenarios, both species are predicted to expand their range to varying degrees and RCP 8.5 provides the largest expansion. Northward core shifts will occur in ranges of both species. Environmental variables which have significant impact on the distribution of mosquitoes were also revealed by our model.

CONCLUSION

Severe habitat expansion of vectors is likely to occur in the future 21st century. Our models mapped the high-risk areas and risk factors which needs to be paid attention. The results of our study can be referenced in further ecological surveys and will guide the development of strategies for the prevention and control of vector-borne diseases. © 2020 Society of Chemical Industry.

Epidemic Changes and Spatio-Temporal Analysis of Japanese Encephalitis in Shaanxi Province, China, 2005-2018

Japanese encephalitis (JE) is a mosquito-borne viral disease, which is the most serious viral encephalitis in China and other countries of the Asia-Pacific region. Since 2005, the epidemic patterns of JE have changed dramatically in China because of the vaccination of children younger than 15 years old, and JE is expanding geographically along with global warming. This retrospective epidemiological study analyzed dynamic environmental factors and the spatio-temporal distribution of human cases of JE in Shaanxi Province—one of the most severely affected areas of China—from 2005 to 2018. The results demonstrated that the high-risk population changed rapidly as the annual rate of JE cases increased by more than 40% in the age group >60 years during the study period, and endemic areas expanded northward in Shaanxi. Hotspot analysis detected four hotspots accounting for 52.38% the total cases, and the panel negative binomial regression model revealed that the spatio-temporal distribution of JE was significantly affected by temperature, relative humidity, wind velocity, El Niño-Southern Oscillation, coniferous forest coverage, and urban areas. These findings can provide useful information for improving current strategies and measures to reduce disease incidence.

Risk assessment for the Rift Valley fever occurrence in China: Special concern in south-west border areas

Rift Valley fever (RVF) is a mosquito-borne zoonotic disease. Since its first outbreak in 1930, RVF epidemics have caused huge economic losses and public health impacts in Africa. In 2000, RVF became a disease of global concern as it spread to the Arabian Peninsula. In our study, a Geographic Information System-based risk assessment for the occurrence of Rift Valley fever in China was established by means of ecological niche modelling. Based on occurrence records (RVF records from FAO EMPRES-i, vector records from literatures and GBIF) and high-resolution environmental layers, the prediction maps of RVF occurrence probability and distribution of five potential RVF vectors in China were modelled using Maxent. An internal validation was adopted for model verification, and high AUC values were obtained (0.918 for RVF and 0.837-0.992 for vectors). By overlaying the RVF prediction map with the combined RVF vector prediction map using Fuzzy overlay tool ('AND' operator) of ArcMap 10.2, we got the first risk map of possible RVF vector transmission. This map was further overlaid with the latest livestock distribution map ('AND' operator) to generate the second risk map of possible RVF threat to domestic livestock. The south-west border provinces in China, Yunnan, Guangxi and Tibet were predicted to have a high possibility of RVF occurrence. Conditions conducive to the local amplification of RVF also exist in these areas. Temperature seasonality, mean temperature of dry season and precipitation of the driest month were considered as key environmental variables for RVF, and common environmental conditions were found conductive for vectors. It is suggested to establish proper surveillance systems in south-west border areas to minimize the possibility of RVF invasion. Our findings can serve as a valuable reference for prevention measures to be implemented.

Predictors of Outcome in Clinically Diagnosed Viral Encephalitis Patients: A 5-Year Prospective Study

Background

Viral encephalitis is the most common infectious disease of the central nervous system and is associated with high morbidity, mortality, and disability. The objective of this study was to analyze the clinical characteristics, auxiliary examinations, therapeutic management, and outcomes of patients clinically diagnosed with viral encephalitis and identify the outcome predictors.

Methods

We conducted a prospective observational study by collecting information from patients clinically diagnosed with viral encephalitis at the First Affiliated Hospital of Chongqing Medical University and Yongchuan Hospital of Chongqing Medical University from January 2013 to December 2018. Univariate and multivariate analyses were performed to identify factors that influenced good patient outcomes (mRS < 3) and poor patient outcomes (mRS ≥ 3) at discharge.

Results

In total, 216 patients were enrolled in the study. The multivariate analysis suggested that the following factors were associated with a poor outcome: Glasgow Coma Scale (GCS) score (OR 0.154, 95% CI (0.078-0.302), and P < 0.001), focal neurological deficits (OR 9.403, 95% CI (1.581-55.928), and P = 0.014), and total length of hospital stay (OR 1.119, 95% CI (1.002-1.250), and P = 0.045). However, neurological intensive care unit (NICU) treatment, status epilepticus, and abnormal electroencephalogram (EEG) findings did not influence the prognosis of patients.

Conclusion

Our study suggests that low GCS scores at admission, focal neurological deficits at admission, and a prolonged total hospital stay are predictors of a poor outcome at discharge in clinically diagnosed viral encephalitis patients. Whether early and effective neurological rehabilitation can improve the prognosis of viral encephalitis patients with focal neurological deficits remains to be confirmed in further studies.

Modelling the potential distribution of arbovirus vector Aedes aegypti under current and future climate scenarios in Taiwan, China

BACKGROUND

Aedes aegypti is one of the most important mosquito species and is a common disease-transmitting pest in tropical areas. Various infectious arbovirus diseases can be transmitted by Ae. aegypti. With ongoing global climate change, we are facing an increasing public health threat from the rapid spread of disease vectors into wider geographical areas. To better understand the current ecological niche range and possible future expansion of Ae. aegypti, an ecological niche modelling approach was adopted to predict its current and future potential habitat in Taiwan, China.

RESULTS

Based on observed occurrence records and environmental layers reflecting climate and land-use conditions, predictions with a high resolution of 30 arcsec (approx. 1 × 1 km) were made by our model. Ae. aegypti was predicted to expand its habitat in varying degrees out of its current niche range under different climate scenarios for the future 21st century. Winter temperature and dry season precipitation were considered as important predictors among climate variables. Croplands, pasture, forested lands and urban lands were important land-use variables.

CONCLUSION

Ae. aegypti is expected to establish new habitats out of its current niche range under the trend of global climate change. The extent of habitat expansion varies under different climate scenarios. Appropriate measures should be taken to prevent its expansion to a broader scale. Our study has important strategic implications for mosquito surveillance and the prevention and control of mosquito-borne diseases. © 2019 Society of Chemical Industry.

The Role of Temperature in Transmission of Zoonotic Arboviruses

We reviewed the literature on the role of temperature in transmission of zoonotic arboviruses. Vector competence is affected by both direct and indirect effects of temperature, and generally increases with increasing temperature, but results may vary by vector species, population, and viral strain. Temperature additionally has a significant influence on life history traits of vectors at both immature and adult life stages, and for important behaviors such as blood-feeding and mating. Similar to vector competence, temperature effects on life history traits can vary by species and population. Vector, host, and viral distributions are all affected by temperature, and are generally expected to change with increased temperatures predicted under climate change. Arboviruses are generally expected to shift poleward and to higher elevations under climate change, yet significant variability on fine geographic scales is likely. Temperature effects are generally unimodal, with increases in abundance up to an optimum, and then decreases at high temperatures. Improved vector distribution information could facilitate future distribution modeling. A wide variety of approaches have been used to model viral distributions, although most research has focused on the West Nile virus. Direct temperature effects are frequently observed, as are indirect effects, such as through droughts, where temperature interacts with rainfall. Thermal biology approaches hold much promise for syntheses across viruses, vectors, and hosts, yet future studies must consider the specificity of interactions and the dynamic nature of evolving biological systems.

The impact of climate variability on infectious disease transmission in China: Current knowledge and further directions

BACKGROUND

Climate change may lead to emerging and re-emerging infectious diseases and pose public health challenges to human health and the already overloaded healthcare system. It is therefore important to review current knowledge and identify further directions in China, the largest developing country in the world.

METHODS

A comprehensive literature review was conducted to examine the relationship between climate variability and infectious disease transmission in China in the new millennium. Literature was identified using the following MeSH terms and keywords: climatic variables [temperature, precipitation, rainfall, humidity, etc.] and infectious disease [viral, bacterial and parasitic diseases].

RESULTS

Fifty-eight articles published from January 1, 2000 to May 30, 2018 were included in the final analysis, including bacterial diarrhea, dengue, malaria, Japanese encephalitis, HFRS, HFMD, Schistosomiasis. Each 1 °C rise may lead to 3.6%-14.8% increase in the incidence of bacillary dysentery disease in south China. A 1 °C rise was corresponded to an increase of 1.8%-5.9% in the weekly notified HFMD cases in west China. Each 1 °C rise of temperature, 1％ rise in relative humidity and one hour rise in sunshine led to an increase of 0.90%, 3.99% and 0.68% in the monthly malaria cases, respectively. Climate change with the increased temperature and irregular patterns of rainfall may affect the pathogen reproduction rate, their spread and geographical distribution, change human behavior and influence the ecology of vectors, and increase the rate of disease transmission in different regions of China.

CONCLUSION

Exploring relevant adaptation strategies and the health burden of climate change will assist public health authorities to develop an early warning system and protect China's population health, especially in the new 1.5 °C scenario of the newly released IPCC special report.

Risk factors associated with sustained circulation of six zoonotic arboviruses: a systematic review for selection of surveillance sites in non-endemic areas

Arboviruses represent a significant burden to public health and local economies due to their ability to cause unpredictable and widespread epidemics. To maximize early detection of arbovirus emergence in non-endemic areas, surveillance efforts should target areas where circulation is most likely. However, identifying such hotspots of potential emergence is a major challenge. The ecological conditions leading to arbovirus outbreaks are shaped by complex interactions between the virus, its vertebrate hosts, arthropod vector, and abiotic environment that are often poorly understood. Here, we systematically review the ecological risk factors associated with the circulation of six arboviruses that are of considerable concern to northwestern Europe. These include three mosquito-borne viruses (Japanese encephalitis virus, West Nile virus, Rift Valley fever virus) and three tick-borne viruses (Crimean-Congo hemorrhagic fever virus, tick-borne encephalitis virus, and louping-ill virus). We consider both intrinsic (e.g. vector and reservoir host competence) and extrinsic (e.g. temperature, precipitation, host densities, land use) risk factors, identify current knowledge gaps, and discuss future directions. Our systematic review provides baseline information for the identification of regions and habitats that have suitable ecological conditions for endemic circulation, and therefore may be used to target early warning surveillance programs aimed at detecting multi-virus and/or arbovirus emergence.

Modeling the present and future distribution of arbovirus vectors Aedes aegypti and Aedes albopictus under climate change scenarios in Mainland China

Aedes aegypti and Aedes albopictus are two important mosquito species which transmit various infectious arbovirus diseases represented mainly by dengue fever. These two species of mosquito have a wide range of distribution and strong transfer capacity. With ongoing global climate change, we are facing an increasing public health threat from the rapid spread of vectors in wider geographical areas. Based on observed occurrence records of Ae. aegypti and Ae. albopictus and high-resolution environmental layers reflecting climate and land-use conditions, a Maxent niche modeling approach was adopted to model the current and future distribution of both species in Mainland China. Our models provide predictions of suitable habitat shifts under future climate scenarios up to the 2050s. Both species were predicted to expand their niche range to varying degrees under future climate scenarios. Aedes aegypti was modeled to expand its habitat from Guangdong, Guangxi, Yunnan and Hainan to Fujian, Jiangxi and Guizhou. Aedes albopictus was modeled to increase magnitude of distribution within its present range of northern, southwestern and southeastern coastal areas of Mainland China. Area and population exposed to mosquitoes are predicted to increase significantly. Environmental variables that have significant impact on the distribution of mosquitoes are also revealed by our model. The results of our study can be referenced in further ecological studies and will guide the development of strategies for the prevention and control of mosquito-borne diseases.

Mapping the potential distributions of etiological agent, vectors, and reservoirs of Japanese Encephalitis in Asia and Australia

Japanese encephalitis virus (JEV) is a substantial cause of viral encephalitis, morbidity, and mortality in South-East Asia and the Western Pacific. World Health Organization recognized Japanese Encephalitis (JE) as a public health priority in demands to initiate active vaccination programs. Recently, the geographic distribution of JEV has apparently expanded into other areas in the Pacific islands and northern Australia; however, major gaps exist in knowledge in regard to its current distribution. Here, we mapped the potential distribution of mosquito vectors of JEV (Culex tritaeniorhynchus, Cx. pseudovishnui, Cx. vishnui, Cx. fuscocephala, Cx. gelidus), and reservoirs (Egretta garzetta, E. intermedia, Nycticorax nycticorax) based on ecological niche modeling approach. Ecological niche models predicted all species to occur across Central, South and South East Asia; however, Cx. tritaeniorhynchus, E. garzetta, E. intermedia, and N. nycticorax had broader potential distributions extending west to parts of the Arabian Peninsula. All predictions were robust and significantly better than random (P < 0.001). We also tested the JEV prediction based on 4335 additional independent human case records collected by the Chinese Information System for Disease Control and Prevention (CISDCP); 4075 cases were successfully predicted by the model (P < 0.001). Finally, we tested the ecological niche similarity among JEV, vector, and reservoir species and could not reject any of the null hypotheses of niche similarity in all combination pairs.

The role of socioeconomic and climatic factors in the spatio-temporal variation of human rabies in China

BACKGROUND

Rabies is a significant public health problem in China. Previous spatial epidemiological studies have helped understand the epidemiology of animal and human rabies in China. However, quantification of effects derived from relevant factors was insufficient and complex spatial interactions were not well articulated, which may lead to non-negligible bias. In this study, we aimed to quantify the role of socio-economic and climate factors in the spatial distribution of human rabies to support decision making pertaining to rabies control in China.

METHODS

We conducted a multivariate analysis of human rabies in China with explicit consideration for spatial heterogeneity and spatial dependence effects. The panel of 20,368 cases reported between 2005 and 2013 and their socio-economic and climate factors was implemented in regression models. Several significant covariates were extracted, including the longitude, the average temperature, the distance to county center, the distance to the road network and the distance to the nearest rabies case. The GMM was adopted to provide unbiased estimation with respect to heterogeneity and spatial autocorrelation.

RESULTS

The analysis explained the inferred relationships between the counts of cases aggregated to 271 spatially-defined cells and the explanatory variables. The results suggested that temperature, longitude, the distance to county centers and the distance to the road network are positively associated with the local incidence of human rabies while the distance to newly occurred rabies cases has a negative correlation. With heterogeneity and spatial autocorrelation taken into consideration, the estimation of regression models performed better.

CONCLUSIONS

It was found that climatic and socioeconomic factors have significant influence on the spread of human rabies in China as they continuously affect the living environments of humans and animals, which critically impacts on how timely local citizens can gain access to post-exposure prophylactic services. Moreover, through comparisons between traditional regression models and the aggregation model that allows for heterogeneity and spatial effects, we demonstrated the validity and advantage of the aggregation model. It outperformed the existing models and decreased the estimation bias brought by omission of the spatial heterogeneity and spatial dependence effects. Statistical results are readily translated into public health policy takeaways.

Influence of Host and Environmental Factors on the Distribution of the Japanese Encephalitis Vector Culex tritaeniorhynchus in China

Culex tritaeniorhynchus is an important vector that transmits a variety of human and animal diseases. Japanese encephalitis (JE), an endemic disease in the Asia-Pacific region, is primarily transmitted by Cx. tritaeniorhynchus. Insufficient monitoring of vector mosquitoes has led to a poor understanding of the distribution of Cx. tritaeniorhynchus in China. To delineate the habitat of Cx. tritaeniorhynchus and any host and environmental factors that affect its distribution, we used a maximum entropy modeling method to predict its distribution in China. Our models provided high resolution predictions on the potential distribution of Cx. tritaeniorhynchus. The predicted suitable habitats of the JE vector were correlated with areas of high JE incidence in parts of China. Factors driving the distribution of Cx. tritaeniorhynchus in China were also revealed by our models. Furthermore, human population density and the maximum NDVI were the most important predictors in our models. Bioclimate factors and elevation also significantly impacted the distribution of Cx. tritaeniorhynchus. Our findings may serve as a reference for vector and disease control.

Spatial, temporal, and spatiotemporal analysis of mumps in Guangxi Province, China, 2005-2016

Background

The resurgence of mumps around the world occurs frequently in recent years. As the country with the largest number of cases in the world, the status of mumps epidemics in China is not yet clear. This study, taking the relatively serious epidemic province of Guangxi as the example, aimed to examine the spatiotemporal pattern and epidemiological characteristics of mumps, and provide a scientific basis for the effective control of this disease and formulation of related health policies.

Methods

Geographic information system (GIS)-based spatiotemporal analyses, including spatial autocorrelation analysis, Kulldorff’s purely spatial and space-time scan statistics, were applied to detect the location and extent of mumps high-risk areas. Spatial empirical Bayesian (SEB) was performed to smoothen the rate for eliminating the instability of small-area data.

Results

A total of 208,470 cases were reported during 2005 and 2016 in Guangxi. Despite the fluctuations in 2006 and 2011, the overall mumps epidemic continued to decline. Bimodal seasonal distribution (mainly from April to July) were found and students aged 5–9 years were high-incidence groups. Though results of the global spatial autocorrelation based on the annual incidence largely varied, the spatial distribution of the average annual incidence of mumps was nonrandom with the significant Moran’s I. Spatial cluster analysis detected high-value clusters, mainly located in the western, northern and central parts of Guangxi. Spatiotemporal scan statistics identified almost the same high-risk areas, and the aggregation time was mainly concentrated in 2009–2012.

Conclusion

The incidence of mumps in Guangxi exhibited spatial heterogeneity in 2005–2016. Several spatial and spatiotemporal clusters were identified in this study, which might assist the local government to develop targeted health strategies, allocate health resources reasonably and increase the efficiency of disease prevention.

Electronic supplementary material

The online version of this article (10.1186/s12879-018-3240-4) contains supplementary material, which is available to authorized users.

How Socio-Environmental Factors Are Associated with Japanese Encephalitis in Shaanxi, China-A Bayesian Spatial Analysis

Evidence indicated that socio-environmental factors were associated with occurrence of Japanese encephalitis (JE). This study explored the association of climate and socioeconomic factors with JE (2006–2014) in Shaanxi, China. JE data at the county level in Shaanxi were supplied by Shaanxi Center for Disease Control and Prevention. Population and socioeconomic data were obtained from the China Population Census in 2010 and statistical yearbooks. Meteorological data were acquired from the China Meteorological Administration. A Bayesian conditional autoregressive model was used to examine the association of meteorological and socioeconomic factors with JE. A total of 1197 JE cases were included in this study. Urbanization rate was inversely associated with JE incidence during the whole study period. Meteorological variables were significantly associated with JE incidence between 2012 and 2014. The excessive precipitation at lag of 1–2 months in the north of Shaanxi in June 2013 had an impact on the increase of local JE incidence. The spatial residual variations indicated that the whole study area had more stable risk (0.80–1.19 across all the counties) between 2012 and 2014 than earlier years. Public health interventions need to be implemented to reduce JE incidence, especially in rural areas and after extreme weather.

Seasonal Patterns of Japanese Encephalitis and Associated Meteorological Factors in Taiwan

The persistent transmission of Japanese encephalitis virus (JEV) in Taiwan necessitates exploring the risk factors of occurrence of Japanese encephalitis (JE). The purpose of this study was to assess the relationship between meteorological factors and the incidence of JE in Taiwan. We collected data for cases of JE reported to the Taiwan Centers for Disease Control (Taiwan CDC) from 2000 to 2014. Meteorological data were obtained from the Taiwan Central Weather Bureau. The relationships between weather variability and the incidence of JE in Taiwan were determined via Poisson regression analysis and a case-crossover methodology. During the 15-year study period, a total of 379 cases of JE were reported. The incidence of JE showed significant seasonality, with the majority of cases occurring in summertime (for oscillation, p < 0.001). The number of JE cases started to increase at temperatures of 22 °C (r² = 0.88, p < 0.001). Similarly, the number of JE cases began to increase at a relative humidity of 70-74% (r² = 0.75, p < 0.005). The number of JE cases was positively associated with mean temperature and relative humidity in the period preceding the infection. In conclusion, the occurrence of JE is significantly associated with increasing temperature and relative humidity in Taiwan. Therefore, these factors could be regarded as warning signals indicating the need to implement preventive measures.

Dengue fever outbreaks in Eritrea, 2005-2015: A case for strengthening surveillance, control and reporting

Background

The geographic distribution and burden of dengue is increasing globally. This study aims to evaluate dengue outbreaks and to substantiate the need for strengthened surveillance, reporting and control in Eritrea.

Methods

Data from two cross-sectional dengue epidemic investigations in 2005 and 2010 were analyzed. Samples were tested for dengue virus-specific IgM and IgG antibodies using capture enzyme-linked immunosorbent assays. Dengue vectors’ breeding attributes were characterized and epidemic risk indices determined. National routine surveillance weekly reports from 2005 to the second quarter of 2015 were analyzed for spatiotemporal trends.

Results

Dengue outbreaks increased in Eritrea from 2005 to 2015 with clinical presentation varying markedly among patients. The house and container indices for Aedes aegypti were 40 and 39.6 % respectively, with containers having A. aeqypti varying significantly (P < 0.04). Serum from 33.3 % (n = 15) and 88 % (n = 26) of clinical dengue cases in Aroget sub-Zoba (district) of Gash Barka Zoba (region) contained anti-DENV IgM antibody in 2005 and 2006, respectively. The national surveillance data from 2005 to 2015 indicate an overall spatiotemporal increase of dengue fever.

Conclusions

The increase in dengue outbreaks has been confirmed in Eritrea and necessitates strengthening of surveillance and health worker and laboratory capacity, as well as targeted vector control interventions.

Malaria elimination in Botswana, 2012-2014: achievements and challenges

Background

Botswana significantly reduced its malaria burden between 2000 and 2012. Incidence dropped from 0.99 to 0.01 % and deaths attributed to malaria declined from 12 to 3. The country initiated elimination strategies in October 2012. We examine the progress and challenges during implementation and identify future needs for a successful program in Botswana.

Methods

A national, rapid notification and response strategy was developed. Cases detected through the routine passive surveillance system at health facilities were intended to initiate screening of contacts around a positive case during follow up. Positive cases were reported to district health management teams to activate district rapid response teams (DRRT). The health facility and the DRRT were to investigate the cases, and screen household members within 100 m of case households within 48 h of notification using rapid diagnostic tests (RDT) and microscopy. Positive malaria cases detected in health facilities were used for spatial analysis.

Results

There were 1808 malaria cases recorded in Botswana during 26 months from October, 2012 to December, 2014. Males were more frequently infected (59 %) than females. Most cases (60 %) were reported from Okavango district which experienced an outbreak in 2013 and 2014. Among the factors creating challenges for malaria eradication, only 1148 cases (63.5 %) were captured by the required standardized notification forms. In total, 1080 notified cases were diagnosed by RDT. Of the positive malaria cases, only 227 (12.6 %) were monitored at the household level. One hundred (8.7 %) cases were associated with national or transnational movement of patients. Local movements of infected individuals within Botswana accounted for 31 cases while 69 (6.01 %) cases were imported from other countries. Screening individuals in and around index households identified 37 additional, asymptomatic infections. Oscillating, sporadic and new malaria hot-spots were detected in Botswana during the study period.

Conclusion

Botswana’s experience shows some of the practical challenges of elimination efforts. Among them are the substantial movements of human infections within and among countries, and the persistence of asymptomatic reservoir infections. Programmatically, challenges include improving the speed of communicating and improving the thoroughness when responding to newly identified cases. The country needs further sustainable interventions to target infections if it is to successfully achieve its elimination goal.

Clinical characteristics and outcome of clinically diagnosed viral encephalitis in southwest China

Patients with viral encephalitis have a high incidence of morbidity and mortality. We analyze the clinical characteristics and outcome of patients with clinically diagnosed viral encephalitis to investigate possible predictors of prognosis. We retrospectively evaluated 1107 patients diagnosed with viral encephalitis in southwest China from 2009 to 2012 by evaluating their outcomes using the Glasgow Outcome Scale. We compared patient outcome at hospital discharge with long-term follow-up visits, and evaluated the prognostic indicators of the outcome. At hospital discharge, 375 (33.9 %) of the 1107 patients who survived made a full recovery, while 399 (36.0 %), 160 (14.5 %), and 145 (13.1 %) had mild, moderate or severe neurologic sequelae, respectively. Twenty-eight (2.5 %) of the patients died prior to discharge from the hospital. Of the 1027 patients who had follow-up assessments, 658 (64.1 %) made a full recovery, while 213 (20.7 %), 103 (10.0 %), and 19 (1.8 %) had mild, moderate or severe neurologic sequelae, respectively. Six (0.6 %) of the patients died after discharge from the hospital. Use of mechanical ventilation, lower Glasgow coma score, and concurrent seizures are predictors for a poor outcome in patients both at hospital discharge and at long-term follow-up visits.

Spatial patterns and determinants of malaria infection during pregnancy in Zambia

BACKGROUND

Malaria in pregnancy (MiP) is a major concern in Zambia. Here we aim to determine the burden and risk factors of MiP.

METHODS

Monthly reported district-level malaria cases among pregnant women (count data) from January 2009 to December 2014 were obtained from the Zambian District Health Information System. Negative binomial regression model was used to investigate the associations between vector control tools, coverage of health care facilities, transportation networks and population density. Data on MiP treatment were obtained from the 2012 Zambian Malaria Indicator Survey. Yearly clusters of MiP were investigated using spatial statistics in ArcGIS v 10.1.

RESULTS

The results indicated that MiP decreased in Zambia between 2010 and 2013. MiP was observed throughout the year, but showed a strong seasonal pattern. Persistent hotspots of MiP were reported in the southeast and northeast regions of Zambia, with districts that had better access to rail road and presence of water bodies associated with decreased prevalence of MiP. Better indoor residual spraying and long-lasting insecticide-treated nets coverage was demonstrated to be protective against MiP.

CONCLUSIONS

Mapping the distribution of MiP to track the future requirements for scaling up essential disease-prevention efforts in stable hotspots can help the Zambian National Malaria Control Center to further develop strategies to reduce malaria prevalence in this vulnerable sub-population.